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Wednesday, 22 August 2001
Page: 30066

Mr NEVILLE (12:08 PM) —I did not intend to speak today; I am not listed to speak. However, as you allowed the previous speaker to range very widely outside the terms of reference of the Health and Aged Care Legislation Amendment (Application of Criminal Code) Bill 2001, which is about the Criminal Code, and to use the opportunity to denigrate the government and its health and aged care programs, I will take the opportunity to speak. I will just make a few comments. This government has spent more on aged care than any other Australian government. The previous speaker talked about St Catherine's, capital costs and so on. When this government came to power it found that the Labor Party had reduced capital spending on nursing homes by 75 per cent over the previous four years. Why would the member for Newcastle come in here today, talk about St Catherine's and cry crocodile tears? He also talked about health care and dental care. Dental care is very interesting.

Mr NEVILLE —The honourable member opposite would know very well, because he was here at the time, that for 96 years of Australia's 100 years, dental health has been the responsibility of the states. The Keating government—and it was quite clear on this—introduced a four-year catch up program for the states. It was cobbled together in the dying stages—I may stand corrected—of 1992 in the lead-up to the 1993 election. It was made very clear to the states what it was for. It was to be a catch-up program.

When we came to office that program had not been completed, and we completed it. It is hypocrisy to say that we terminated dental care, because in your own forward estimates you had made no provision to continue it for another four years. And you perpetuate this untruth in every forum by saying that this dreadful coalition government cut out dental health. That is untrue, and it was never your intention when in government to continue it for any more than four years.

When it comes to nursing homes, I make a big thing about nursing homes. I visit them regularly and I am familiar with the improvements to nursing homes. It is interesting that, if it is so difficult to run nursing homes and they cannot be made to meet their costs, how is it that when there is a new allocation of beds in both regions covered by my electorate there are any number of existing and new bidders who want to take up those 20 or 40 places or whatever the number might be? In fact, there is quite intense competition for them. So I just find that view about difficulties a little bit hard to take.

Nor did we do anything unjust when we altered the scales from seven to eight. All it did was distribute the load over eight categories instead of over seven. So obviously some would come down a bit and some would go up a bit, depending on where you slotted in. We introduced the system of the ACAP team assessing people to make sure they fitted into the right categories. I do not have the figures here at my fingertips, but for a level 1 patient, the government's contribution is over $30,000 a year, and levels 2, 3 and 4 are also quite generous. Nursing homes that are well run not only operate well but some of the commercial ones make a profit.

I know that a number of nursing homes in Australia—I am not familiar with the full circumstances of St Catherine's—and some of them are big old two-storey buildings, have had a lot of difficulty in converting to units that can be modernised and made to work effectively for old people. That is part of the problem. It is not so much the amount of funding from the government but rather that some nursing homes have difficulty with their capital costs.

The previous government did leave nursing home care in a parlous state. When we came to office we found also that the previous government left us 10,000 places short on their own benchmarks. They went out of office 10,000 nursing home places short of what they benchmarked for themselves. That is a huge catch-up for any government to make in five years, but we have made a real effort to do it.

The member for Newcastle complained about the difficulty in getting nurses. That is interesting. I am a Queenslander and I take a lot of interest, as I said, in nursing home care. For many years the Keating and Hawke governments perpetuated a program that saw nursing homes receive less funding in Queensland, and to a lesser extent in South Australia, than the other states—appallingly so. I did some rough figures one day and I saw that there would be a difference of up to half a million dollars a year for some nursing homes because the daily rates were paid differently for each state, and Queensland in particular—and to a lesser extent South Australia—received less. So we introduced a system of coalescence where over seven years, without reducing the level of funding to states like Victoria, New South Wales and Tasmania, the other states were brought up—and I might again stand corrected, I am not speaking from notes—but we are about four years into that seven-year process which will deliver greater equity to those states. Of course, in delivering equity you allow the homes a better opportunity to be able to fund the nursing component of the care of aged people.

Regions need to have strategic plans for aged care in place. I have two ACCs in my electorate. The Central Queensland ACC, in the northern part of my electorate, in looking at employment generally, very generously funded a scheme to look at aged care needs in the northern part of my electorate. The scheme cost over $50,000 but it gave us great data that resulted in Gladstone getting 40 nursing home beds within 12 months.

Mr Horne —Nursing home or hostel?

Mr NEVILLE —Nursing home—40 high care beds. I then approached the Wide Bay ACC, which is in the southern end of my electorate, and we are now going to have a $120,000 program, covering parts of the Wide Bay and Hinkler electorates, to enable us to strategically place high care and low care beds.

The member for Newcastle had a few free hits at the government, most of them quite unjustified. It is true that we cut back in a number of departments in the year we came to office. There is no secret about that. You all know the reason: when we came to office we found a $10.3 billion black hole—that fact has never been contested—which had to be addressed by all departments. Had we continued, year after year, to do what the member for Newcastle said, he would have some grounds for criticism. But from the 1995-96 financial year through to the 2001-02 financial year, our funding of residential aged care increased from $2.5 billion to $4.2 billion. That far exceeds any increase by any Labor government. You might argue that needs have increased—of course they have—but that increase is well ahead of inflation and well ahead of the ageing of the population.

We had to bring in tougher rules for nursing homes because, as I said, when we came to power 13 per cent of nursing homes did not meet relevant fire standards, 11 per cent did not meet health authority standards and 70 per cent did not meet outcomes standards. In 51 per cent of nursing homes people were in wards of three or more beds. That was not quality of care, and that was the other thing we had to address. We set up new standards, as you know. At the last count I saw, 137 nursing homes have been closed or relocated. That shows a fair amount of commitment. Those homes are subject to spot checking. There has been a difficult situation with a home in my electorate, and I know just how well the department supervises these things. Yet when Labor was in power only one, I think, was ever closed.

A lot of the problems that we are encountering are because there were no standards in place. It is like maintenance of property: if you do not keep your maintenance standards up over a period of time on anything—whether it is a public building or facility or a theatre— there comes a point when you have a huge bill and have to scrap everything and totally renovate. In nursing homes that maintenance was not happening because they were totally and utterly neglected during the term of the previous government. I found the presentation of the member for Newcastle to be a little bit self-serving. I understand his concern about St Catherine's. As I said, I am not fully aware of the circumstances, but I suspect that it is one of those older homes that need major renovation from the ground up or perhaps it needs relocation.

It is also interesting to know that, in the two years to June 2000, $1.4 billion throughout Australia was committed by the industry to capital works. In other words, there has been a commitment—because of the new standards we set—to building better and more acceptable aged care facilities. Twelve per cent of all aged care homes in Australia have been either newly built or rebuilt. Considering that we had a year to do the assessment, a year to find out that the previous government had fallen 10,000 places short of its own targets, we have virtually had only about 4½ years to get where we are now. I think we have done a pretty good job.

Mr Horne —You don't want another 4½?

Mr NEVILLE —I think if we were given another three-year term you would find that many of these things would really zing along. I apologise for intruding into the debate, but I found that the member for Newcastle misused this debate and I felt that some of the matters that he raised were worthy of rebuttal.