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Thursday, 16 May 2013
Page: 3477


Dr STONE (Murray) (12:11): As I was saying in my earlier remarks before the debate was interrupted: you can imagine that the economies of scale are such that just a few vacancies—perhaps only three or four over several weeks—can make a significant difference to the viability of a small rural or regional aged-care facility that may only have some 40 or 50 beds. Then there is the issue of the burden of the red tape—a crippling lot of regulations, often simply for the sake of regulation, it seems. The sector is stymied by requirements to document and double-document, often requiring the hiring of expensive consultants. Everyone agrees that the sector needs appropriate and tight quality control. We are all horrified when we see in the media cases of the most frail and vulnerable taken advantage of in an aged-care facility. However, that is a very rare occurrence, and most facilities do their utmost to make sure they have an excellent standard of service and safety.

The burden of red tape should not be such that one-size-fits-all is the standard. If you have a facility of 500 or so beds in a metropolitan area, your capacity to constantly send back forms and be oversighted is quite different to when you have a 50-bed facility located on the banks of the Campaspe River. I agree that the requirement for the same quality of care needs to be there, but the capacity for those two different facilities to employ special administrative staff or consultants is quite different. The endless compliance requirements are often replicated, and it kills the passion for the work for many of the aged-care nurses, who are there to support their residents, not to endlessly fill in duplicated and meaningless forms. Given that aged-care nurses earn 20 to 30 per cent less than their acute-care colleagues, this adds mightily to their frustration with their workplace. No wonder the aged-care workforce is ageing and that it is often difficult to attract a new generation of aged-care workers, particularly when there is an acute shortage of division 1 nurses in the nearby hospital. We need the very best quality of care in these facilities. We need men as well as women working in these places, as there are more men coming into aged care.

Numbers of aged-care facilities in my electorate have made the point that we can go too far in keeping people supported in their homes if it means that when they finally come in to residences they have already had a significant compromise in their own health. Of course we support ageing in place. In the Howard government days we significantly advanced the opportunities for older people to remain at home for as long as possible, but it does come to a stage where it is not sensible to provide a whole range of very expensive services to people in their own homes when they are beyond being able to be independent in their own places. We need to watch that we do not swing the pendulum too far in the other direction.

In summary, the Living Longer Living Better package of five bills does not resolve many outstanding viability issues for providers, particularly in rural and regional Australia where the size of the facilities is typically much smaller than those you find in metropolitan areas. The $1.6 billion cut from the aged-care funding instrument, ACFI, under these reforms has placed even more pressure on the sector, and many now fear they are going to the wall. These five bills only cherry pick a few recommendations of the Productivity Commission report Caring for older Australians, which was delivered in 2011. The five bills add to regulation for an already overburdened and highly regulated sector. The five bills establish the framework for the workforce supplement, which has created uncertainty and will be potentially costly for providers. This relies on cuts to ACFI and appears to be a political mechanism to unionise the sector rather than a sensible activity which will make sure that you have a proper matching of the workforce with the workplace.

The five bills are typical of this government's practice of enacting framework legislation and leaving the bulk of the detail to delegated legislation. This is asking us to buy a pig in a poke. It is putting off the hard work until a little later, or is it a case of trying to keep more of the bad news out of the House and therefore genuine debate? We are very suspicious that there is not enough detail in this legislation. It should not be a mere framework; it should give us a great deal of detail, so we can understand whether it serves our ageing population well into the future. We do not know the full impact of these bills yet, and that is a serious problem.

I end where I began, by saying that care of our aged, our frail elderly, our most vulnerable, is one of the most important things a civil society can do. Australia needs to be proud of the quality of its aged-care sector. I commend the member for Mackellar, who, when she was Minister for Seniors, did extraordinarily good work in making sure that the quality and standards of Australian aged care were world's best. But you can overburden the sector with costs and you can underfund the sector. You can overburden the sector with regulation, and all you do is cripple the sector which is so important to the future of older Australians. We are an ageing population. We have a significant number of concerns about proper care of and the best place for those with dementia or Alzheimer's conditions. At the moment in rural and regional Australia we have a significant skilled workforce issue and have difficulty in finding division 1 nurses who need to be in this sector. I am concerned about this set of bills. I think that a lot of the sector is waiting for a change of government to put all of this right. Let's hope a change of government comes soon enough.