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Thursday, 5 December 1985
Page: 3076


Senator HARRADINE(8.56) —The Minister for Community Services, Senator Grimes, is wont to say that the speakers list on any Bill is in inverse proportion to its importance.


Senator Puplick —Or its time in the session.


Senator HARRADINE —I was just about to make that point. I do not think the Minister should regard the speakers list on this occasion as indicating that. We have all been given the very strong message that we have to get out tomorrow. The Government wants this measure passed; the Opposition wants this measure passed; I want the measure passed; and I am sure that those people on whose behalf the Bill has been presented and those who have been engaged in the work preceding the Bill want it passed as well. I will not be long in speaking on this measure. However, I want to indicate that it has two main objectives. The Minister's second reading speech states that the home and community care program objectives are:

to promote the provision of a comprehensive and integrated range of home and community care designed to provide basic maintenance and support services (both directly and through their carers), to persons within the target population and thereby to assist them to retain their independence in the community and avoid their premature or unnecessary admission to long-term residential care; and

to expand and develop home and community care services through the joint co-operation of the Commonwealth, the States, local governments and community organisations representing both service providers and users under a single cost-shared arrangement.

Those two objectives are very worthy indeed. Anybody who has had anyone who has been critically ill or severely disabled in their home for some considerable time will realise immediately that those patients, those individual persons, prefer for the most part to remain at home. Nevertheless, it must be acknowledged- acknowledged it is by the Minister, the Opposition, myself and others-that a great deal of stress and strain is placed on the carers. I believe that the intention of this Bill is to co-ordinate the variety of programs that are running throughout Australia to ensure that those carers and patients are given the best deal possible in the circumstances.

The Minister has adverted to the fact that a very substantial number of people are in the target group. He has indicated in his second reading speech that the 1980 Australian Bureau of Statistics survey on disability revealed that around 325,000 people over 65 years of age were severely or moderately handicapped and that over 70 per cent of this group live in the community. The interesting point is that that figure of 325,000 represents 42 per cent of the total moderately and severely handicapped population. There are a large number of others, of course, including the young. I admire greatly those families who nurture and bring up young disabled people. The Minister will recall that I have been in correspondence with him on their behalf in respect of respite care programs. It is necessary for these people from time to time to be able to get out of the home and have somewhere for the child to be looked after for a period. If this measure is going to improve that situation I applaud it and I applaud the work that has been done by the Minister and others on this development.

I would like to raise a couple of matters besides that of respite care. Those matters deal with independence, transport and people in the bush. I wonder how far work has proceeded in examining the possibility of some sort of voucher arrangement or financial arrangement whereby carers can apply some of the amount which would otherwise be applied to the provision of transport to the provision of other services, particularly in areas where these services are not readily available. I am referring to country areas.


Senator Peter Baume —Cash versus services.


Senator HARRADINE —It is a cash versus services situation where services are not available. I imagine a fair bit of work has been done on that but I would be interested to know. If not now, then at some stage I would be obliged if the Minister could give me access to expert advisers in this area.

The other matter dealt with by Senator Grimes was the no growth category of post-acute care, palliative care and services primarily to families in crisis, and services designed specifically for a particular disability group. It has been noted that services for these groups will be maintained at the existing level. However, as the Minister has indicated, this does not mean that people who suffer from a particular disability such as multiple sclerosis or a psychiatric disorder will be excluded from receiving services under the home and community care program. On the contrary, people requiring such basic support as will be provided through the home and community care program will, of course, be eligible, but the new program is not a vehicle for the provision of specialist services or for other services which have traditionally been the functions of other Commonwealth and State services.

However, I wish to make the point that somewhere along the line it must be admitted that the demand for these services is indeed great and it is important to ensure that the money amounts being made available for these services are increased. If that means they have to be increased from the State level, that is where it will have to come from. But certainly I believe that the review that is promised ought to examine where this matter has gone. Indeed, before that review is undertaken a monitoring of the situation in respect of those programs should be undertaken.

I wish to make this final remark: The community-indeed, we as human beings-owe a great debt of gratitude to those carers who recognise the inherent human rights to life of those persons whom they are caring for in their own homes, and in particular those who are doing so under enormous pressures and strains. I know many of them do it very happily, but others work under a cloud and under strain and do not readily recognise the great task that they are undertaking and the great merit that derives therefrom. My support is for a co-ordination of services to assist these people and the target groups. My concern is that there could be a great deal of bureaucratic control. I am also concerned about the amount of money that might flow. I know that the Minister said in his second reading speech that there will be a 20 per cent increase in money terms in 1987-88, as well as a 20 per cent increase in each successive year. I do not know whether that is going to be sufficient. In fact, I very much doubt whether it will be, because, due to techniques in medicine-the Minister would know this better than I-the rate of longevity will increase. A recent report from the Department of Immigration and Ethnic Affairs said that in the last 100 years the longevity rate had increased by 10 years, and that that will increase by another eight years in the next 36 years. So I believe the 20 per cent increase in money terms may very well be below the mark. I believe that both we and those who are responsible for the review should look at that. In closing, I congratulate those who have worked on this legislation. It seems to me to be worthy of support, and I hope it is successful.