Daryl Melham (Banks, Australian Labor Party) Share this | Hansard source

The Aged Care (Bond Security) Bill 2005, the Aged Care (Bond Security) Levy Bill 2005 and theAged Care Amendment (2005 Measures No. 1) Bill are designed to protect accommodation bonds held by residential aged care providers in the case of a provider becoming insolvent. The bonds are paid on entry to low-care facilities by non-concessional residents and by some ‘extra service’ residents in high-care facilities. When residents exit an aged care facility they, or their families, may be eligible for a refund of part of the accommodation bond paid. Currently, this refund cannot be guaranteed should a residential care facility provider become bankrupt or insolvent. These bills will ensure that residents will be refunded any of the accommodation bond they are owed.

The bills provide that the government will repay any outstanding accommodation bond balances in the case of an aged care provider defaulting. The levy bill will then allow the Commonwealth to impose a levy on aged care providers to the extent that it is necessary for the Commonwealth to recoup the amounts it has not been able to obtain from defaulting providers. Labor will support this legislation, as far as it goes.

However, these bills go only a small way towards addressing the critical issues confronting Australia’s ageing population. The government is only now coming to the table in dealing with these matters. The Hogan Review of Pricing Arrangements in Residential Aged Care was concluded in 2004. The Senate Community Affairs References Committee tabled their report Quality and equity in aged care on 23 June 2005. I note that that report was unanimous. Both these documents contained numerous recommendations for action this government could take in reforming the aged care system in this country. Yet all we see is this paltry attempt to deal with what is rapidly becoming a national crisis. The government cannot claim to be underinformed of the issues facing this sector, yet has chosen to do little about it.

The Hogan review identified a series of demand drivers. Perhaps the most critical were the demographic changes due to the increased health expectancy of older people and changes in older people’s living arrangements, along with their access to informal care. The review states on page 22:

Over the next four decades the number of older people will almost triple. Moreover, the older population will grow twice as fast as the total population during that period.

There can be no doubt that there will be an increasing demand for aged care services. That demand will have to be met. Given the Hogan review’s projections in table 3.1 on page 24, which state that over the next 40 years the total cost of supplying aged care services will more than double in real terms, it will grow by 113.1 per cent. The Hogan review provides 20 key recommendations. The Senate committee report outlines 51 recommendations. This legislation before the House today deals with only one aspect of the matters in those reports.

Consider for a moment the number of aged care beds. When this government came to office there was a target of 90 residential beds for every 1,000 people over 70 years of age. As at June 2005, there was a shortfall of 9,275 aged care beds against this target. This target has since been lowered to 88 residential aged care beds for every 1,000 people aged 70 and over. Even against this target, there is still a shortage of 5,500 aged care beds. Recommendation No.1 of the Hogan review stated that the government should commit to sustaining a rate of 108 places for every 1,000 people over 70. My colleague Senator McLucas noted in her media statement of 21 November 2005 that it was interesting to consider exactly wherethe shortfall occurred. For example, there was a shortfall in south-eastern Sydney of 1,496 beds yet there was an oversupply in northern Sydney—and there are no surprises for guessing which electorates are in northern Sydney.

I would like to outline briefly some of the areas Warren Hogan noted in his review as requiring immediate change. I do this to provide a clear statement of what the government could and should be doing in relation to aged care. I have already dealt with planning arrangements. Further recommendations were made in relation to greater flexibility in allocations; increased support for aged care assessment; aged care assessment teams’ role in reassessment of existing residents; the resident classification scale; funding supplements; the Aged Care Standards and Accreditation Agency; the aged care workforce; financial assessment on entry; the guarantee fund; viability supplement; targeted capital assistance; conditional incentive supplement; comprehensive data repository; and corporate information. There are an additional five recommendations focused on medium-term reform. Only one of those recommendations—the guarantee fund—is currently being dealt with by this House in the form of the bills today. This is an appalling state of affairs.

I would now like to turn to the key recommendations proposed by the Senate Community Affairs References Committee. This report, by the way, was tabled after the Hogan review and was unanimously supported by committee members. This is a continuing saga of so much to do, and so little done, so many opportunities lost. For example, in recommendation No. 1, the committee welcomed the allocation by the government of an extra 400 nursing places at universities in the 2004-05 budget. Unhappily, this is short of the 1,000 places recommended by the Hogan review. One of the key issues raised by both the review and the committee was the need for increased numbers of trained aged care workers.

The committee made seven recommendations to deal with the issue of lack of appropriately trained staff for the aged care sector. There are 11 recommendations dealing with the accreditation agency, accreditation standards and complaints resolution. There are nine recommendations to improve documentation and technology in the aged care sector. In terms of funding for aged care residents with special needs, the committee detailed nine recommendations. One of these was recommendation 32, which read:

That the Commonwealth establish a funding supplement for residents in residential aged care who have additional needs arising from mental illness.

What I find so inexcusable is the fact that there is no such supplement now. Surely, it is evident that people with special needs require additional funding. There are another 11 recommendations dealing with community care programs. The committee acknowledged the recent funding increases in the Home and Community Care program. It further noted, however, the need for more comprehensive levels of care and the need to ensure sufficient funding growth to meet new demand.

The committee directed several recommendations to the particular needs of some specific groups. Recommendation 39, for example, focused on people from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islanders, people with dementia, financially disadvantaged people and people living in remote or isolated areas. Recommendation 40 recognised the special needs of homeless people or people at risk of becoming homeless as they age. Recommendation 41 dealt with the costs of providing community care services in regional, rural and remote areas. Finally, recommendations 48 to 51 dealt with matters of transitional care.

So there we have it, a total of 20 recommendations from the Hogan review and 51 recommendations from the Senate Community Affairs References Committee inquiry; yet this government appears to take only one of those matters so seriously that it has introduced legislation to address a matter of national significance. I can speak of this subject with some personal knowledge—my own constituents raise these matters with my office on a regular basis. One recent example is an elderly man with emphysema who is unable to find a place locally for his wife. He is forced to travel to Croydon, some kilometres away, to visit her. Pensioner couples are very concerned over the low threshold of the assets test. One woman is very concerned that her savings will not last. She is required to pay an extra $16.63 per day for her husband, who has dementia. With the daily care fee of $28.62, this is a total of $316.75 per week in addition to the extra costs of pharmaceuticals, ancillary health and personal items. For a pensioner couple, the assets test is $61,000. This obviously does not last long at almost $320 per week in extras.

I doubt that I am the only member of parliament who, in the normal course of a day, has concerns raised with him or her on the matter of aged care. Yet we are dealing with three pieces of legislation which deal only with the matter of prudential requirements. I acknowledge that this is a necessary part of the reform process. The Labor Party will of course support these bills. But, to coin a phrase, this is very much the tip of the iceberg. There is so much more to be done in this area and this government has had more than enough time and input to take action to ensure that our ageing population will be cared for in the manner most appropriate to their needs. I commend the government on the start it has made in introducing this legislation. I can only continue to urge that now is the time for the transformation of aged care.

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