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Tuesday, 19 September 1972
Page: 913

Senator GREENWOOD (VictoriaAttorneyGeneral) (2:29 PM) -

I move:

That the Bill be now read a second time.

The purpose of the Bill is to give effect to the announcement made in the Treasurer's Budget Speech that the Government would legislate in this session to encourage and assist the provision of additional hosteltype accommodation for aged persons. Before giving details of how the legislation will do this I would like to explain to the Senate the general context into which the measure will fit.

Since 1954, when the Aged Persons Homes Act was introduced, the Commonwealth has been subsidising the building by religious and other non-profit organisations of homes for aged persons, originally on a $1 for $1 basis and since 1957 on a $2 for $1 basis.

Three types of accommodation are eligible to attract this subsidy: Firstly, selfcontained units, in which aged people may live independent lives; secondly, hostel-type accommodation, where residents have their own individual bedrooms, but have meals and other personal care provied for them; and thirdly, nursing homes, for those no longer able to look after themselves and who require regular nursing care.

Grants made under the Aged Persons Homes Act to date total over $150m, with the aid of which accommodation has been provided for over 45,000 aged persons - 23,000 in self-contained units, 17,000 in hostel-type accommodation and 5,000 in nursing accommodation. Grants made during 1971-72 reached the record level of $23. 8m, and the amount of accommodation approved in each of the three categories I have mentioned exceed all previous records, thus demonstrating the continuing success of the legislation Homes established under the Aged Persons Homes Act, of course, accommodate only a fraction of the aged population of Australia. Of our 834,000 age pensioners, for example, the records of the Department of Social Services show that over 519,000, or 62 per cent, own their own homes. State housing authorities and unsubsidised hostels provide for at least a further 25,000 and approximately 40,000 are living in nursing homes which were not subsidised under the Aged Persons Homes Act - mainly those being operated commercially. Departmental records indicate that many of the remaining aged persons would be living either with their families or relatives, under conditions which they themselves would not want to change or in good standard accommodation which they rent from private owners at a reasonable rate. A residue, however, would be living under unsatisfactory conditions - that is, either living in accommodation of an unsatisfactory standard or paying a rental that they are not able to afford. It has been estimated that as many as 50,000 pensioners may be in either of these categories.

There is still plenty of scope, therefore, for further expansion of our aged persons homes scheme. Indeed the accommodation subsidised by the Commonwealth up to date could be doubled before the housing needs of the aged could be said to have been met. At the present rate of progress it would take many years to clear the backlog and in the meantime, of course, the need continues to increase. It has been estimated that the number of aged people needing satisfactory accommodation is increasing at the rate of 1,000 per year. The problem is not simply a matter of accelerating the rate at which accommodation is being provided under the Aged Persons Homes Act. The need is not only for more accommodation but for more of the right type of accommodation and for the available accommodation to be directed more towards the people most in need of it. It has become increasingly obvious that there is an imbalance between the types of accommodation available to aged people. As a result, according to surveys carried out by the Department of Health, many aged people who had no real need for medical supervision have been admitted to nursing homes. It has been reliably estimated that this may be true in respect of at least 12,000, or 25 per cent, of the patients in nursing homes throughout Australia. There is no doubt that one of the causes of this situation is that there is insufficient alternative accommodation, of the type that really suits their needs - namely hostel-type accommodation. This view is borne out by the fact that there are long waiting lists for most of the hostel accommodation conducted by non-profit organisations under the Aged Persons Homes Act.

The purpose of the Bill I now place before the Senate therefore is to provide added encouragement for these non-profit organisations to build more hostel accommodation as quickly as possible. The legislation provides for the Commonwealth to make grants to eligible organisations for the building of hostel-type accommodation on the basis of existing homes which were built either without government subsidy or when subsidy was available only on a $1 for $1 basis. The Commonwealth is offering to meet the full cost of providing new hostel accommodation for 2 people for every one at present accommodated in the unsubsidised home - or one additional person for every 2 in an existing home subsidised on a $1 for $1 basis - up to a maximum of $7,800 for every aged person or necessary staff member accommodated. In other words it will not be necessary for the organisation to make any contribution from its own resources unless the capital cost exceeds $7,800 per head, or the bed capacity of the new home exceeds the number of free beds for which they are qualified. In adopting this principle the Government's aim is to place organisations which operated homes prior to the introduction of the $2 for $1 subsidy scheme in the same relative position as can be achieved by new organisations under the present Aged Person Homes Act, that is, where two-thirds of their accommodation for the aged will have been provided by the Commonwealth. The Bill also provides for grants of up to $250 per person to be made towards the cost of furnishing these free homes.

