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Labor's $467 million plan to tackle the aged care crisis [media statement] [and] Kim Beazley's plan for aged care.



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Kim Beazley - Labor's $467 Million Plan To Tackle The Aged Care Crisis http://www.alp.org.au//media/1001/kbmsage131001.html Tuesday, 16 October 2001

ALP News Statements

Labor's $467 Million Plan To Tackle The Aged Care Crisis Kim Beazley - Leader of the Opposition

Media Statement - 13 October 2001

A Labor Government will spend $467 million to address the crisis in aged care and to ensure our frail aged are cared for with respect and dignity.

The package I am announcing today will guarantee older Australians can get a nursing home bed in their local community when they need one and that our aged receive high quality care. It will deliver real beds, more care funding, more nurses and better care to our elderly.

Labor's commitment to Australia's aged includes:

A $287 million investment to get 'phantom' beds built. ● Increased funding of $180 million to fund quality care. ●

How we care for our elderly says much about the society we are. The Howard Government's aged care system has failed older Australians and placed families and public hospitals under immense pressure. Bronwyn Bishop's legacy is a national shortage of more than 12,000 aged care beds, longer waiting lists, fewer nurses and real cuts to care funding.

Getting 'phantom' beds built

Labor's first priority will be to deliver the 12,000 aged care beds that the frail aged on lengthy waiting lists need. I am today committing to an immediate investment of $287 million to turn Bronwyn Bishop's 'phantom' beds into real beds.

In addition to the capital funding already in the forward estimates ($63

million over four years), Labor will provide:

$200 million in interest-free capital loans to get new beds built in areas where there are shortages. ●

$50 million in interest-free capital loans to build better housing options for young people living in nursing homes. ●

$37 million in direct capital grants to build up to 1000 long-stay respite beds, freeing up aged care beds for people needing permanent residential care.

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A $180 million increase to fund quality care

Inadequate care funding under the Howard Government has made the provision of quality care unviable for many providers, and the aged care system is struggling to attract and retain qualified staff.

To guarantee high quality care for our frail aged and to stop nurses leaving, Labor will develop and implement a National Benchmark of Care. Under Labor, the level of care subsidies will be directly linked to the cost of providing benchmark levels of care.

The benchmark will take two years to develop, but Labor will increase care funding in the interim. The combined effect will be an increase in care funding of $180 million over four years. This will comprise:

$109.2 million over four years to improve pay and conditions for the aged care workforce, with a focus on tackling the wages gap between nurses in aged and acute care.

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$18.3 million over three years to ensure that real funding to nursing homes in Victoria and Tasmania is maintained. ●

$52.5 million in 2004-05 under the National Benchmark of Care. ●

Under Labor's plan to tackle the aged care crisis, I also guarantee:

Surprise inspections of all nursing homes at least once a year. ● Better-coordinated community care services and the maintenance of budgeted growth in community care funding. ●

Measures to keep nurses in the aged care sector. ● The delivery of appropriate staffing levels on every shift. ● Measures to drive bad providers out of the aged care industry. ● The cutting of red tape to free up four million hours of nursing time for

the care of residents. ●

Labor's plan is the most comprehensive aged care policy in Australia's history. It needs to be. After five years of neglect, funding cuts and ministerial incompetence, our frail aged, their families and our hospitals are saying enough is enough.

This plan will put the care back into aged care. It will ensure our frail aged can get a nursing home bed when and where they need one. Labor's guarantee is that all our elderly will be cared for with respect and dignity. Unlike John Howard, Labor believes older Australians deserve nothing less.

Kim Beazley's Plan for Aged Care

Authorised by Geoff Walsh, 19 National Circuit, Barton ACT 2600.

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Kim Beazley's Plan for Aged Care http://www.alp.org.au//policy/health/aged_care.html Tuesday, 16 October 2001

Kim Beazley's Plan for Aged Care Overview Putting the 'Care' Back Into Aged Care ❍

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The Howard Government's Failures ● Kim Beazley's Plan for Aged Care A Commitment to Community Care ❍ Tackling the Aged Care Bed Shortage ❍

Interest Free Capital Loans ❍ Capital Grants for Respite ❍ Getting Young People out of Nursing Homes ❍ Transition Care ❍

Flexible Options ❍ Better Planning ❍ Funding Quality Care ❍ Keeping Quality Staff ❍

Victoria and Tasmania - Maintaining Real Care ❍ More Funding for Care - A National Benchmark of Care ❍ More Staff for Better Care - Minimum Staffing Guidelines ❍ Ensuring Quality of Care ❍

One Strong Regulator ❍ Cutting the Red Tape ❍ More Surprise Inspections ❍ Getting Tough on Sub-Standard Homes ❍

An Aged Care Ombudsman ❍ Building an Aged Care Workforce ❍ Improving Wages and Conditions in Aged Care ❍ More Care Funding and More Staff ❍

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Less Paperwork, More Care ❍ Scholarships in Aged Care Nursing ❍ Costing ●

Overview

Putting The 'Care' Back Into Aged Care

"The test of a people is how it behaves toward the old. It is easy to love children. Even tyrants and dictators make a point of being fond of children. But affection and care of the old, the incurable, the helpless, are the true gold mines of a culture." Abraham Herschel, Philosopher

Labor will address the current crisis in aged care.

