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Tuesday, 25 September 1973
Page: 1477

Mr CHIPP (Hotham) - This is a cognate debate covering 3 Bills which are virtually Budget Bills - the Aged Persons Homes Bill, the Delivered Meals Subsidy Bill and the States Grants (Home Care) Bill - to which the Opposition has no objection. I will deal with them briefly in turn, firstly the Aged Persons Homes Bill. The Aged Persons Homes Act was introduced in 1954 to encourage nonprofit organisations to erect or purchase homes for the aged. Capital cost subsidies on a $1 for $1 basis were provided under the Act to religious, charitable or returned services organisations and other organisations approved by the Governor-General. In 1957 this was increased to $2 for every $1 of capital cost. In November 1967 local government organisations became eligible for this subsidy.

The Aged Persons Homes Act was amended in 1969 to include personal care subsidies to approved homes for the aged. To receive the subsidy homes are required to provide meals and to employ sufficient staff to help residents in need of personal care. At least one member of the staff must remain on the premises at all times in case of an emergency. Initially the personal care subsidy was $5 a week for each resident aged 80 years and over. In 1972 it was increased to $10 a week for each resident aged 80 years and over. The Aged Persons Homes Bill presently before the House provides for an increase in the personal care subsidy of $2 a week from $10 a week to $12 a week for each resident deemed to be in need of personal care services. The eligibility agc limit previously prescribed under the Act of 80 years and over is to be amended to include all those in aged persons homes who require or who are receiving personal care attention.

The proportion of residents 80 years and over in homes currently receiving the personal care subsidy is 45 per cent. The proportion of residents who will attract subsidy under the extended criteria is highly speculative, as I think the Minister far Social Security (Mr Hayden) has admitted, but it is expected to rise by about half to aproximately 67i per cent. To determine which residents in an aged persons home do in fact require personal care services the present Government has incorporated classification procedures in the amending legislation. Homes will be required to make individual applications in respect of each hostel resident of under 80 years of age whom they consider to be in need of personal care attention, and registered geriatric or general nurses from the Department of Social Security will visit the homes at regular intervals to assist in classifying any of the borderline' cases. The Minister has indicated that 'the classifications will proceed on fairly liberal lines'. In fact, there have been some pronouncements by the Minister lately which have given us encouragement as to his liberality. Applications for personal care subsidies from aged persons homes in respect of residents under 80 years of age will be made every month. Visits to the homes by nurses attached to the Department of Social Security possibly will be made on a thrice yearly basis. Thus the existing amount of paper work in respect of residents 80 years of age and over in aged persons homes will be increased to include a monthly list of residents under 80 years of age considered by the homes to be eligible for personal care. Nurses from the Department of Social Security will be required on each visit to assess the condition of each resident on the list under 80 years of age and decide whether or not that resident is eligible for continued personal care and subsidy. However, despite this tendency to what might be considered to be bureaucracy, provisions in the Aged Persons Homes Bill for increased capital grants and extended terms of personal care subsidy may encourage - the Opposition hopes they will - organisations to provide further accommodation for the aged. I make a personal appeal to the Minister and to his senior departmental advisers in the House tonight not to let this personal inspection become a nightmare. I say that because bureaucracy can go mad. The Department of Social Security is notorious for its liberality in looking at cases. I hope that will continue. But if an army of trained nurses is to go out to these homes and check every borderline by some sort of slide rule method the thing could become a nightmare. I know that the Minister is conscious of that.

Mr Hayden - It will be discreet and liberal.

Mr CHIPP - I thank the Minister for his assurance. At the end of the 1971-72 financial year 45,000 persons were accommodated in homes provided with capital grants under the Act. Of that number 23,000 lived in selfcontained units and 17,000 in hostel-type accommodation and 5,000 in nursing accommodation. Those figures represent only a small proportion of the aged population of Australia. Of the 834,000 aged pensioners in 1972, 519,000 or 62 per cent lived in homes which they themselves owned. State housing authorities and unsubsidised hostels provided for a further 25,000 and approximately 40,000 were living in profit-making homes not subsidised under the Aged Persons Homes Act. It has been estimated that as many as 50,000 pensioners are living under unsatisfactory conditions. I was quoting from the statement made last year by my friend, the honourable member for Mackellar (Mr Wentworth), who I am sure would have loved to have spoken in this debate tonight.

