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Tuesday, 5 June 1984
Page: 2486

Senator MESSNER —My question is addressed to the Minister representing the Minister for Health. I refer to the recently announced guidelines for the approval of new nursing home beds. Is it true that no new nursing home beds have been approved since the election of the Hawke Government 15 months ago? Does the Minister agree with remarks made by a voluntary organisation administrator that the new guidelines are grossly obstructive and make it virtually impossible to obtain any new approvals? Finally, what provision, if any, has been made under the new guidelines to make beds available for sick and elderly people thrown out of hospitals under the 35-day rule?

Senator GRIMES —No, I have not seen the reports to which Senator Messner referred , although I have had some correspondence from one organisation. The aim of the Government's policy in the area of aged care is to ensure that, first of all, there is adequate and appropriate accommodation for aged people who need it- accommodation of all types; nursing homes, hostels and independent units-and, secondly, there is provision for adequate community care services so that people can remain in their own homes, which is largely where they want to stay. The second thing I will say is that surveys done over the last seven or eight years have repeatedly shown that anything up to 25 to 35 per cent of people who are in a nursing home should not be there and would not be there if, firstly, they had been properly assessed; secondly, they had had proper treatment and proper home care services available; and, thirdly, if other more independent forms of accommodation were available. Senator Messner should realise that over the last 20 years or more it has been the view of most people who are knowledgeable in this area that there has been an unnecessary concentration on nursing home beds as distinct from the more independent type of accommodation made available for the aged.

When we came into government we decided to do something about this situation. The first thing we had to do was not only take a careful global look at the relative numbers of nursing home and hostel beds, et cetera, throughout the community, but also look at the unnecessary concentrations which, as many people here would know, existed in the more affluent suburbs. There was a great absence of nursing home beds in lower socio-economic groups in the western suburbs of Sydney, et cetera. We then proceeded and we are continuing to develop a more co- ordinated policy which will concentrate on providing community care services, which we hope, with the assistance and the co-operation of the States, will provide more hostel beds by the provision of what we consider is a more fair hostel bed subsidy system. We also looked at the distribution of nursing home beds in the community.

If Senator Messner is talking about approvals in principle given by the Minister for Health in the last 12 months, I think the number is not quite nil, but there have not been many. I think some two or three nursing homes have been given approval in principle by him while we are reassessing the whole situation. But I remind Senator Messner that there is a large backlog of nursing home approvals in principle which have been given in recent years and for which funding will have to be found in future years. Approval in principle does not in itself give a guarantee of funding, it just gives approval by the Minister for Health or the Department of Health, and in most cases the State Department of Health, for a particular nursing home. The fact that no more new approvals in principle have been given does not mean that this Government will not fund nursing homes. Of course we will, and I am considering at the moment the capital funding of nursing homes which have been given approval in principle in past years.

We want a more rational system. We do not want a great tail of not only approvals in principle but also approvals for funding which were given many years back but which have never been taken up because the organisations have not had the capacity to raise the funds or to build. The answer is that we are developing a rational system of aged persons accommodation, and we will continue to do so. To suggest, as Senator Messner does, that there will be no more approvals under the new guidelines which provide for a limited number of nursing home beds per capita-something which the previous Government took into consideration-to provide for proper standards of nursing home beds is not true. I think that will be demonstrated to be untrue by the number of applications which will come in in the near future.

Senator MESSNER —Mr President, I ask a supplementary question. The Minister did not in his reply address the last part of my question which referred to those people who have been missing out on beds and who have been thrown out on to the streets as a result of the Government's Medicare program. Secondly, does he now confirm that the Minister in the House of Representatives, Dr Blewett, lied yesterday in saying that the Government-

The PRESIDENT —Order! The honourable senator knows that the word is unparliamentary, and I ask him to withdraw it.

Senator MESSNER —I withdraw, but I replace it with the words he 'untruthfully said' yesterday in the House of Representatives that 2,132 beds had been approved by the Labor Government since coming to power.

Senator GRIMES —I have not read Dr Blewett's answer, but I will. I have no doubt that Senator Messner is referring to different figures to those that I have talked about. We have certainly funded many nursing home beds. Senator Messner's suggestion that hordes of pensioners are being thrown out of hospitals as a result of the Medicare program is plainly and clearly untrue. It is emotional nonsense. If we had had a rational policy in recent years of developing proper accommodation of all types-independent hostel types, semi-independent and nursing home accommodation-we would not be in the position we are in now, with too many people in nursing homes who should not be there but who are because there is nowhere else to go, too many people in acute stay hospital beds who should be in nursing homes or hostels, and people unable to stay in their own homes because inadequate community services are available for them. That is the situation we have to correct. That is the situation which has arisen as a result of conservative governments for all but three of the last 30 years in this country. I certainly am not going to listen to Senator Messner accusing Dr Blewett after 14 months of government of being the cause of any difficulties in this area when it was his Government that was in power for all that time.