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Tuesday, 25 September 1973
Page: 1487

Mr BERINSON (Perth) - This is a cognate debate on 3 social security Bills. I intend to restrict my comments, in much the same way as did the previous speaker, the honourable member for Sturt (Mr Wilson), to one of the Bills - the Aged Persons Homes Bill. In strictly mechanical terms this Bill accounts for only 2 small differences to the existing scheme. It makes allowance for an increase in the personal care subsidy from $10 to $12 per week. In the second place it eliminates the age of 80 as a sole criterion for eligibility for that subsidy and extends it to those who require and actually receive personal care irrespective of their age. That second extension of the scheme strikes me as being logical and sensible. Not only that, it also strikes me as being a good example which we should be carefully considering for the purpose of extensions in other areas as well. If I could give just one example of that proposal 1 would refer to the domiciliary nursing care subsidy.

This is a new scheme. It was implemented from the beginning of this year and we have had limited experience of it. But we will presumably continue it and if it is to continue it seems to me to be hard to find any justification for restricting its availability to persons caring for aged relatives. The requirements of eligibility for personal care subsidy as they are summarised in the recent annual report of the Department of Social Security are simply put this way:

To be eligible for the benefit the patient must -

(i)   be aged 65 years or more;

(ii)   have been issued with a certificate (on the authorised form) by a medical practitioner that by reason of infirmity or illness, disease, incapacity or disability he has a continuing need for nursing care by a registered nurse;'

(iii)   have been issued with a certificate (on the authorised form) by a registered nurse that the patient is receiving nursing care involving at least two visits each week by the registered nurse.

If one considers those criteria for eligibility one will see that with the sole exception of this age limit - that the patient has to be at least 65 years of age - there is really nothing in the criteria that would prevent the benefit applying in reason or in logic or in fairness to a person who is under 65, such as a young paraplegic, to take one example. To take that case, there would be an opening for exactly the same sorts of arguments for staying at home, perhaps even greater arguments--

Mr Lloyd - Or handicapped children who stay at home.

Mr BERINSON - I take the point of the honourable member for Murray. I think it is a valid extension of the argument I am putting. We find exactly the same arguments available to us as apply to the aged people; that is, if it is desirable in the interest of the aged person to remain within a home environment rather than an institutional environment, or if one wants to be a bit more callous about it and simply look at the economic argument that even from the public point of view it is cheaper to keep a patient in those circumstances out of hospital rather than in hospital, I cannot for the life of me see how either of those arguments can apply to the person who reaches 65 years of age but not to one who has not reached that age. I am aware that the Minister for Social Security (Mr Hayden) is conscious of this problem. I hope that something will come of it. I give it just as one example of our tendency to pluck at some quite arbitrary dividing line and to make benefits available above the line and not below it.

As a matter of fact, in the same Aged Persons Homes Bill is another example of a requirement that a person has to be 65 if male or 60 if female to be eligible to be resident in a home covered by the Aged Persons Homes Act. Again, one wonders what there is in particular about the ages of 60 and 65 that make this facility so highly desirable - I accept that it is highly desirable that people in these categories should have the homes available to them - to be provided for persons above those ages and not to people below those ages, such as in the case of a person who is permanently reduced to the invalid pension. I give both of those examples in the hope that this first extension of the scheme cutting through one arbitrary age barrier might he extended into other areas as well.

I turn away from the details of the Bill to discuss some aspects of it in more general terms. Like other social security legislation that has been introduced by the Government, the Bill appears to me to be important not only for what it does, but also for what the

Minister said when introducing it. I am sure that the Minister will not mind if I say that one of the reasons I liked what he said was that it reminded me so much of what I have said in previous debates on the same subject.

Mr Daly - He had a good base to work from.

Mr BERINSON - He had a very good base to work from. The Leader of the House would know that as well as anyone present. I particularly welcome the view of the Minister for Social Security that residents of aged persons homes should have the right to elect representatives on management committees. I know that 'participation' is one of the current 'in' words. I suppose 'open government' are another two. But I want to say very earnestly to honourable members that it is not on that sort of ephemeral or abstract basis that I am advancing the proposition that residents of aged persons homes should have a voice in the management of their homes. I am not arguing for any abstract democratic principle; I am saying that this sort of development is highly desirable because tensions and misunderstandings in the environment of aged persons homes will inevitably arise otherwise to the discomfort and the unhappiness of the residents and also to the discomfort and concern of management committees.

Representation on those committees would automatically meet another course for which I have been arguing for some time, namely, that residents should have the right of access to detailed financial accounts of homes in which they live. I will not argue again - I think I have it in Hansard on 2 or 3 other occasions - about the insurmountable problems which presently exist when attempts are made by anyone other than the Director-General of Social Security to secure detailed financial statements of aged persons homes. Whether expressed or not my own experience has been that in the absence of this shared confidence, increases in rents or maintenance payments are almost invariably accompanied by feelings of resentment or at least suspicion by residents. I believe that to be unnecessary and so easily avoidable. Frankly, given the universal acceptance that no improper motives or activities by management committees could possibly be involved - on the contrary that they have earned the highest respect and gratitude of residents, their families and the Government alike - I have never been able to understand the general reticence of management committees on this question of taking residents into their confidence.