Labor will make aged care a priority because we believe older Australians have a right to be cared for with respect and dignity. We are committed to providing security for our aged and their families from the time they need help to mow the lawn, to the time they require residential or palliative care.

Like all Australians, Labor was shaken by the use of kerosene baths at the Riverside Nursing Home. We have watched the way the Howard Government has treated our elderly and we share the community's offence and unease.

We understand that the problems in the aged care system are as urgent as they are complex. They demand immediate action to get beds built and a longer-term strategy to ensure sustainable, quality care.

Unlike the Government, Labor has a plan to do both.

There are only two Australians who deny that our aged care system is in crisis.

The failure of John Howard and Bronwyn Bishop to acknowledge that there are problems shows they are not listening to the elderly, to families, to nurses, doctors or care staff.

Had they listened, they would have heard the loneliness of the frail resident who could not find a bed in his local community.

They would have heard the despair of a daughter who has faced a harrowing search for a nursing home place and an interminable wait to get her Mum settled.

They would have heard the weariness of an aged care nurse rushing from

resident to resident without the time to provide proper care.

Labor stands for putting the 'care' back into 'aged care' and meeting the residential and community care needs of older Australians. We stand for ensuring that our frail aged can find a nursing home bed when and where they need one. We stand for properly funding quality care and building a sustainable future for the aged care sector. And we stand for services that have more nurses and care staff, with more time to care.

Labor will help restore the community's confidence in our aged and community care system. Labor will ensure that our elderly are cared for with respect and dignity and that we provide both quality care and quality of life.

The Howard Government's Failures Whichever way you look at it, the Howard Government has failed on aged care. It has failed to ensure that there are enough beds and care services to meet the needs of our frail aged. It has failed to provide proper care funding and to guarantee high quality care. It has failed to get tough with sub-standard providers and drive them from the industry. And it has failed to protect vulnerable residents when they have been placed at serious risk.

The community care system is complex and fragmented. The aged and their carers need a map, compass and cut lunch to navigate their way to the supports and services they need.

When John Howard called the election he said the policy challenges of an ageing population would be a priority for his Government. It has not been a priority thus far. The National Strategy for an Ageing Australia (due in 1999) was abandoned in high farce on Day 3 of the campaign when Bronwyn Bishop refused to hand over the document. On Day 4, John Howard claimed that he would deliver an extra 6000 community care places (the majority in 2005-06) but provided funding for just 3200. The Howard Government has shown no capacity to plan for the aged and community care needs of older Australians and have left others to carry the burden.

Families have become desperate and distressed as they add the person they love to another lengthy waiting list further away from home. Carers have reached breaking point because they can't access planned or long-stay respite care. And older people have been left to wait in crowded public hospitals for want of a nursing home bed.

The Howard Government's aged care system has clearly failed older Australians and their families. It has failed on every count.

The Government's Top Ten Failures. John Howard and Bronwyn Bishop have:

Turned an 800 bed surplus when the Howard Government came to Office into a national shortage of 12,250 aged care beds. ●

Let two years pass without a single surprise inspection. ● Doubled the average wait for a nursing home bed before refusing to publish the latest waiting time data. ●

Issued over 15,000 licences for 'phantom' beds that have never been built. ●

Cut care funding in real terms, forcing providers to cut back on nurses, care staff and the standard of care. ●

Turned a blind eye, while nurses and care staff have been driven from the aged care system. ●

Left providers to fill their rosters with nurses working back-to-back shifts and casual agency staff. ●

Placed more emphasis on the documentation of care than its delivery. Placed more emphasis on paperwork than people. ●

Ignored recommendations by the Commonwealth Ombudsman to fix the Complaints Resolution Scheme. ●

Allowed providers who deal in sub-standard care to keep their doors open while homes committed to quality care have been forced to close their doors.

●

In June this year, the Minister was asked whether she was aware of a public report showing that a Sydney nursing home had failed critical care standards.

The Minister calmly replied: "Not until I saw it in the paper". (5 June 2001, 2GB interview)

The Report had been issued by her own Standards Agency.

Kim Beazley asked: "Prime Minister, how much worse do things have to get for aged and frail Australians before you sack Bronwyn Bishop?" (21 June 2001, Hansard)

The Prime Minister said, "I believe that my Minister has done an outstanding job." (21 June 2001, Hansard)

Labor and the Australian community know she has not.

Kim Beazley's Plan for Aged Care

A Commitment To Community Care

Labor is committed to supporting the health and care needs of older Australians who continue to live in the community. We understand that most older people want to stay in their own home for as long as they possibly can, and respect their preference for community-based care.

Community care services are critical to delivering the support older people need to remain at home. They encourage independence and improve quality of life. They provide vital support to carers whose contribution sustains our community care system. And they prevent early and inappropriate admission to residential care.