Mr SPEAKER - He has the mumps.

Mr CHIPP - Thank you, Mr Speaker. I hope that your sympathy for him is as strong as mine.

Mr SPEAKER -I sent him a letter.

Mr CHIPP - Thank you. Modern industrial society is geared to the concept that work is of vital importance. The aged can suffer from the limited opportunity to work and from the insecurity of becoming a useless member of society in economic terms. Non-employment of the aged results from the stereotyped attitudes of their inability to maintain efficiency. However, evidence has shown that the peak of creative production remains high in later years and that older workers have an attendance record as much as 20 per cent better than that of their younger counterparts. That evidence seems to fly in the face of philosophers such as Alvin Toffler who tells us that from the age of 16 years part of our minds and brains starts to deteriorate. Those of us who are over 16 years of age can take some comfort from the fact which I have just quoted from the New York Family Health Magazine of March 1970.

My colleague, the Deputy Leader of the Opposition (Mr Lynch) stated in 1972 that older people too often believe that human activity which is not production oriented is not worthwhile; it should not surprise us that some old people who accept the conclusion that life's only meaning is linked with being economically productive breakdown with apathy and boredom after retirement, and soon die. How true that statement is. I know that the Minister is sympathetic with the view that our present society is geared to the concept that is given us from the time we begin to think, namely, that we must create to justify our existence on earth. Thus, in addition to developing areas of support for the aged such as aged persons homes, it may be desirable to foster programs which would psychologically, as well as materially, support the aged, such as employment programs and classes for the encouragement of the arts and crafts. For instance, the Minister might be interested to know that in the United States elderly people are being employed in some areas as tutors for those falling behind in school. That may sound a wild idea. I know that the Minister has called for a further report on this question. I am sure he will agree that simply to create homes for the aged is not an answer in itself; one must go deeper than that.

The secretary of the Australian Association of Gerontology, Mrs Ruth Inall, claims that the aged often have problems adjusting from work occupation to full-time leisure activity; most people reach retirement without being sufficiently equipped to cope with free time; and attention could be given to promoting education for a time. I hope that is a concept which the Minister and his Department have in mind. I am reminded of those immortal words which I think G. K. Chesterton once said, namely, that millions long for immortality but do not know how to occupy themselves on one rainy Sunday afternoon. The concept of retirement could be altered by encouraging a change of attitude in the community towards the aged. This could be done by a conscious effort to re-evaluate their roles. The arbitrary retirement age of 65 years could be reviewed and perhaps adapted in employment situations to meet the desires and capabilities of those approaching that age. There is often no reason why a worker should terminate employment when he is 65 and conversely a worker in a dull routine job would probably appreciate an earlier retirement scheme. But is such a person ready for retirement. To what does a worker retire? Does he retire from a job of boredom to a life of what? As the life span of more people in our community extends because of the growth in the knowledge of medical science, this aspect will become an increasing problem. The Bureau of Census and Statistics has projected a marginal increase in the proportion of the aged in the community to the year 2001. In 1972 those over 65 years of age comprised 8.3 per cent of the population. By the year 2001 this figure will increase to 8.5 per cent of the population if account is taken of existing immigration trends or 9.1 per cent if immigration is not considered.

I turn briefly to the Delivered Meals Subsidy Bill 1973. I commend the Minister for Social Security on a speech which contained a great deal of humanitarian content with which the Liberal Party and, I am sure, the Country Party would agree. In fact, it is consistent with the philosophical thrust of my colleague, the honourable member for Mackellar (Mr Wentworth). Perhaps he might appreciate a meals on wheels service, or something else, this evening. I know that many friends on the Government side, such as the honourable member for Hunter (Mr James), would be delighted to deliver a meals on wheels service to the honourable member for Mackellar tonight. The Delivered Meals Subsidy Act was passed in 1970. It provided a subsidy of $1 tor each 10 delivered meals provided by approved meals on wheels organisations, including those run by local government bodies. The object of the legislation was 'to assist in the establishment, expansion, improvement and maintenance of the meals on wheels type of service'.

