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Wednesday, 23 August 1972
Page: 360

Senator GUILFOYLE (Victoria) - In a Budget designed to be an expansionary influence on our economy, many achievements of social and economic goals have been included. Many speeches will be made in this session on both sides of the Senate opposing and upholding the goals which have been set as priorities. Economic circumstances at present demanded an expansionary Budget. But I would like to think that in our Party social conscience and community concern for the welfare of the individual have dictated the priorities which are included. The Minister for Civil Aviation (Senator Cotton) earlier this evening talked in economic terms of the effect of this Budget, of its aims and of the possibilities which it will provide to develop the economic climate which we consider desirable for Australia. Members on this side of the Senate have been rewarded for their strenuous efforts by the inclusion of a proposal for the abolition of the means test in this Budget.

Senator Cavanagh - The promise of it.

Senator GUILFOYLE - There is a promise that the means test will be abolished within a 3-year period. Perhaps the honourable senator acknowledges and understands that the Prime Minister is already on record publicly as having said that thai does not mean that it will take 3 years to implement this proposal. The inclusion of this policy for the abolition of the means test is something which is rewarding to those members of the Government members' committees who have strenuously pushed this as a means of providing social security for the Australian people at. a certain age group. The Treasurer (Mr Snedden) termed this as an historical decision and a major social advance. I believe both have been acknowledged throughout our community. I would term it also as a decision which has been demanded by the people of Australia for a long time, and it is a measure of social security which we now consider desirable. Of course, it does have considerable financial implications. This is acknowledged. But a decision has been taken to institute an advisory committee which will design ways and means of implementing this proposal. I would hope that that committee would look also to the means of financing in a responsible way the introduction of a national superannuation scheme. 1 feel that, at this stage, we have broken through those last cobwebs in our thinking with regard to this measure of social security.

I felt that 1 should mention that aspect of the Budget's proposals in isolation and point to the total of approximately Sl,460m which has been budgeted for social service measures in general. This appropriation shows an increase of $250m in excess of that which was provided in last year's Budget. The appropriation does provide many measures for age and invalid pensions, for widows pensions, for child endowment and for all those other areas of social services which have been part of our Budgets for many years. The increases in pensions have been noted already. The easing of the means test is also something which we commend. We do hope that the abolition of the means test as a future proposal will be something seen as a social advance. The increases in. pensions have been documented by the Treasurer. They will be spoken about at the introduction of the appropriate Bills. I do not propose to list them in detail at this stage because I wish to talk in a little, more general way on our attitude to the matter .of social welfare and our social conscience. .

To do this, I refer also to the decision to institute an inquiry into poverty. This is a Government decision which has been taken in recent days. The decision of the Government to establish this committee of inquiry is one which I welcome. I would hope that this inquiry will not simply be a body which will determine and point to what are levels of subsistence so that we may reach those and salve the national conscience. I would hope that the committee of inquiry into poverty or social distress would be one which would be sensitive enough to show us ways of escaping from the self-perpetuating cycle of poverty which does seem to be limited to some family groups. I would hope that the way to escape in the future from this cycle of poverty from one generation to another will be pointed to us through this committee of inquiry in the broadest possible terms arid that the Government will grasp it and interpret it as a social matter and in many ways introduce initiatives and new opportunities for that sector of the community which has this self-perpetuating poverty cycle. I feel that if we could give greater self-confidence to this group of people and if greater opportunities could be provided to them in the future, there might be some measure of attainment of the national goals which we seek.

Senator Georges - You could pay them more.

Senator GUILFOYLE - I was saying that 1 feel that that is not the way in which the problem should be approached. I would like to think that we did not determine a level of subsistence and that we did not say that that was enough and that people could live on that even in meagre dignity, but that we would say that we would seek new initiatives and new opportunities for these people so that they might escape from this cycle in which they have been placed. I wish to say as a further thought that I would not want to see this done simply by feeling that if we suppressed the top level we could automatically raise those at the bottom of the scale. I would like to think that we would attempt to raise the lower level by using as a leverage that initiative that branches to the top. If we have the sort of inquiry into poverty which I envisage, there may be opportunities for these new social initiatives which. I feel, would create a greater opportunity to achieve an ideal society in Australia and certainly the attainment of the national goals which I would hold.

This Budget introduces many concepts with respect to new care for the aged and the sick. I would like to think that other groups who experience hardships would have the same opportunities and that they would not be overlooked in future proposals. I am thinking of single parent families and in particular of the special difficulties experienced by widowers with young children. I feel that there is a gap in our social welfare programme and that attention should be given to the particular hardships surrounding the widower with young pre-school age children and the many difficulties he has to face. I am sure that this gap will be pointed to by the commit tee that will inquire into poverty because quite unusual strains are faced by people in that situation.