However, Labor believes that this vital part of our caring infrastructure is too complex and fragmented. It places enormous organisational strain on families at a time of personal and emotional stress.

While other service sectors talk about 'one stop shops', the Howard Government's community care system is a series of specialty boutiques scattered far and wide. Labor believes community care services need to be a source of support, not a source of anxiety and confusion at an already stressful time.

While state and local governments deliver many of our community care services, Federal Labor will lead the better coordination of services across all levels of government. The cooperative funding arrangements delivered through Labor's Medicare Alliance will break down the boundaries between programs and stop the elderly and their families falling through the gaps.

A Beazley Labor Government will drive the consolidation and better coordination of our community care system. We will better integrate the complex amalgam of primary, acute and community care services, which currently meet the medical and care needs of the frail aged.

The Labor model of care will be a flexible and integrated network of care services which can respond to the diverse and changing support needs of older Australians. It is a model that supports the preference of older people to remain at home, and makes life easier for those coordinating their care.

Labor will maintain the budgeted growth in community care funding of $215 million over the next four years. This will provide total funding for Community Aged Care Packages (CACPs) and the Home and Community Care (HACC) program of $1.1 billion in 2004-05. We will also coordinate planning of CACPs and HACC services at a national level. This will ensure that as an individual's care needs grow, so to will their access to higher levels of support.

Under Labor, CACPs will be better targeted so they reach the people they were designed to help - the frail aged who would otherwise need hostel care.

We will also move to a tiered HACC system so that as a person moves from needing Meals on Wheels or help mowing the lawn, to needing a more comprehensive range of services, they will get access to extra organisational support or individualised funding.

In Labor's HACC model, 'HACC Basic' will provide for the majority of clients who need just one or two services. HACC Plus will provide co-ordination support and case management for those who need a broader range of services, while HACC Exceptional will provide individualised funding for people with high and complex care needs.

Labor will also improve access to respite care by providing $37 million in capital grants to build long-stay respite facilities. Planned respite care is a vital support for older Australians and carers, offering them greater control over their lives and a much-deserved break.

Labor will be releasing our full Carers Policy later in the campaign. As our population ages - and individuals and families assert a preference for home-based care - we must focus on enabling carers to sustain their caring responsibilities. We will also be announcing initiatives to improve the skills and training of community care workers as part of our Employment and Training Policy.

Labor's community care system will enable older people, families and carers to access the care they need with ease and confidence. It is a care-centred system that will enable older Australians to remain in their homes and communities, with increased independence and greater control over their lives.

Tackling The Aged Care Bed Shortage

"Vincent Marina has been lying in Melbourne's Western General Hospital for eight weeks because no nursing home bed can be found for him. Marino's daughter, Connie, says the stress of trying to find a nursing home has split the family. When she looked at the 'good' homes, they all had waiting lists. As for the 'bad' ones, you wouldn't put a dog in. When you see what's happened to Dad it makes you afraid of growing old." The Age, 27 August 2001

Across Australia, thousands of our frail aged face an unacceptable wait for a nursing home bed. For each person on the waiting list there is a partner, son or daughter searching desperately for a bed and struggling to provide the specialist care that the person they love requires.

Labor's first priority is to deliver the beds and care that frail elderly Australians on waiting lists need.

The Coalition has turned an 800 bed surplus when it came to Office, into a national bed shortage that has passed the 12,000 mark and continues to grow. It has issued thousands of licences for 'phantom' beds that have yet to see the light of day. It has doubled the average wait for a nursing home bed from 29 to 55 days and is refusing to publish the latest waiting time data.

When the Howard Government was asked about the explosion in waiting times the response was "older people are willing to wait" (Senate Hansard, 29 March 2001).

Labor is not willing to wait. Unless we get beds on the ground our frail aged, their families and our public hospitals will continue to suffer.

In the longer term, Labor will build a properly-funded aged and community care system that will provide older Australians with the aged care services they need, when and where they need them. In the short term, we have an immediate problem to solve. Labor has a six-part plan - six immediate actions - to bring Bronwyn Bishop's 15,000 'phantom' beds to life.

Interest Free Capital Loans

While the Howard Government has handed out more and more aged care bed licences, fewer and fewer are turning into beds. Many providers have decided they can't afford to build new aged care beds when the Government's care funding doesn't cover their costs. They are handing back their licences and deferring plans to invest. The result is 15,000 'phantom' beds and a problem for Labor to solve.

To get 'phantom' beds built requires a commitment to increased care funding and an injection of capital to make investment in residential aged care a going concern. Labor will deliver on both.

Labor will provide $200 million in interest free capital loans to get new beds built in areas where there is a bed shortage. This is in addition to current capital funding of $63 million over four years. Loans will also be available to re-furbish existing facilities in areas where there are shortages. Priority will also be given to proposals providing for the specific care needs of residents with dementia and those from non-English speaking backgrounds.