Recently 1 have had 2 welcome signs in my own electorate of a new approach to this question. Organisations have indicated voluntarily - because the Government has not reserved any rights to demand this co-operation - that they will offer this information. I hope that that is an example which will be followed not only by other homes in my own area but also generally wherever aged persons homes have been established. I also draw attention to and welcome the Minister's stated objectives of keeping rentals within the limits that pensioner residents can afford. I would tend to modify that statement just a little to say that they should be limited to the demonstrable costs of the home, although, given the special advantages of these homes, namely, the absence of interest payments and their exemption from such costs as land tax and water and municipal rates, in most cases the two should amount to the same thing.

I certainly see nothing in either of those approaches which would justify one unfortunate incident that occurred - again in my electorate - of a management committee seeking to establish a system whereby 20 per cent of each pension increase automatically goes to the home by way of rent or a maintenance payment. I think it is self evident that a formula of that sort bears no relationship either to capacity to pay or to actual costs involved. I think it was an indefensible stand to take. In the last resort, in the face of a lot of resident resentment, the organisation changed its mind. I make a distinction between paying as much as one can and paying as much as the place actually costs to run.

With due respect to the Minister, I think he did tend to sound rather more moralising than he probably intended when he said during the course of his second reading speech that he would like to see the administration of this program considerably strengthened by requiring organisations to demonstrate their charitable and benevolent motives by keeping rentals and other charges within the limits that pensioner residents can afford. I regard the organisational and administrative responsibilities accepted by these committees as being a most important contribution that they make to the scheme and to the welfare of the aged people who are residents under it. I do nol believe that the scheme could have got off the ground without the sort of voluntary assistance that has been made available. There are some cases where the organisations pay the total costs, but I would say that if it had not been for the preparedness of these sponsoring organisations to come forward with their time and work this scheme would not have got ofl the ground. Had it got off the ground it certainly would not have been able to operate successfully on the scale it has, namely, of already housing 50,000 residents with many more continuing to come.

I would relate this - with some qualification also - to another comment by the Minister about donation-linked entry, although I go along with him completely on the general principle which he is arguing. The Minister did suggest that he was looking to the situation where homes could be allocated strictly on a needs basis. I presume that that is a reference to the suggestion that they should be available for allocation without reference to donation. In order to look at this proposition I think we have to go into the background to the scheme. If we were to do so we would find in the first place that in the original scheme - which was set up in a very sloppy way, if I might say so, with far too few restrictions - there was no limit on the number of times a unit could be sold'; I am referring to donation-linked entry. Since the new standard form agreement of 1970 that has been changed to some extent - to a major extent - in that under the new form of agreement only half the units in any given home can continue to be resold.

If I understand the Minister's comments correctly he is possibly suggesting that we should be in a position to prevent any sale at all. Again with due respect, I would suggest to him that at this stage anyway that might be going a bit too far and if we want the scheme to continue at anything like its widespread present scope we will realistically have to accept the position that all units should be permitted to be sold' at least on the first occasion but on no more than one occasion. So far as I can see there is no justification - I would be interested in hearing from anyone who knows one - for the provision that even as many as half of them should be permitted to be continued to be resold. By allowing that we are putting up positive barriers in the way of quick expansion of the availability of these homes on a rental basis, which in general terms will be on the basis of availability to the most needy persons first.

In his second reading speech the Minister referred to the disappointing response to the Aged Persons Homes Act by local government bodies and invited suggestions on how to stimulate it. I am wondering whether one form of encouragement might be provided by a relaxation of the rule against the use of borrowed funds and mortgages of aged persons homes in the case - I emphasise these words - only of homes sponsored by local government bodies. The proviso about not accepting loans and not entering into mortgages is, in any event, easily set aside by a device whereby a local government body sets up a formal separate aged persons homes organisation to which it makes donations - not loans - on the basis of money which the local government body itself has in fact borrowed. This has led me to wonder in turn whether the estimate by the Minister that only 500 places have been made available by local government action might be partly due to the fact that further units have been formally made available under a device whereby in reality the local government body provides the assistance but it comes through some intermediate voluntary organisation.

Again I am not raising this matter on a theoretical basis. We have had a very good example of it in my electorate with the Shire of Bayswater, which has entered into a first class development which is admirable in many respects. Before it was able to do so it had to set up what is called the Shire of Bayswater Aged Persons Homes Incorporated. The existence of this whole body is only to avoid the one mechanical problem that the Shire itself would not have been permitted directly to use loan funds for the project. It is in fact using loan funds indirectly. But who would argue that that is in any way improper, whether done directly or indirectly? Having mentioned the Shire of Bayswater scheme, I wish to pay a tribute to the Shire for having in many respects created a pattern which other homes should follow. From the outset the Shire has agreed that residents should be represented on the management body. From the outset it has agreed to the annual financial accounts being published and made available not only to residents of the homes but also to ratepayers in the district. I think that is quite proper.

It has, by the way, raised a further problem. This has been alluded to this evening by the honourable member for Sturt (Mr Wilson). I refer to the fact that the maximum subsidy is now leaving too great a gap, given the inflation of building costs. In order to demonstrate the problem, I seek leave to incorporate in Hansard a table showing the maximum subsidies under the scheme over the years.

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