Annette Ellis (Canberra, Australian Labor Party) Share this | Hansard source

I rise to speak on the Aged Care (Bond Security) Bill 2005, the Aged Care (Bond Security) Levy Bill 2005 and the Aged Care Amendment (2005 Measures No. 1) Bill 2005. In doing so I will begin by concurring with the remarks made by the member for Chisholm, the speaker immediately before me, particularly when she made the point about the need for some balanced appropriations towards aged care generally. These bills do what should have been done years ago. The Howard government has had nine years to get aged care right. It has taken nine years for this government to protect the hard-earned money—sometimes hundreds of thousands of dollars—that some elderly Australians pay when they go to live in an aged care facility.

The legislation being debated here today is, in my opinion, good legislation. It does three important things. Firstly, it provides a scheme whereby the Commonwealth government will repay an outstanding accommodation bond balance in cases of aged care provider default—for example, if an aged care provider becomes insolvent and cannot repay the accommodation bond it owes to an aged care recipient. I am aware of cases where, for a short time, there was uncertainty about the ability of an aged care provider to repay an outstanding accommodation bond balance. This caused great stress to the residents of those facilities.

The example of a family who had a relative in Villa Lombardia in Victoria demonstrates how dangerous the current legislation is. After Villa Lombardia went into receivership in 2003, the relative in this facility of whom I am speaking passed away. The receivers told the family that moneys could not be found and that the family was considered an unsecured creditor. Thankfully, this turned out to be incorrect; nevertheless, the family had to wait until the facility was sold to be able to receive the remainder of the bond. I am sure we would all agree that this situation is far from acceptable. As shadow minister for ageing at the time, I said at an aged care industry conference, the ANHECA conference of 28 October 2003:

I’m aware that the aged care industry is working closely with the minister to resolve this issue, and I look forward to an outcome in the near future so that other families won’t have to go through the stress of the families with residents in Villa Lombardia.

It took another three years for this government to fix the problem. I do not find that acceptable—far from it. Labor has been calling on the government for years to address this problem and, thankfully, the government has finally responded.

The second major change in this legislation is that the Commonwealth government will be able to impose a levy on all aged care providers to recover the funds it has spent and has not been able to obtain from defaulting aged care providers. I am very pleased that the aged care industry has found it possible to support this measure. The third element of this legislation is to strengthen existing prudential requirements related to accommodation bonds, especially in relation to liquidity, record-keeping and disclosure. It is about time. It took the Howard government nine years to protect the hard-earned money of elderly aged care residents. I find that to be a disgrace.

One of the important changes is in schedule 4 of the Aged Care Act 1997, ‘Refunding of accommodation bond balances’. The legislation before us now forces aged care providers to refund accommodation bond balances with interest. Currently, if there are legal complications—or simply any undue delay—and an aged care provider retains the accommodation bond after a resident leaves or dies, they only have to repay the bond balance without interest.

I know of a case where a family estate had not received the bond balance after several years, and were not entitled to receive any interest when they eventually received the balance. This we would all agree is extremely unfair, when you consider that residents can be charged interest on the bond they owe to the facility from the day the resident enters a service until the day they pay that bond. That is the current provision in the act. I am pleased that, where people are leaving or passing away and no longer need accommodation at the facility, we can now have this particular issue addressed at the end of the process. It is a pity that it took so long, but I am pleased to see that it has finally been addressed.

I do not truly believe that this government fully understands how difficult it is for people to save to buy their own homes and then have this uncertainty that many of them feel, if they are in the position of having to pay a bond when they enter into an aged care facility. There are still many areas in aged care that need fixing but, after nine years, I do not think I will be holding my breath waiting to see them fixed.