The funding arrangements introduced by the Howard Government in 1997 are not getting beds built, especially not in regional and rural Australia. Labor's $200 million in interest free loans will break the impasse. We can then begin work with consumers and the sector on a long-term plan to meet future capital needs. Unlike John Howard, Labor does not believe that nursing home bonds are the way of the future.

Capital Grants For Respite

A number of our aged care beds can be allocated to permanent residents or

made available for residential respite care. For many providers, clients, and carers these respite arrangements have proved unsatisfactory. In many regions respite care must now be booked a year in advance, if it is available at all. As a result, carers are not getting the breaks they need. A nursing home may also be an inappropriate care environment for people with disability or for older people who require respite care but who can eventually return home.

Labor will provide $37 million in direct capital grants to build long-stay respite facilities. These will provide a more appropriate care environment for people with a disability, frailty, mental illness or chronic conditions who require respite care.

The Commonwealth will enter capital partnerships with other levels of government or organisations to deliver respite beds to those areas where they are not available. Based on capital-fund matching this initiative will provide up to 1000 new respite beds. These may be located in a purpose-built respite facility or co-located with existing residential or day care services.

Labor's Capital Grants for Respite program will address three care needs. First, it provides more appropriate accommodation for those who need respite care. Second, it provides carers with the chance for a longer break. Supporting carers reduces the chance of early or inappropriate admission to residential care. Finally, the provision of up to 1,000 new respite beds frees up aged care beds for people on waiting lists for permanent residential care.

Getting Young People Out Of Nursing Homes

Across Australia, there are more than 1,000 young people with disability living in nursing homes because no other accommodation is available. Some have Multiple Sclerosis (MS). Others have Acquired Brain Injury (ABI) as a result of a car or diving accident. For these younger people nursing homes can be totally inappropriate to their medical, social and emotional support needs. A 20 year-old with ABI, who is not allowed to play loud music or eat dinner after five, may have little quality of life.

Labor will provide $50 million in interest free capital loans to create more appropriate housing solutions for young people with disability currently resident in nursing homes. Capital loans will be available to organisations that can demonstrate that their proposed housing model reflects the preferences and needs of people with disability.

Once again, this measure reflects Labor's commitment to meeting the care needs of individuals. It provides more appropriate housing options for younger people with disability and frees up nursing home beds designed for -and needed by - the frail aged.

In the longer term, Labor will work with the States to ensure that there is no ongoing placement of people with disability in nursing homes. This will be a

joint objective of the Commonwealth State Disability Agreement and Labor's Medicare Alliance.

We currently have a situation where cost shifting and blame shifting between the Commonwealth and the States operates on a number of levels. The State health system is under pressure because the Commonwealth has not supplied enough nursing home beds, leaving the frail aged to wait in public hospitals. At the same time, a number of Commonwealth nursing home beds are being occupied by people with disability because the States have not provided enough supported accommodation and respite care.

Only Labor is prepared to enter agreements with the States, which will ensure that funding will support the sick, frail and people with disability in the most appropriate care environment.

Transition Care

Many older Australians have been left stranded in public hospitals because of the acute shortage of nursing home and convalescent beds, and shortage of care packages for those able to return home.

Bronwyn Bishop's 'phantom' aged care beds have left many of our frail aged on ever-growing waiting lists. Others have been forced to accept a bed in a distant suburb or town away from their family and friends.

Labor will not stand for older people receiving inappropriate care.

Labor will provide new funding for better transitions between the health and aged care systems. Details will be announced in our Health Policy prior to the election. The funding will provide appropriate convalescent care for older people who are ready to leave hospital, have been assessed as needing nursing home care, but are unable to access a nursing home bed

State hospitals will receive the care subsidies that would have flowed to nursing homes if beds had been available. These funds will enable hospitals to care for the frail aged in a more appropriate and homely care environment.

Hospitals can use funds to provide care options which best meet the needs of the patient - convalescent care beds in the hospital; paying for nursing home type care in other appropriate care settings; or providing high level community care at home.

Some people will still require a nursing home bed when one becomes available. However the 'convalescent period' will give the individual and their family the time and space to explore and consider their care options. For others, appropriate convalescent care provides a chance to get better, enabling them to return home with the support of community care services.

Flexible Options

Following consultation with the aged and community care sector, Labor will pursue 'flexible care options' to alleviate the pressure on residential care.

First, Labor will audit spare capacity in existing facilities. We will examine granting temporary licences where the facility meets accreditation and building standards. We cannot afford to have a new fully compliant facility -like the Cabrini Nursing Home in Melbourne - standing empty for months on end because the Government did not issue it bed licences.

Second, Labor may allow providers holding (unbuilt) low care licences to convert them to Community Aged Care Packages (CACPs) on a temporary basis. We could also allow low care facilities to take high care residents, where the facility has the staff and clinical capacity to deliver high-level care.

Third, Labor will aim to accelerate the roll out of Extended Aged Care at Home (EACH) places. The EACH program delivers nursing home-level care in the individual's home and has been successfully trialed. The positive evaluation found that many people - who would otherwise enter nursing homes - could receive quality care at home through the EACH program. An expansion of the EACH program will meet care needs while reducing waiting lists for residential care.