I turn now to the conditions upon which these special grants will be made. The Bill provides that the existing qualifying home should be one which, unless the DirectorGeneral of Social Services otherwise determines, would have attracted a grant under the Aged Persons Homes Act if built recently. In exercising his discretion under this Section the Director-General will make allowance for advances in the standards of aged persons homes which have occurred since the qualifying home was established. In accordance with the principle established in the Aged Persons Homes Act, existing homes which were established wholly with funds provided by State governments will not be eligible for approval as qualifying homes. Where the capital cost of the home was shared between the organisation and the State, a proportion of the accommodation, calculated on the basis of the organisation's contribution, will be acceptable as the basis for a grant under this legislation.

The Bill also includes a requirement that construction of the new hostel must be substantially commenced within a period of 12 months from the date of approval of the grant by the Director-General of Social Services. Otherwise the approval shall be deemed to have lapsed. The object of this provision is to bring about the building of the new accommodation within a reasonably short period. The legislation will operate for a 3-year period commencing from the date on which the Bill receives royal assent. In order to ensure that the free homes established under this Bill provide accommodation for those most in need of it, it will be a condition of approval that the accommodation is to be allocated strictly on the basis of need and without any donation being required either from or on behalf of an applicant.

Need' is to be decided by the organisation having regard to the following considerations: (i) the applicant's degree of frailty or medical condition; (ii) the agc of the applicant - priority to be given to those in the upper age groups, that is over 75 years of age; (iii) the applicant's existing accommodation situation - preference to be given to frail elderly people living alone or those whose families can no longer accommodate or care for them for domestic, social dr other reasons; and (iv) the financial position of the applicant - other things being equal preference is to be given io pensioner medical service pensioners, particularly those who cannot afford to meet the rental of the premises in which they are residing.

I would like to reiterate that the primary intention of this legislation is to stimulate the building of additional hostel accommodation, in order to reduce admissions to nursing accommodation of people v/ho have no real medical need for nursing care. As most honourable senators will be aware, the cost of establishing nursing accommodation may be subsidised under the Age Persons Homes Act on the basis of one nursing bed for every 2 ordinary residential beds. It is not intended to permit the special hostel accommodation established under this Bill to be taken into account in this way for the purposes of the Aged Persons Homes Act. In order to preserve this intention, the Agreements into which organisations receiving grants under this Bill will be required to enter will provide that Commonwealth nursing home benefits are not to be sought for any beds in the hostels established under this special legislation, that no existing hostel accommodation which was estabished under the Aged Persons Homes Act is to be registered for the purpose of receiving Commonwealth nursing home benefits on the basis of this special hostel accommodation, and that a further grant is not to be sought under the Aged Persons Homes Act towards the cost of establishing nursing accommodation on the basis of the hostel accommodation established under this special legislation.

It will be expected, of course, that organisations which receive grants under this legislation on the basis of existing homes will continue to use the qualifying homes as accommodation for aged persons. It should be noted that the personal care subsidy, provided under Part 111 of the Aged Persons Homes Act, will be payable, subject to the usual conditions, to homes established under this legislation. As a further incentive to the provision of hostel accommodation, honourable senators will be aware that, by another Bill, the Government is also legislating to double the present rate of personal care subsidy. It should also be appreciated that this new legislation is not in any sense a substitute for the existing Aged Persons Homes legislation. That highly successful Act will continue to operate unaffected by the present Bill, which is a temporary addition to cover the 3-year crash programme, lt is in order to make this quite clear that the present Bill is a separate piece of legislation, not an amendment to the existing Act.

This special programme is thus specifically tailored to achieve its objectives, which are: (i) the quick provision of beds of the type most needed; (ii) the allocation of those beds to the people most in need of them; and (iii) the administration of the beds by the organisations best qualified to administer them.

It is not possible at this stage to give a reliable estimate of the number of hostel beds likely to be brought into being by this legislation. Available information indicates that there are nearly 10,000 beds in unsubsidised homes conducted by voluntary organisations throughout Australia, but it is believed that a significant number of these would have been established with the aid of State government grants and therefore would not qualify for the purposes of this legislation. In addition, there are some 3,400 in homes that have been established under the Aged Persons Homes Act . on a dollar for dollar basis.

It is estimated that expenditure under the legislation could exceed $5m in the first full year. However, because an initial period is necessary for planning projects and calling for tenders, expenditure is not expected to exceed $2m in 1972-73. This Bill represents only one part of the comprehensive measures being undertaken by the government in this session through both the Department of .Social Services and the Department of Health to improve the health and welfare position of aged people. But I feel sure that its importance will be recognised and applauded by all honourable senators and by the churches and other voluntary organisations which have for so long been serving the community by providing much-needed accommodation for elderly people. I commend the Bill to the Senate.

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