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Wednesday, 2 December 1998
Page: 1044


Senator WOODLEY (11:02 AM) —The bill we are debating today, the Aged Care Amendment (Accreditation Agency) Bill 1998 , is a bill that puts enables the Aged Care Standards and Accreditation Agency to do a very necessary thing, and that is to charge aged care services fees for accreditation to enable it to partly fund its operation. The point is, of course, that from 2001 all aged care services must be accredited in order to receive Commonwealth subsidy for the provision of aged care. The government has established the Aged Care Standards and Accreditation Agency to manage the accreditation of aged care services. We agree with the government and with the Labor Party that it is very necessary that these things should be properly accredited and properly accountable.

I think all of us are concerned with this issue because all of us have relatives who are aged and therefore require this kind of assistance or assistance through other government measures, or we ourselves know that one day we will face the need for this kind of help. So there is no doubt about it that aged care is an issue that involves all of us, either by proxy or directly. This bill seeks to enable the agency to partly fund its operations through a fee.

I want to point out that the amendment does not set the level of fees for aged care services. That will be set through subordinate legislation, through regulations. We understand that those regulations will be subject to disallowance. We agree with the Labor Party that it really is a pig in a poke for the industry to be hearing that fees will be imposed but not to know what the level of the fees might be. But they are separate issues, and the Democrats do support the establishment of the agency and the ability of the agency to fund itself partly through this particular method. We will, however, be very careful to scrutinise the subordinate legislation, the regulations, which will set those fees. If necessary, we will certainly be involved in disallowing that schedule of fees if they are not realistic—realistic in terms of funding for the agency but, even more importantly, realistic in terms of the ability of the industry to cope with the level of fees charged. So the minister might address in his speech or in the committee stage the question of disallowance, that we have the assurance that we will have the ability to disallow the fee level if it is not in line with what the Democrats believe is a fair thing.

The other issue which the Labor Party has raised is one which is also very important to me personally but also to the Democrats as well. That is the effect on small rural and remote communities and the ability of their services to pay fees when most of them are really struggling to maintain, in the government's words, their own aged folk within their own communities. The working title for some of these reforms that I think the Senate would remember was the title `Ageing in Place'. The Democrats very strongly endorse that concept, that not only should people be able to enter a facility and stay within that one place but also they should be able to enter aged care institutions within their geographic location, particularly for rural communities. People in rural areas who want to stay there ought to be able to do so and not have to be sent, or even have to make the choice to travel, hundreds of kilometres from where they have lived all their lives and where they have the support of friends and relatives, which are things that are very important to them.

The whole idea of ageing in place was one which we endorsed very strongly, and we want to make sure that for those small communities and those small services in those areas the fee structure will not inhibit their ability to operate when we know that many of them are really stretched in terms of their ability even at the present time. So another question to the minister to address is that we have had some assurance that there will be a differentiated fee for small rural and remote services, and we really do need on the record a very strong assurance that that will be so. Then, of course, once the regulations are put in place we will look at the schedule of fees to see if that is so.

We understand that the Labor Party will oppose the bill. As I have listened to the debate, I have had some sympathy for that position. But we believe that they are confusing two issues at this point. The two issues are whether or not the agency should be able to fund itself through a fee structure and the level of fees themselves. We believe that we need to separate those two issues.

From our conversations, the feedback that we get from the industry is divided. But, on balance, the feedback is that the industry does believe that the agency should go ahead and that it should be able to charge fees but that, once the fees have been set, if they are too high we certainly need to have the ability to disallow them. So we would separate those two issues—as they are separate in terms of the legislation and the regulations—and we will support the legislation, although we will certainly listen to the debate. I know the Labor Party have amendments. I will be listening carefully to the justification for those amendments. At this stage I would not rule out supporting them, but we will need to hear the reasons for them. At this stage, however, the Democrats will support this legislation because we believe the principle is right.

Most of the groups to whom we spoke believe that giving the accreditation agency the ability to charge fees needs to be seen as a separate issue to the level of the fees themselves. Certainly that was the feedback we got from Aged Care Australia and Community Services Australia of the Uniting Church. They believe this legislation should be passed because, without the ability to charge for services, the accreditation process itself may fall over. As the Labor Party have said, nobody wants that to happen. We want the accreditation process to go ahead because that is absolutely critical.

Those are the issues on which we need to hear from the government. We understand the Labor Party's position in respect of their philosophy on aged care; that is, that the Commonwealth should be responsible for the total funding of aged care. We have had this debate on quite a number of occasions. The Democrats do not agree with that because we are simply aware of the reality of the tremendous cost which is involved. We have also said that we know there are people who are quite willing and able to make a contribution to their own care and their own accommodation in their old age. We would not want to inhibit those people from also contributing and therefore, in a sense, cross-subsidising the people who are unable to pay.

The Senate would be aware of the work that the Democrats did with the major churches in establishing the subsidy for financially disadvantaged residents. I understand that that part of the reforms is the one part that is really working well. I understand that in most institutions there is no need for the mandatory level of financially disadvantaged residents and that most institutions are exceeding that because the $12 a day subsidy is actually working very well. We are pleased about that.

I need to put on the record that we do not altogether accept the Labor Party's position that the Commonwealth has to totally fund aged care. If, in an ideal world, that were possible, we would accept it. But I noted that even the Labor Party did not actually promise in their election policy on aged care to fund adequately the amount which would have been needed for the infrastructure upgrades. That really meant that the Labor Party were saying it was not really possible to do it totally through government funding.

That was one of the problems that we saw with the Labor Party's policy. In an ideal world we would endorse it, but in the real world there are those who are willing and able to pay for their accommodation in their old age. We believe there should be at least an ability for them to do so, while endorsing very strongly the subsidy which we helped to negotiate for financially disadvantaged residents.

The Democrats will be supporting this legislation. We will listen to the case for any reasonable amendments to it and at that time we will respond. But, in principle, the legislation has our support while we signal that, once the level of fees are established and providing that they are a disallowable instrument, we will certainly want to return to the debate about whether or not the fees which are set are fair. We certainly will want to have an assurance on—and will monitor very carefully—the effect of fees on rural, remote and small services.