Fourth, Labor will consider allowing some providers to convert unbuilt aged care bed licences into EACH places, in regions with a chronic shortage of aged care beds. EACH places can be up and running almost immediately, providing high-level care to the frail aged who would prefer to - and are able to - remain at home. Under the Howard Government's system, care funding attached to an aged care bed licence is 'locked up' until the bed is built. Converting a number of phantom beds to EACH places will allow care funding to flow and reduce the demand for nursing home care.

Finally, Labor will better target Community Aged Care Packages (CACPs) to ensure they meet the needs of the target population, and take the pressure off aged care hostels.

Better Planning

Labor has a comprehensive strategy to address the current aged care bed crisis but we will also make sure that Bronwyn Bishop's aged care crisis never happens again.

Labor will introduce a new approach to aged care planning. Planning failures are at the heart of the current crisis and changes are needed to ensure a sustainable future.

If we are to meet the future care needs and preferences of an ageing population, a long-term and integrated planning framework is required. Our

challenge is to allocate resources to the supports and services that older people need and to the communities where they live.

Labor will begin by replacing the annual 'lucky dip' allocation round for aged care services with a longer planning cycle. We will start by projecting the care services a particular area will require five years down the track. Beds and packages will then be allocated for a three-to-five year period and providers will build and deliver these services in accordance with an agreed timetable. This approach will provide greater certainty for the aged care sector. It will encourage investment in residential aged care and ensure that beds are open for care when they are needed.

Labor will also review the aged care planning ratios to ensure that they reflect an appropriate division of resources between residential and community care, and take account of the growing need for dementia-specific and ethnic-specific care services.

At a broader level, Labor will work towards an integrated planning model. We will start from the network of health, community and residential care services available in a local area and consider its compatibility - or otherwise - with the care needs and preferences of local people. One of the reasons why the current system is awry is that aged care planning regions are far too large. Another is that the allocations for different types of care services are not coordinated.

To support an integrated and local approach, Labor will align the allocation rounds for aged care beds, Community Aged Care Packages (CACPs) and Home and Community Care (HACC) services. We will encourage local providers to form strategic partnerships and provide for the care needs of older clients from the time they need help to mow the lawn, to the time they need nursing home or palliative care. By building these caring relationships we will reduce the 'organisational' stress on family members and carers.

Funding Quality Care

Labor has a plan to ensure that the frail aged can access the care they need. But we must ensure that the care they receive is of the highest quality. Labor will properly fund quality care to ensure high standards of care for our frail aged and a sustainable future for our aged care services.

Doctors, nurses, providers, residents and families agree. The current crisis in aged care is the direct result of the Howard Government's failure to provide adequate care funding. As a result, staff have been cut and elderly residents are waiting longer to be toileted, showered and fed.

Care standards are being jeopardised by the failure of the Government's funding system to focus on care. The absence of any link between funding and the cost of providing care has made the provision of quality care unviable for many providers. Many are handing back bed licences and deferring

decisions to either invest in new facilities or upgrade existing ones.

Bronwyn Bishop can hand out licences until the cows come home but unless we address the inadequacy of daily care subsidies, licences will not become beds and waiting times will continue to grow.

Over the last five years, John Howard has delivered real cuts to care subsidies and particularly savage cuts to care funding in Victoria and Tasmania. Indexation has not kept pace with the growth in staffing costs forcing providers to cut back on nurses, care workers and the standard of care.

Aged care nurses are underpaid relative to nurses in acute care hospitals, while many care workers can earn more working in a supermarket or call centre. It should come as no surprise that the Howard Government's system is struggling to attract and retain qualified care staff. As remaining staff are forced to work double shifts, and facilities rely on casual and agency staff to fill their rosters, the quality and continuity of resident care suffers.

The only way to guarantee high quality care for our frail aged is to return care to the centre of the aged care funding equation and to stop our nurses leaving. Labor will deliver more care funding to do just that.

Keeping Qualified Staff

To ensure that our nursing homes can attract and retain qualified staff, Labor will inject $109.2 million over four years to improve pay and conditions for aged care workers. Particular attention will be given to closing the wages gap between the acute and aged care sectors. It is an immediate commitment that will deliver more nurses, more care staff and more care.

By improving the pay, conditions and career structures available to our aged care workforce, we will stem the flow of nurses and care staff from our residential facilities. This will improve both the quality and continuity of resident care.

Victoria And Tasmania - Maintaining Real Care

Labor will commit $18.3 million over three years to ensure that real funding to nursing homes in Victoria and Tasmania is maintained.

Under the Howard Government's 'funding equalisation' strategy, real care subsidies in Victoria and Tasmania have been frozen until 2006-07 to bring their funding into line with a notional national average. No explanation has been given as to how nursing homes in Victoria and Tasmania are expected to maintain care standards over the next five years as their costs rise and their funding falls in real terms.