In 1972 amending legislation increased the subsidy to $1.50 per 10 meals and provided an additional 5c per meal subsidy if the meal included approved types and quantities of fresh fruit, fresh juice or fresh tomato - that is,$2 per 10 meals if fruit or juice or tomato is part of each meal. These fruits and juices, as you would know in a flash, Mr Speaker, contain vitamin C. The Minister declined, in his usual reluctant fashion, to answer my interjection when he was speaking when I asked whether he had given consideration to including vitamin E for those people in this age group and, if not, why not. I have a table which has been provided to me by the Parliamentary Library setting out the expenditure by the government since 1969 to 1973 under this Act. I ask leave of the House to incorporate the table in Hansard. -

Mr SPEAKER - Is leave granted? There being no objection, leave is granted.


Mr CHIPP - This Bill proposes to increase the subsidy rates to $2 per 10 meals, plus 50c per 10 meals where the fresh fruit or juice supplement is included - that is, $2.50 per 10 meals, an increase of 50c per 10 meals of either kind over the prevailing subsidy rates. The Bill also provides for the subsidy to be paid quarterly so as to assist organisations in their financial arrangements by avoiding problems caused by the present practice of annual payments.

The organisational structure of meals on wheels services may well be a particularly fine example of government and voluntary aid combining to provide an effective and extensive social welfare benefit. In 1970, after various private and local government groups had proved the value of the service, the Liberal Government initiated the subsidy scheme which has enabled existing organisations to consolidate and expand their services, and has encouraged the establishment of new services. The results so far show an increase in the number of approved meals on wheels services from 191 in June 1970 to more than 350 in June 1973. Meals served and subsidies paid have increased substantially also.

The value of a hot, cheap midday meal is very significant to large numbers of aged and partly disabled people who remain in their own homes. Growing immobility, forgetfulness and carelessness can cause a risk of malnutrition and lower the resistance of aged people to illness, as well as reducing their general wellbeing. The fresh fruit or juice subsidy aims to ensure a supply of Vitamin C, which may be destroyed in prepared heated meals. There is little we know about malnutrition amongst the aged. I will quote from a survey which was carried out by Dr Sandra Silink and Dr Sylvia Mobile of the Medical Department and Vitamin Laboratories, Roche Products Pty Ltd. They say:

Malnutrition may be overt or subclinical requiring special tests for its detection. A further category, that of marginal nutrition, is one in which an episode of stress will cause rapid precipitation of oven clinical malnutrition.

I compliment the Minister for recognising this fact in his second reading speech. In addition to its nutritional value the delivery of the meal represents an important daily social contact to many people. Mrs E. McCallum, who is a senior social worker of the City of South Melbourne, has been quoted as saying:

In all our thinking about the meals on wheels services we are providing, we must not overlook the important role played by the person who actually takes the meal into the home. This person must feci a real concern and deep interest in the people she is seeing, as very often she may be their only regular contact with the outside world.

She continues - and I invite the Minister and his advisers to note this:

For this reason, in South Melbourne we keep detailed records of all our meals on wheels clients, the name of their doctor, next of kin or friend, and each deliverer of the meals is required to report buck to the Social Work Department if any of the people on her round are in trouble or fail to open the door. Even though we know that the food delivered is so important for physical well-being, the personal and regular contact which accompanies the meal is of almost equal importance.

I do not think it is important only to the elderly person to whom the meal is being delivered. I think it is equally important in recruiting that type of person who delivers the meals on wheels to make them feel more involved with the clients in their visits. In other words, it takes them out of the category merely of being a delivery girl or a delivery lady if, without being busybodies, they can feel some form of involvement with the physical, psychological, mental and spiritual condition of the elderly person they are visiting. The Minister's second reading speech refers to a departmental survey to establish the gaps in meals on wheels coverage. Accurate figures on need are not available but in speaking in the debate on the Delivered Meals Subsidy Bill 1972 my colleague the honourable member for MacKellar (Mr Wentworth) suggested that 6 million delivered meals a year would be needed adequately to meet Australian needs. One would join with him in hoping that this target would be reached in the next year or two.