One major problem is aged care shortages. I particularly want to refer to my electorate of Canberra. A Productivity Commission report into government services released last week found that, compared to the rest of Australia, the ACT has the lowest number of residential aged care places, the longest waiting list for aged care places, and the highest level of complaints for aged care services. The current aged care planning ratio is 88 residential aged care places for every 1,000 people aged 70 years and over. That is the government’s own target. The Productivity Commission report showed that in the ACT there are 72 beds per thousand people, rather than 88. I think that is a bit of a disgrace, particularly when we know the demographics in Canberra; they are pretty undeniable. We do have an increasing ageing population in this town.

The Productivity Commission report also showed that it took up to one month for 24 per cent of Canberrans seeking an aged care place to enter into an aged care facility, compared with 49 per cent of people in New South Wales. Furthermore, it took three months for 51 per cent of such Canberrans to enter a facility, compared with 75 per cent of people in New South Wales. Canberrans have to wait longer to get into an aged care facility, and that is not good enough. Elderly and frail people who need to go into an aged care facility should have access when they need it. The government has failed Canberrans, I believe, on this issue.

Even if the government was meeting its own target, I am not sure that all of the people who need an aged care bed would have access. Labor has been arguing for years that the ratio should have been subject to regular review over the past seven years. The Howard government did change the ratio, by increasing the number of community care places—and I am very pleased about that. But what the government does not tell people, and does not make very clear in its publications, is that it actually reduced the ratio of aged care beds. The Howard government has made it harder for people to get into an aged care facility.

I want to make a couple of comments about an aged care facility versus community care at home. At-home care is a very good thing and something I am very supportive of. However, families and individuals must be able to make that choice—between at-home care and facility care—confidently and considering all of their circumstances. I am concerned to see that the ratio for aged care beds has come down, even though—granted—we are seeing an increase in community care places. I want to know why that is the case.

There will be some people out there, I am sure, who will make the right decision for all the right reasons, but there will be circumstances—and we all know them—where community at-home care may not work for that particular family or individual. And we need to make sure, in any of the changes that occur in relation to the allocation of these places, that we really think very carefully about the impact those numbers and those changes might have on people’s ability to make those choices.

I know that there are many families out there who are really struggling, even though they are doing what they believe is the right thing in their hearts in caring for and assisting in the care of a relative at home. But I want to make sure that the decision that they are making is being made on the basis of that confidence I spoke of and on the basis that they do know that they have choices.

The Howard government has not reviewed the ratio adequately since it came into power. I do not understand how the government can continue to allocate beds on an old ratio, considering the changing demographics in our society. Our population is ageing and people are living longer and are healthier until much later on in life. The ratio for the target population—that is, people aged 70 years and over—should be reviewed, as should the balance between high- and low-care places and Community Aged Care Packages—that is, at-home care. That ratio should also take into consideration the growing need for dementia-specific and ethnic-specific care services. People in the community are crying out about the shortage of both community and residential places. Labor figures show that, based on the government’s ratio, there is a shortage of 386 beds in Canberra and 9,275 residential places in Australia. We can safely assume that is an underestimate of the shortage in terms of real needs.

Let us not forget the impact of the increasing prevalence of dementia in our society, sadly, which will have a major impact on aged care services in the future. It will also, as I have just said, have a major impact on the ability of people to care for their loved ones at home. It is not an easy thing to do. In many cases I do not know how people manage to do it, but they do. With the increasing prevalence of dementia come all of the stresses and the pressures we are talking about when we talk about choice, confidence in choice and access.

Another important issue I want to talk about today is the shortage of aged care nurses. Unfortunately, since coming into power, I do not believe this government has done anything significant except increase the burden for nurses in the aged care sector. Nearly $900 million of taxpayers’ money, which was given to aged care providers to pay nurses and care workers decent wages, is being spent, but we do not know exactly how, because the government refuses to mandate that that money is actually passed on to the nurses. In the 2002-03 budget, according to the budget statement, the Howard government increased residential aged care subsidies:

... by $211 million over four years to assist employers of aged care workers provide for increases in wages and improved workforce conditions.