The social welfare aspects in general will be amplified by many subsequent speakers, as I said earlier, and I want to talk for a short time about some of the health pro-, posals in this Budget. This Budget contains new initiatives in health matters, in particular in connection with the nursing home benefits. Comprehensive proposals were outlined in the Budget. There is( a proposal to spend some $592m on health services, which is an increase of almost $66m over what was provided at this time last year. It seems to me that not enough information is flowing out to the community at the present time on the new proposals. If the right sort of publicity were given to these new proposals they would be grasped eagerly by the people of Australia. These health proposals give many new comforts to aged people who are receiving care permanently in nursing homes. They also will assist in alleviating the hardship and strain which the families of those people have had to bear as a result of the perpetual cost of paying for nursing home care for an aged parent. Costs seem to be every rising. . They are creating a ' bigger gap between a pension and a. supplementary allowance and the cost in a moderate nursing home.

Senator Georges - Is there any way we can keep down, the costs in these hospitals and thus prevent the need, to subsidise them continually?

Senator GUILFOYLE - If the honourable senator will listen 1 shall speak briefly on that aspect. The statement of the Minister for Health (Senator Sir Kenneth Anderson) on 16th August gave the Senate many details of the Treasurer's announcement of the new proposals. ;They deserve loud acclaim in our community because many areas of personal hardship will be alleviated. I think we should define some of these areas. The provision of nursing care has been comprehensively reviewed. The Minister for Health had a personal concern about this matter for many months prior to the formulation of the Budget.

There is to be a new measure of assistance in the area of domiciliary nursing care benefit. I know, from moving about the community, just how widely this measure 0t Government assistance has been sought A rate of $14 a week is to be granted as a payment to persons who are willing and able to care in their own homes for aged persons who otherwise would qualify for the nursing home benefit. This is an imaginative step forward. The Government recognises that sometimes the atmosphere in a home is more desirable for the care of an aged person than that of the somewhat impersonal atmosphere of a nursing home service and this is to receive Government assistance in the form of payment of $14 a week. This is to be commended as a very personalised service and will be of assistance to people in that age group.

Another measure which I think will be of great assistance is the payment of additional subsidy in the area of home care services - that is, nursing care which is provided in the home. Honourable senators will remember that the Treasurer stated that there will be an increase in the subsidy payable to eligible home nursing care organisations. Two different rates have been payable. In those homes and services established prior to the introduction of the present scheme in 1957 the subsidies payable will be increased from $3,200 to $4,300 per annum for each additional nurse employed on home nursing. For those organisations established since 1956 the rate will be increased from $1,600 to $2,150 for each nurse employed. This home care service also is a supplementary assistance designed to help those people to remain in their own homes and in their own family circles as long as that is practicable.

Perhaps the really good news is for nursing home patients. In this field there has been the hardship, which I mentioned earlier, of the gap between what can be received by a pensioner patient and what has to be paid by that person to a moderately priced nursing home. It will be recalled that not so many months ago the Government raised the rates payable to patients in registered nursing homes to a level of $24.50 a week for people who received ordinary care and $45.50 for those who required intensive nursing care. These payments were made without the patient being required to register as a health insurance contributor. It is noteworthy that 80 per cent of patients in reg istered nursing homes are pensioners. However, this left a gap of about $30 a week between the nursing home benefit entitlement of $45.50 plus the pensions paid by the Government to a single pensioner and the cost in what would be regarded as a moderately priced nursing home. The Government now recognises this gap.

Senator Georges - The point I am making is that most of these hospitals immediately put up their prices. Therefore what the Government endeavoured to achieve was lost immediately.

Senator GUILFOYLE - If the honourable senator did not have the opportunity to hear the Minister's statement he should listen and I will explain to him how the Government has approached this problem and what assistance will be given to ensure that nursing home costs and fees charged to patients receive a measure of Government supervision. This will meet the point he just made.

Senator Georges - A couple of hospitals in Brisbane raised their prices immediately.

Senator GUILFOYLE - -This proposal has not yet taken effect. The decision announced in this Budget means that three-quarters of a single pensioner's pension and allowance will bV the patient's participation in the scheme. That will be the sum that the patient will, have to pay to the registered nursing home. The amount involved is $18 a week. This will leave $6 in the hands of the pensioner for personal needs. Surely it is a sensitive and humanitarian attitude on the part of the Government not to deprive a pensioner of his entire income and to apply it to nursing home costs. Three-quarters of the pension will be applied to those costs and $6 will be left for the pensioner's personal needs.

The Commonwealth now has determined the rate of the new benefits needed to meet the costs of nursing homes. The Commonwealth will provide the following differing rates for each State: In New South Wales the amount will be $10.50 per week per patient; in Victoria it will be $22.40; in Queensland it will be $10.50; in South Australia it will be $14; in Western Australia it will be $11.20; and in. Tasmania it will be $10.50. These benefit rates will be reviewed to reflect changes in the prevailing fee levels.