The third Bill before the House is the States Grants Home Care Bill. Honourable members would know from the framing of this Bill that it is a States Grants Bill. Under this Bill money is granted by this Parliament to the States in a tied way. That is to say, the States must spend the money in a certain way. In this case it is on home care. It is an allied Bill and it has 3 main provisions. The first of the 3 provisions relates to the financial assistance provided by the Australian Government for home care service schemes. This is housekeeper and other domestic assistance which helps to keep aged people in their own community for as long as possible. The principal Act provides for State Government expenditure on such schemes to be shared by the Australian Government on a $1 for $1 basis. The amending Bill, this Bill we are now considering, enables this subsidy to be increased from one-half to two-thirds of State Government expenditure. I suggest to the Minister that instead of Si for Si that means $2 for $1. I wonder why he did not say that instead of going into these rather strange fractions. To ensure that the additional subsidy is used to expand home care services, however, and to ensure that the State's contribution is not reduced it will be a condition of the increased subsidy that the States own expenditure must not be reduced below its level in respect of the financial year 1972-73. The Opposition supports the increase and supports the concept that State Government expenditure must be maintained.

The second provision of the States Grants Home Care Bill concerns senior citizens centres. The principal Act provides for the Australian Government to contribute up to one-third of the capital cost of such centres on a matching basis with State or local government expenditure. The amending Bill doubles the Australian Government's contribution to $2 for every $1 contributed by the State government or the local governing authority. Again the Opposition supports that portion of the Bill. I note one aspect of the Minister's speech on which I would hope subsequent speakers on both sides of the House will comment. It is an interesting contribution by the Minister. He said:

I further noted that some such centres are being largely monopolised by particular aged persons groups, or treated as clubs and open to members only. To my mind this is quite wrong. All aged persons within the local area should be encouraged to feel that the centre is there for their use.

The Minister hopes to do something about this. I absolutely agree with him. It is rather sad sometimes, as all members of this Parliament would know, to go into senior citizens centres and find the atmosphere there is a club atmosphere and cliquey to such an extent that an elderly person breezing in off the streets is regarded as a Johnny-come-lately and is not welcome. This is human nature. It is unfortunate and I wish the Minister luck in what he hopes to do. I cannot make a contribution as to what his answer on this might be but I thoroughly agree with his views on this and 1 share his concern.

The third provision in the State Grants Home Care Bill concerns assistance towards the employment of welfare officers. Section 10 of the principal Act provides that where a person is employed as a welfare officer of a senior citizens centre wholly or mainly in connection with the provision of approved welfare services by or in association with the centre, the Australian Government may pay an amount equal to one-half of the welfare officer's salary. The Minister in his second reading speech said:

In order further to encourage and assist the provision of the welfare services to which I have previously referred the amending Bill increases the Australian Government's subsidy from one-half to two-thirds of the salary paid to appropriate welfare officers.

Again I ask the Minister why could not he have said: 'Instead of $1 for $1 we now pay $2 for ST? The Opposition thoroughly supports this legislation but as I said in my speech in response to his statement on the welfare commission I do invite the Minister's Department to look at the employment of amateurs in this field. I am the first to admit that one of the great menaces of our society is the misguided humanitarian or the busy do-gooder - the persons who believe they have a monopoly of wisdom on any particular subject and intrude themselves. As an example I will speak of the honorary probationary service of the childrens' court in Victoria. The Government realised that there were not enough paid social workers or welfare officers to cope with delinquent children and it handpicked with meticulous care adult citizens to act in a capacity of honorary welfare officers. I have someone fairly close to me who is an cutstanding welfare officer.

Mr Hayden - Male or female7

Mr CHIPP - Female.

Mr Hayden - Very close?

Mr CHIPP - Very close. In fact she is one of the most outstanding women I have ever met. She happens to be my wife. This has worked with astonishing success in recruiting people who can make a contribution. It reduces cost and also has an involvement of people in the community towards community problems which, I know, is part of the philosophy of the Minister.

Mr Hayden - Often with a lot of maturity and experience which professionals have not been able to get.

Mr CHIPP - Indeed, but I suggest that they still need advice from time to time from the professionals. I would ask the Minister to look at that point.

In conclusion, the Minister says that he is unhappy about the fragmented arrangement whereby several departments each sponsor welfare programs. The Ministers referred specifically to the Department of Immigration, the Repatriation Department and Department of Social Security. Each give assistance in restricted or largely restricted ways which deprive the bulk of the community from the benefit of such services. I could not agree with the Minister more. We should have done something about this. Whether the Minister will be able to do it, whether he will be able to buck his colleague Ministers and the other departments with their compulsions of empire building, I do not know. I wish him luck in that exercise as well. The Opposition supports the 3 Bills.

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