In 2002 the wages gap between nurses working in residential aged care and those working in the public sector was $84.48 per week nationally. In the 2004-05 budget, Minister Julie Bishop announced through the budget statement:

An extra $877.8 million over four years through a Conditional Adjustment Payment to improve the financial position of aged care providers and allow them to pay more competitive wages to staff.

The wages gap in 2005 is now $191.83 per week across Australia. It has gone from $84.48 in 2002 to $191.83 in 2005. Minister Bishop is no longer the minister—she has now moved on to another area. It is time for the new minister to develop a mechanism so that this funding is actually passed on in wages so we can recruit and retain nurses in an area that is struggling to keep them. This is in the interest of not only nurses and care workers but also providers, so that they can attract and retain quality staff.

The recently released unanimous Senate Community Affairs References Committee report Quality and equity in aged care noted that delivery of quality care was under threat from the retreat of qualified nurses, both registered and enrolled nurses, from the aged care sector. The report also noted that there had been 34 reviews of nursing in seven years. You wonder who reads these reviews in government. If this government were really serious about the provision of quality care for older Australians they would have made a commitment to seriously increasing the number of undergraduate nursing places and closing that wages gap between nurses working in aged care and those working in the public sector. We have a serious aged care nursing shortage now and the Howard government needs to take immediate action to prevent this crisis getting even worse.

I would like to refer to a young constituent of mine who came into my office just eight or nine days ago. She is a mother of five who is taking herself off to full-time university to study nursing—something I was particularly pleased to hear. She told me that she decided she would get some extra work over the Christmas holiday break to help the family budget—her husband is sick at the moment and she has five children. She got a job as a personal carer in an aged care facility here in Canberra—something that we would all applaud. It is interesting: she is training to be a nurse, and we need those desperately; she tried to do work as a personal carer in an aged care facility over the holiday period, something we need desperately, but she had to stop after two or three weeks because it was financially so much to her detriment to undertake that work. The wage was so low and the impact on the family finances so great, thanks to the way the government has created these structures, that it was actually costing her money to go out and do that work. The whole thing is just a puzzle to me, and it is something that needs some serious attention.

On a more positive note, there are some really good things happening in aged care in the ACT. I want to mention one of them in particular. Goodwin Aged Care Services in Farrer in my electorate has commenced construction of 19 new independent living units. These units are an example, considering our rapidly ageing population, of what we need to be doing. The Goodwin aged care independent living units have been designed to comply with or exceed the adaptable housing code. This means that residents will be able to remain in those homes much longer and receive more care as they age and/or become frail. It will delay or remove the need for many of those older people to enter into those aged care facilities, given the facility that has been constructed for them now.

The units have more space for residents, who may need wheelchairs, and for their carers. There will be a call system with around-the-clock monitoring in case of emergency. The bathrooms are designed for easy adaptation as the care needs increase, and the bedrooms allow for a mechanical lifter. I commend Goodwin Aged Care Services for this initiative. The Goodwin people have a longstanding excellent reputation in this town. I have been interested in adaptable housing for several years now—it is particularly interesting when we are talking about housing accommodation for older Australians. I believe it is the only way that we can ensure that we look after our ageing population into the future. I have a view that wherever possible the adaptable housing code should apply to any aged care facility or independent aged housing for older folk. In fact, we should almost be mandating it, if we were strong enough to take it that far.

We had an exhibition house built in a housing development on the north side of Canberra. It was completely and absolutely adaptable. It was built in a normal housing display village, just to show people that you can construct houses with easily removable walls, lift-up or drop-down cupboard levels and all sorts of things. I think the more we move towards this model of specialised housing for older people, should it suit them, the more we will help people and alleviate the need for people to move on.

In conclusion, I support this legislation being debated here today. I wish it had been here a little while ago, but we have it today and I am pleased to be able to support it. I know that older Australians out there who are in the position of requiring that security in a prudential fashion for their bond payments will feel all the better knowing that these positions have now been adopted by the government.

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