In both States, the aged care sector is already under pressure and the

community has genuine concerns about the quality of care being provided. Labor will guarantee the planned real increases in care funding to (historically under-funded) Queensland nursing homes. But now is not the time to cut real funding to their Victorian and Tasmanian counterparts. Labor's package will guarantee that care subsidies in Victoria and Tasmania are maintained in real terms.

More Care Funding - A National Benchmark Of Care

A sustainable future for the aged care sector requires a long-term strategy for properly funding care. Labor has committed to increasing care funding so that our frail aged get the care they deserve.

In 1999, the Productivity Commission described the Government's funding of aged care as "inappropriate and inequitable" and urged them to introduce a national benchmark of care. Having asked the Commission for advice, the Government flatly rejected their recommendations. Labor will put them in place.

As we announced in February this year, Labor will develop and implement a National Benchmark of Care to ensure that aged care in Australia is of the highest quality. For the first time, a clear set of standards will spell out the level and quality of care to be delivered to all older Australians in nursing homes.

Under Labor, aged care funding will explicitly link the level of care subsidies to the cost of providing the National Benchmark of Care. Subsidies will be indexed against changes in component costs to ensure that care funding is maintained in real terms.

The National Benchmark of Care will be developed over the next two years in consultation with aged care consumers, providers, employees and community representatives. This will represent a new benchmark in aged care funding for the future.

In 2004-05, Labor's National Benchmark of Care will deliver an extra $52.5 million in care funding. This will be in addition to the $40 million we will provide in 2004-05 to address the wages gap between the aged and acute care sectors. The additional $92.5 million per annum from 2004-05 will address current under-funding and finance improved care standards.

The National Benchmark of Care is a new approach to funding that will create certainty rather than doubt. Our elderly, and their families, will know what level of care they are entitled to receive. Nursing homes will know what level of care they are being funded to provide. Providers can invest in aged care, secure in the knowledge that care funding will reflect their costs and ensure viability.

In the long-term, Labor's National Benchmark of Care will provide proper care funding to Australia's nursing homes and hostels and a secure, quality future for our aged care services.

More Staff For Better Care - Minimum Staffing Guidelines

"The aged residents, who often can't speak become objects. Facilities develop a production line mentality…As a registered nurse I've had to tell crying residents that I will try to come back later because I have several buzzers going and there is only two of us to look after 50 residents…Because staff haven't the time to care they often cease to care to survive…This facility considers itself to be above average." Registered Nurse

As part of our National Benchmark of Care, Labor will introduce minimum staffing guidelines.

Minimum staffing guidelines will ensure that on every shift, in every nursing home there are enough qualified staff to deliver quality care to our frail aged. Minimum staffing guidelines are not about rigid formulas and fixed ratios. They are not 'one size fits all.' We will develop guidelines that set the level of staff and the skill mix required to provide for the diverse care needs of residents.

A nursing home that provides dementia-specific or psycho-geriatric care will require a different mix of staff than a low-care hostel. Labor's guidelines will deliver the care, which residents with differing degrees of dependency and frailty need.

It would not seem possible to talk about quality care without talking about the nurses and carers who provide it. Much of the community's concern about care standards relates to under-staffed facilities and the national shortage of nurses. Yet the Howard Government has nothing to say on staffing. In the Government's deregulated system there are no minimum staffing levels.

Under-staffing not only effects the care of the elderly it affects their quality of life. Residents are waiting longer to be toileted, bathed and fed. There are few chances to share social time with their carers and fewer organised activities.

Labor's staffing guidelines will ensure that the frail aged receive quality care and that staff have the time and support to practice their vocation.

Ensuring Quality Of Care

It is the responsibility of government to regulate and monitor the care of

those who are vulnerable, and to ensure that their rights are at all times protected. This is particularly important for older Australians in residential care. Most are frail and suffer from some form of dementia. Many are unable to express their care needs or voice their concerns.

Labor supports effective regulation, accreditation and a drive for continuous improvement in the aged care sector. But we do not believe that the Howard Government's regulatory systems have done any of these jobs well.

Two years slid by without a single surprise inspection. Accreditation decisions are inconsistent and serious concerns have been raised about the independence of the Standards and Accreditation Agency. Regulatory arrangements are confused and focus on paper rather than people. There are so many authorities and inspection teams policing the sector, that time and resources are being stripped from the care of residents.

Labor will sort this mess out and deliver more effective regulation of aged care standards.

One Strong Regulator

There will be inherent tensions while ever the Standards and Accreditation Agency is charged with both a regulatory role, on behalf of the Government, and an accreditation role, on behalf of the sector.

Under Labor, the Agency will focus on accreditation and will drive continuous quality improvement in the aged care sector.

Unlike Bronwyn Bishop, Labor will appoint people to the Board of the Standards and Accreditation Agency on the basis of merit and experience.

Under Labor's system, the Department of Health and Aged Care will have sole responsibility for regulating and monitoring standards of care.

Cutting The Red Tape

As part of our commitment to a more effective regulatory system, Labor will dramatically reduce paperwork and red tape in the aged care sector.

