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Wednesday, 2 December 1998
Page: 1052


Senator DENMAN (11:53 AM) —No-one would object to measures aimed at increasing the level of care given to the elderly. They, more than most, deserve our support and care in their later years. After all, they fought and died for us and gave this country a foundation to build upon. The Aged Care Amendment (Accreditation Agency) Bill 1998 merely creates an illusion of increasing that standard level of care. In its current form, that is all that it is—an illusion.

Accreditation can be a useful tool to achieve minimum standards of care, but this can only be achieved if the measure is clear and implementation well considered. As the bill stands, none of these basic requirements are present. A major deficit in the legislation, causing insecurity within the sector, is that there is no indication of the costs of the implementation of this accreditation to the various providers.

Stability, both emotional and financial, is vital in a sector, and this is particularly true of community services. If the community service providers of that care are insecure, it will inevitably flow on from even the most professional of providers of care to the clients. This ill-conceived amendment is creating this insecurity because the costs of its implementation are not known. What is known is that there are hidden costs associated with the implementation of the standardised service delivery standards. These costs include employing within their budget the additional administration time, and the time to observe and report, that all accreditation systems require, particularly at their instigation. Secondly, accreditation often incurs additional staff training costs both for learning how to implement the new system and for the additional training which may be required for staff to lift their skills to meet the required standard.

These are just a few of the hidden costs associated with the amendments proposed by the government. This bill is an example of how ill-conceived plans may actually contribute to a reduction in the standards that the amendment is seeking to redress. My home state of Tasmania has a large population of people requiring aged care. Thus the provision of aged care is an industry in our state that supplies employment for many people. While our regional and rural economy has many disadvantages, it can provide a special environment for caring for the aged. A moderate climate and a gentle pace of life contribute to idyllic circumstances to care for the elderly. However, this bill in its current form does not allow for the needs of the rural and regional sector, where economies of scale may cause prohibitive costs—for example, resident classification procedures that are too rigid to work practically in smaller residential hostels.

There are many other factors that can create additional costs to supplying care in regional Australia. Given this government's history of ill-conceived regional policy, combined with their apparent inadequacy when factoring in the needs of rural Australia, I can understand why many providers are extremely apprehensive about this bill.

The extent of the negative impact of this bill will differ from state to state. Each state has its own awards and regulations and the costs of implementing any of the changes could vary considerably. There appears to be no recognition of this at all in the amendment. I have had numerous communications expressing the insecurity of the sector not only on behalf of the organisations and their employees involved in the sector but also from the children of the elderly, who are also expressing their concerns. These concerns relate not only to the cost of providing the care but also to the need for reassurance that the costs associated with this bill will not mean the closure of some of these facilities, thereby endangering the health of the elderly.

In some cases this could result in the elderly moving from the district where they have spent most of their lives. This could have a serious detrimental effect if the elderly face a reduction in choice and are further isolated by the possible closure of the smaller rural hostels. This bill arrives just after another superficially conceived resident classification scale that resulted in immediate calls for review from the government's own partners—the former National Party government in Queensland—because it represented a substantial reduction in revenue from the Commonwealth that will have to be picked up either by the state government or by the elderly.

Largely as a result of this government, Tasmania cannot afford the transfer of the revenue base the reclassification represented. But when you see this amendment in its true light, you see that it also represents a transfer of cost away from the Commonwealth, which is currently responsible for the cost of monitoring standards via the Department of Health and Aged Care to the industry. Thus, the elderly and their families will inevitably pay the cost of accreditation, as the state cannot afford the additional burden and the industry can in no way soak up this cost that could amount to $10,000, just for the accreditation fee. This does not include the costs that may be incurred by satisfying the demands of accreditation, which may be as much as $50,000 for standards to be met. Is it any wonder there are many smaller facilities in Tasmania that are seriously contemplating closure, when presented with the never-ending cost liabilities this government has been imposing on the elderly?

The inability of the industry to absorb this cost becomes clear when we acknowledge that the industry has been savaged to the tune of $500 million in lost revenue since this government came into office. This does not include the additional losses the elderly have incurred in terms of service provision by losing dental care, choice in medication and numerous other erosions of benefits this government is responsible for.

Thus, aged care is in crisis, as are many other institutions since this government came to power. However, the elderly are particularly vulnerable and, as illustrated by my colleagues' illuminating communications over the past days, the elderly who live in regional and rural states such as my own are even more so. They are disadvantaged by ill-considered, superficial policies. Due to economies of scale, reductions in funding, transfer of cost away from the Commonwealth onto the elderly and a looming cloud of the GST, they will not have their day in the sun. Instead, due to this government, they are in real danger of being dislocated, penniless and cold.