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Wednesday, 3 October 1984
Page: 1521

Mrs KELLY(8.32) —In the last 20 minutes this House has been subjected to a further example of the Opposition's tactics and treatment of the very important issues of care of the aged and health in this country, which are dealt with in the Health Legislation Amendment Bill. We have heard shallow comments directed only to scare the Australian population, to scare those people who are ill and aged. I think the tactics are to be deplored. It is important that the electorate listen to the constructive comments that have been made by various speakers on this side of the House and by the Minister for Health (Dr Blewett), who is in the House tonight. This Government's constructive approach to care of the aged is reflected in the legislation before us tonight. What we see is a new approach to care of the aged in Australia. Honourable members opposite sigh. They sigh because in the seven years they were in government they did not look forward at all to planning for care of the aged in this country. The recommendations in this legislation start us on the track to thinking constructively about the problem of care of the aged in Australia. There is no doubt that it is a problem because we are an aging population. Opposition members closed their eyes to the future when they were in government over a seven-year period.

Mr Carlton —We did not kick them out after 35 days.

Mrs KELLY —I am very disappointed with the interjection of the honourable member for Mackellar. It illustrates the scare tactics and the lack of constructive policies the Opposition is presenting, particularly on the future of the aged in this country. People over 65 years of age currently constitute about 10 per cent of the Australian population. By the year 2001 they will have increased to 11.8 per cent and by 2021 to 15.9 per cent. Those figures should be sufficient impetus for the Parliament to recognise that we have before us a real challenge in the equitable distribution of resources so that no sector of our community is seriously disadvantaged in comparison with other sectors. This is the real crux of the problem with which we as a community have to come to terms. How do we deal with care for the aged? Again, the Opposition has presented no constructive policy.

If we consider the well documented fact that the participation rate for older ages has declined sharply in the last decade we might also consider that those aged between 55 and 64 years of age presently constitute 13.1 per cent of the population and by the year 2021 will constitute 18.7 per cent of the population. Let me tally these percentages for the convenience of honourable members, and for members of the Opposition particularly. The proportion of the population presently over 55 years of age is now 23 per cent. By 2021 it will be 34.6 per cent. Instead of giving in to panic and refusing to acknowledge the existence of such evidence, as the Opposition did in its seven years in government, this Government has sought to address the situation by acknowledging the problem. With the help of the aged community it is actively seeking to initiate some long term planning.

Some of the amendments in this Bill are evidence of our attempt to streamline facilities and services already in place. The home and community care package announced in the Budget will extend home care services, especially in those States that agree to participate in the program. No doubt honourable members are aware of the complexity of services available to the aged at all levels of government. The Commonwealth Government provides, amongst other things, pharmaceutical, nursing home and domiciliary nursing care benefits, assistance to the States for home care services and senior citizens centres, and assistance to local government and non-government organisations for delivered meals, deficit financing for nursing homes, aged person's homes, hostels and personal care services. This finance is provided through the departments of Health, Social Security, Veterans' Affairs and Housing and Construction. The home and community care package announced in the Budget marks the beginning of these departments working together on age policy. I think the Ministers and departments involved deserve the support of all members in this task. I hope that over the next few years we will see a much better recognisation of the administrative structures to support care for the aged. I also hope that the State, local government and non-government organisations take the opportunity they have to make an input into those deliberations.

My concern is that people involved get together before seeking finance for projects. This concern has been reinforced by a recent occurrence in my own electorate when two organisations sought funding for a similar handy help project. This is an example at the micro level of what is occurring in the wider realm of age care. We have to look at the whole administrative restructuring of care for the aged in this country. Because of such concerns I urge that an audit of services for the aged and the handicapped be conducted so that this Government has the basic information it needs to begin to evolve a long term policy for the aged in our community. The community cannot continue to ignore the problems it will face in years to come if we do not know what resources we have to care for the aged and to administer them effectively. Turning to specific measures in the Bill, I remind honourable members that very few aged persons are dependent on institutional care for their survival. Those aged persons to whom I have spoken do not want to be institutionalised. However, they want somewhere to go when those who care for them need a rest or are in a period of crisis in their lives. This Bill will help to cater for that need. Clause 12 provides for qualified or repatriation patients to be temporarily absent from nursing homes for up to 28 days per year. Where applicable, Commonwealth nursing home benefits will continue to be paid for absent patients. Under clauses 15 to 17 these temporarily vacant beds can be occupied by short term respite care patients. Together, these clauses should provide some peace of mind for many of the aged in our community.

Not all the sick need to be put away. Certainly tuberculosis sufferers can exist in the community. All the handicapped are no longer hidden away, since we discovered that their handicaps did not necessarily mean that they had nothing to contribute to society. And not all the aged are sick. Indeed, those who are sick and institutionalised constitute only some three per cent to four per cent of the current aged population. The aged do not thank us for protraying them in the role of the sick. I am pleased that this Bill recognises this through the provision of respite care for those who are not necessarily sick, but whose carers need a break. This Bill recognises that through the provision of respite care in existing institutions, users may be able to stay out of those institutions and in their homes, except for those times of crisis when carers need a rest. And, very importantly, the new arrangements should ensure that neither the temporarily absent patient, nor the respite care patient suffer any disadvantage in respect to fees paid, compared with other patients in the nursing home. Thus the financial strain placed on patients and their families by having the nursing home patient hospitalised or visiting relatives away from the home, can be alleviated. For up to 28 days per year, patients who are absent will be required to pay no more than the difference between the full fee and the Commonwealth nursing home benefit. That is a very welcome improvement in care for the aged. I commend this Bill and also the new direction in health care which the Minister has outlined in this legislation tonight.

I am also very pleased to note that repair and maintenance of hearing aids acquired by persons in accordance with section 9A of the National Health Act or otherwise will henceforth be available. One of my constituents, a pensioner with no other source of income, has very recently been to see me about such repairs to a hearing aid purchased before she became a pensioner. Repairs are very expensive and non-functioning hearing aids are pretty useless. I also note that the Bill provides for simplification of the administration of existing schemes for the provision of medical and surgical aids and appliances. The effect of this amendment will be to give responsibility and accountability to those bodies which administer the scheme, thus freeing the Commonwealth of the need for infrastructure.

Under the amendments to the Tuberculosis Act, special tuberculosis allowances will be phased out. The whole aura of tuberculosis patients languishing in an isolated institution, gently coughing themselves to death in the manner of a Chopin, a Beethoven or a Lord Byron, has thankfully passed. Tuberculosis patients are no longer to be institutionalised or put away. They are now treated as part of our community. This whole concept of putting groups away, such as tuberculosis sufferers and the aged, I hope is well and truly at an end. The aged, the handicapped and the sick are part of the community and can both contribute to the society as well as utilise its resources.