We will simplify and streamline the Resident Classification Scale (RCS) following consultations with nurses, care staff and providers. At a minimum, Labor's RCS will have fewer questions, fewer classification levels and will be better integrated with other aged care paperwork.

RCS paperwork is to the aged care sector what the BAS is to small business. It is vital that the RCS is reconfigured so that the rationale for documentation is improving the care of residents. Care standards are currently being jeopardised as nurses spend more time documenting care than delivering it. As a result, many nurses are leaving the aged care sector.

On Bronwyn Bishop's watch, the RCS has been re-invented as a Peter Costello savings tool. The Department now employs 92 people who will carry out 24,000 classification reviews each year, clawing back $51 million in care subsidies per annum.

Labor argues that it is more important to consider why the assessment system has become less accurate over time and address the complexities and pressures generating classification errors. Simply clawing back care funds from providers does not build a better system and diverts funding from the provision of quality care.

If we can reduce the paperwork by four hours each day, in every nursing home, we will free up four million hours for resident care. Labor is committed to more effective regulation based on fewer forms and greater care.

More Surprise Inspections

Labor will not provide a place in our aged care system for homes that repeatedly breach care standards. The Department will conduct annual surprise inspections of all residential facilities and homes with a poor record of care will be targeted.

The Howard Government's failure to conduct a single surprise inspection for two years precipitated the crisis in aged care, when a small minority of providers took advantage of the lack of regulatory attention to reduce care standards.

Getting Tough On Sub-Standard Homes

Labor will introduce tougher sanctions to force sub-standard nursing homes to quickly meet our Benchmark levels of care. If homes are unwilling, or unable, to provide quality care, we will drive them from the industry.

At a time when beds are in short supply, and waiting times are long, closing down facilities and evacuating residents is not an answer. When residents are found to be at 'serious risk', Labor will immediately send in experienced care teams to manage sub-standard facilities and provide quality care.

An Aged Care Ombudsman

Labor will appoint an Aged Care Ombudsman to ensure that the rights of the frail aged in our nursing homes and hostels are at all times observed and protected.

The Ombudsman's first task will be to replace the Howard Government's Complaints Resolution Scheme with a system that works. Under the Government's scheme, serious complaints are not the subject of thorough

investigation while minor complaints are rarely resolved to the satisfaction of both parties.

Labor's Aged Care Ombudsman will design and implement a system to ensure that complaints are swiftly investigated and resolved. The Ombudsman will be empowered to investigate serious complaints, will be able to pursue complaints on a confidential basis and will work with the sector to promote the effective resolution of internal complaints.

Building The Aged Care Workforce

"Two Assistants in Nursing (AINs) are each responsible for approximately 14 residents. These days the average resident is often immobile and incontinent…In half an hour the two AINs are expected to change soiled linen under all residents, wind up beds, get some up and next to the bed and start showering. The lack of time means that the AINs quickly move from one resident to the other, handling soiled linen and inserting dentures…" Registered Nurse in aged care

At a time when demand for aged care services is growing rapidly we have a crisis in the aged care workforce. Nursing homes cannot fill their rosters and advertise vacancies for months on end without receiving a single application. Nurses are being asked to work sixteen hour shifts and are increasingly dependent on casual agency staff. Families acknowledge the skills and dedication of staff but wish they had the time to offer social and emotional support to the residents for whom they care.

As the stress, hours and responsibility escalate, experienced and committed nurses and care workers are leaving the aged care sector. Many are burnt-out and injured. Many are torn between deep concern for the wellbeing of their residents and colleagues and the ethics of working in a system that does not allow them to deliver proper care.

Nurses and care staff are leaving because the Howard Government's aged care system does not respect their vocation. Every departure represents a diminished level of care for our frail aged but the Minister - ignoring all evidence to the contrary - denies there is a problem.

Bronwyn Bishop brushes off the aged care nursing crisis as a 'State responsibility' (it isn't) and notes that 'young women today have other career options' (they do).

The Minister responsible for residential aged care has denied any responsibility for aged care staff and the quality of care they deliver. She has failed to understand the complexity and gravity of the current crisis and to provide the comprehensive policy response needed to fix it.

This may be good enough for Bronwyn Bishop but it is not good enough for aged care nurses and care staff, and the residents for whom they care. It is certainly not good enough for Labor.

Labor understands that the crisis in the aged care workforce is being driven by a range of factors - poor wages, long hours, excessive paperwork, staff shortages, high rates of injury, limited opportunities to develop specialist skills and limited career paths. All of these must be addressed to enable the aged care sector to attract and retain the staff needed to deliver quality care. Labor has a comprehensive plan to do just that.

Improving Wages And Conditions In Aged Care

As discussed earlier, Labor will commit $109.2 million over four years to improve the pay and conditions of aged care workers. Particular attention will be given to closing the wages gap between the acute and aged care sectors. It is a commitment that will deliver more nurses, more care staff and more care. In government, we will negotiate funding arrangements to ensure that our wages allocation is used to close the gap.

