Julia Gillard (Lalor, Australian Labor Party, Shadow Minister for Health and Manager of Opposition Business in the House) Share this | Hansard source

The member for Ballarat reminds me that Rob Knowles is a Ballarat person, and she is an expert in such matters. He lent his voice to the need for broadening investigative powers. There was also a recommendation for the protection of whistleblowers. But not until April 2007 is the Howard government finally going to get its act together and do something to address these issues, which are all quite basic in terms of making sure that elderly Australians are protected. We have to have a complaints system that works. We have to have investigative powers that are adequate. And whistleblowers have to be able to come forward, certain in the knowledge that they are going to be protected; otherwise whistleblowers will not come forward.

I will go on now to talk about a third problem with aged care. I have talked about quality in terms of fire safety standards and I have talked about issues to do with protecting aged-care residents from abuse. The third issue is of course the issue of not having enough workers. This is a chant, if you like, that is heard right across our health system and aged-care system, and of course the two are interrelated. The acute sector in particular, and even our primary care sector, is in competition with the aged-care sector for nurses. In circumstances where we are short of nurses, it can be very difficult for aged-care facilities to hold their workforce. We know that the Productivity Commission report into Australia’s health workforce highlighted the significant shortage of nurses and care workers in aged care. Our residential aged-care workforce is ageing and decreasing in size. The stark reality is that this is only going to get worse if the government continues to avoid dealing with the issue.

Any national health workforce strategy must include the need for trained healthcare workers in residential aged-care and community care facilities. Some years ago the Senate community affairs committee inquiry into nursing identified aged care as the area of nursing in greatest crisis—with the acute shortage of nurses having led to increased use of unregulated workers to the detriment of quality care. That situation is worsening, not improving, and this is an issue that lies directly at the feet of the Howard government. The Howard government do so much to try and duck and weave and deny responsibility in health. The Howard government have made an art form out of blaming others. Indeed, I have thought from time to time that they spend more time in the ministerial wing of this building working out who else to blame than they do on any other single task that ministers attend to. Certainly that is true in health. The minister for health always has a very creative explanation as to why it is nothing to do with him when something is going wrong in our health system.

There is one thing that the Howard government most certainly cannot walk away from—in reality they cannot walk away from a lot of what is wrong with our health system. What is unambiguously clear is their failure to train enough Australians to make sure that we can properly staff our health and aged-care system—that is entirely the responsibility of the Howard government. They fund the university system in this country which produces many of the professionals we need. They have shared responsibility in a funding sense for the TAFE system, which produces many of the workers that the health system needs. The continued neglect of these sectors and their systemic underfunding has put us in a situation where we now have a health and medical workforce crisis.

There is no sector of our health and aged-care system where this shows more clearly than in our aged-care institutions. I am sure members in this place routinely visit aged-care institutions in their electorates. If staffing is not one of the first issues raised with them when they walk in the door then I would be very surprised. It is an issue raised with me consistently.

Concerns about our aged-care system motivated the shadow minister for ageing, Senator Jan McLucas, to move a substantive amendment to this bill in the Senate. The minister at the table, the Minister for Community Services, has referred to this substantive amendment in critical tones, but I think it warranted proper consideration from the Howard government. Unfortunately, it did not get it. The amendment would have legislated for one unannounced annual spot check on all residential aged-care facilities in Australia. The amendment provided that this spot check would be conducted on all 44 quality outcomes of the Aged Care Standards and Accreditation Agency.

That, in fact, is what the Minister for Ageing promised earlier this year following allegations of sexual abuse in three aged-care facilities. Once again, we have hollow words from the Howard government—something promised but not delivered. We provided in the Senate, through a substantive amendment, the legislative vehicle by which this could have been delivered. But of course the Howard government is not known for honouring its word and it did not honour its word on this occasion. It refused to support this substantive amendment.

Labor’s amendment would have enshrined a Howard government promise in this legislation, and the Howard government voted against it. It makes you think about what, really, a Howard government promise is worth. The amendment Labor offered in the Senate gave the government the language and the legislative instrument to deliver on what they had been saying. The community has a very strong understanding that every facility in this country is given a spot check every year. People think that happens. But what does a spot check mean? It should mean that it is unannounced. Everybody in the street knows what having an unannounced check means. It means someone turns up without telling you. But that is not what is going on now with the checking of residential aged-care facilities in this country. It is what should be going on, but it is not going on now.

I think every person who has some basic common sense would know that you only really find out what is happening if you turn up unannounced. If you turn up having given notice that you are going to arrive at a particular time, then people will tidy up—it is a human instinct. They will do a series of things that they do not do on an ordinary day. Some of that will be motivated by the goodwill of putting on the best possible face, but, in residential aged-care institutions that have problems, some of that will be motivated by covering up problems on the day that the aged-care accreditation people turn up. To take a simple example I have referred to during this speech, if food quality and food quantity is an issue, that can obviously be resolved for the day that the planned check happens. If you were not properly feeding residents in aged-care facilities, you would obviously put on a special meal when the people who do the checking come around. Once the people who have done the checking leave the building, you go back to your ordinary ways. The only way of making sure that we get a genuine check of what is served on an ordinary day and what is done on an ordinary day, how people are treated on an ordinary day, is to turn up unannounced for an opportunity to view what happens on an ordinary day. That is what Labor’s amendment would have done.

We have been told by the government that it is too expensive to undertake the spot checks against all 44 quality outcomes and that providers would not like it. A spot check system is about protecting people in the aged-care area and assuring that there is quality of care. It is not an opportunity that should be missed by the Howard government. We can only assume from the Howard government’s failure to support the substantive amendment in the Senate that it really does not care enough about honouring its word for unannounced spot checks, that it really does not care enough about the quality of what is happening in our aged-care facilities to make sure that these annual unannounced spot checks happen as a result of a legislative requirement. There are 166,000 residents in residential aged care who deserve better. With that, I move:

That all words after “That” be omitted with a view to substituting the following words: “whilst not declining to give the bill a second reading, the House condemns the Government for:

(1)

failing to protect our vulnerable aged population by ensuring that all residential aged care facilities receive at least one unannounced spot check every year; and

(2)

rejecting amendments to this bill that would have ensured the promised annual unannounced spot checks were enshrined into legislation”.

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