I turn now to the question of patients in nursing homes who are not pensioners. New provisions have been announced to cover these people. The same benefits per week - they are the figures I just mentioned for the various States - will be provided by the Government as assistance to those patients in nursing homes who are not pensioners. The patient benefits from hospital insurance funds will be exactly the same as the benefits for pensioners, namely $18 a week. Initally these benefits will be financed by the registered hospital benefit organisations out of their reserves and no adjustment to hospital fund contributions is necessary at present. This is a very desirable feature of the scheme to cover the cost to those people who qualify by age for registered nursing home care but do not qualify for pension assistance in other ways. Apart from the new benefits which I have mentioned $78m is provided to meet the existing benefits. A further $9m is provided to cover these new benefits, which I have outlined, for the remainder of this year and an expected amount of $22m will be needed for a full year of these new proposals.

Now this covers the point raised by Senator Georges. It is proposed to establish an independent nursing homes fees review committee to review the appeals of nursing home proprietors with the Department of Health when new fees are established. This nursing homes fees review committee will be the sort of body which will negotiate between the nursing homes and the Commonwealth Department of Health to ensure that there is not simply a handing on of an increase either in a pension or in a health benefit to a nursing home proprietor without some review being undertaken by a responsible body. There will be negotiation between the nursing homes and that body in the Department. I rather feel that this feature of the proposed scheme will ensure the best opportunity for co-operation on the matter of costs. It will provide to the Government a means of justifying increases in costs which may be proposed by nursing home proprietors. I feel that that is a very desirable feature.

Two other measures have not made very much impact on the minds of people, perhaps because of a delayed announcement of some of the Budget proposals through the media. I am sure that they will be acknowledged by the community when some of the details unfold. I refer particularly to hostel type accommodation for aged persons. In this area it is proposed to double the personal care subsidy, from $5 to $10. This applies to persons over the age of 80 years who are in nonprofit hostel accommodation. Approximately half the people in these institutions are over the age of 80 years. The second proposal relates to aged persons homes. This is perhaps the most magnificent social welfare proposal in the Budget. As I have moved throughout the community and as organisations have contacted me I have established firmly in my mind that this hostel type accommodation has been in short supply in many States. The opportunity is now given to institutions which are already established and functioning with this type of accommodation to match running costs a little easier, because there will be a rise in the pension as we have already noted. There will be a rise in supplementary assistance. Now there is an opportunity to offer an increase in capital support.

The new provisions will give support for a 3-year period to organisations which are already eligible under the Aged Persons Homes Act. I understand that there are some 7,500 beds in this category in Australia at present. Organisations which are willing to build will be granted the cost of 2 hostel beds for every one unsubsidised bed which they hold at present or one bed for 2 beds where the hostel was previously built under the Aged Persons Homes Act on a $1 for $1 basis. There is a condition which is important and that is that the beds are to be allocated without donation and to persons with the greatest need. This is another gap which I feel is being filled through this present Budget. These institutions are being given the opportunity to expand to 3 times their present size under this new provision without an outlay of capital. At this stage surely this is the best way in which we can treble the amount of hostel type accommodation which is available for the aged people in Australia. The cost of the measures in relation to nursing homes, home nursing and aged persons homes which I have mentioned is estimated at $ 16.9m for this year and $43 .9m in a full year.

In all these instances I have quoted figures. But 1 do not think that we are simply talking about money. I rather think that we are talking about measures which are very close to the people of Australia. They have been provided in a responsible way by departments which have had responsible reviews undertaken. They have worked closely with those organisations in the community which are conducting many of our social services. In this year's Budget we have established a programme of assistance which will be an enrichment to the aged and- sick in our community. It will be of great benefit to us in matters of social concern. This is a Budget with many aspects. It is a Budget on which the Government could well go to the people of Australia. It is acknowledged that there will be honourable senators on the other side of this chamber who hold other views about how a Budget should be constructed at this time. But I do not feel that this Government needs to make any apology for the priorities which it has established. In economic terms it has provided an expansionary Budget. In sensitive terms it has provided many new initiatives in social welfare and health proposals. Other honourable senators will talk of many of the expansions in our education programme and many of the decisions taken with the regard to the defence priorities of Australia, national development projects, communications systems which we are developing and all those other things which are part of a great national programme. I feel that this is a Budget well suited for an approach to the people of Australia because it shows responsible economic understanding and personal priorities in matters of welfare and all those other things which the people of Australia have demanded from governments for so many years in the past. I commend the Budget to honourable senators.

Debate (on motion by Senator DrakeBrockman) adjourned.

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