For nurses who are tired of double shifts and paperwork, the wages gap between the aged and acute sectors is often the final straw. Aged care nursing is physically and emotionally demanding and rhetoric about 'valuing staff' has little meaning if an aged care nurse can earn an extra $100 a week by moving to the public hospital down the road.

More Care Funding And More Staff

The implementation of the National Benchmark of Care, along with the funding to improve wages and conditions and other initiatives, will deliver a total of $100 million a year in additional care funding to our nursing homes and hostels. The introduction of minimum staffing guidelines alongside the Benchmark will ensure this care additional funding delivers more staff and better care.

Labor's minimum staffing guidelines will also help to attract and retain qualified staff. Under Labor, nurses and care staff can report for work, secure in the knowledge that the roster will have the staff and skills to deliver care of the highest order.

Less Paperwork, More Care

"More time is spent writing about residents than attending to their needs." Josephine, Aged Care RN 2, Victoria

Nurses will also take comfort from the fact that under Labor they will spend less time documenting care and more time delivering it. By simplifying and streamlining the Resident Classification Scale (RCS), Labor will ameliorate one of the factors driving aged care nurses away.

Nurses are leaving the aged care sector because the demands of RCS paperwork leave them with little time to practice their vocation.

The Government admits that RCS documentation is not about resident care planning and does not specify medication requirements. The paperwork is an accountability tool that has no bearing on the quality of care that residents receive.

Australia is the only country in the world in which nurses have responsibility for funding decisions. Our nurses have their professional and clinical judgement questioned by RCS validation teams who scrutinise the paperwork but not the standard of care delivered.

As we said earlier, if a simplified RCS can reduce paperwork by four hours each day, in every nursing home, we will free up four million hours for resident care. Labor, nurses and care staff are ready to embrace fewer forms and greater care.

Scholarships In Aged Care Nursing

Aged care residents are increasingly frail and dependent, and require nurses with specialist skills in geriatric and dementia care to meet their complex care needs. When the Howard Government slashed HECS-based graduate places - and made specialist graduate nursing courses full fee paying - they created a major financial barrier for aged care nurses keen to undertake post graduate training.

As part of Labor's Nursing Workforce Package, we will provide HECS scholarships for postgraduate positions, to increase the number of nurses with specialist skills in aged care. And we will provide a further incentive by meeting the HECS repayments for postgraduate nurses who agree to work in aged care for a period equivalent to the length of their course.

The combination of these measures will give aged care nurses much easier access to postgraduate training without requiring them to meet the cost of fees from their own pockets. Where nurses take up HECS funded places they will have options to "work off" their HECS obligations by making an appropriate commitment to work in aged care.

Labor sees the development of specialist skills in aged care as critical to improving the status of aged care within nursing, and - in the long-term - to attracting nurses to the sector.

Costing

  01-02 02-03 03-04 04-05 Total

Improving Wages and Conditions in Aged Care 10.0 26.7 32.5 40 109.2

Victorian and Tasmanian Supplementation 0 3.3 7.5 7.5 18.3

Benchmark of Care 0 0 0 52.5 52.5

Respite Care 37.0 0 0 0 37.0

Loans for Aged Care Beds (1) 0 0 0 0 0

Loans for Accommodating Young People in Nursing Homes (2) 0 0 0 0 0

Annual Surprise Inspections (3) 0 0 0 0 0

Aged Care Ombudsman (4) 0 0 0 0 0

Better Planning 0 0 0 0 0

Cutting Red Tape 0 0 0 0 0

Aged Care Nursing Scholarships (5) 0 0 0 0 0

TOTAL (millions) 47.0 30.0 40.0 100.0 217.0

(1) The provision of $200 million of loans under this initiative affects only the composition of the Commonwealth's financial assets. As such this measure has no direct impact on fiscal balance. These loans are made possible because of the early repayment of debt from the corporatisation of the Snowy Mountains Hydro Electric Authority. The public debt interest implications are $11 million per annum commencing 2002-03. For costing purposes, and consistent with page 5 of the Guidelines for Costing Election Commitments circulated on 8 October 2001, this adjustment will not be included against the measure but will be subsequently included by Labor as an adjustment in the Treasury Portfolio.

(2) Refer to Endnote 1. The Public Debt Interest implications are $2.75 million per annum commencing 2002-03.

(3) Funding for the Aged Care Ombudsman assumes the abolition of the Aged Care Complaints Commissioner from 2002-03 (saving $997,000 per annum) and the redirection of $300,000 per year from the 2001-02 budget initiative pertaining to the Complaints Resolution Scheme. This will provide a total budget for the Ombudsman of $1.3 million per annum.

(4) Labor's initiative will ensure more inspections will be conducted without notice. Any addition to the total number of inspection visits will be covered by the allocation of an additional $10 million over four years in the 2001-02 Budget.

(5) Funding for this initiative was announced as part of Labor's National Nursing Policy on 11 October 2001.

Authorised by Geoff Walsh, 19 National Circuit, Barton ACT 2600.