Nicola Roxon (Gellibrand, Australian Labor Party, Shadow Minister for Health) Share this | Hansard source

This is a very significant matter of public importance because it is an opportunity for us to debate what is happening currently in health care in Australia. We do have, compared to many countries around the world, a good health system—no-one on either side of the House disputes that—but it is a system that could be so much better if the federal government paid a little attention to the growing and gaping gaps and dints in our healthcare system. A couple of them in particular that I want to talk about today are the way we treat our elderly Australians and the pressures that are being put on our hospital system when people who would be more appropriately cared for in an aged care setting are forced to stay in hospitals for long periods because aged-care beds are not available. We have heard horror stories of do-it-yourself dental care in which elderly Australians use their toolshed in the backyard to go and file down their dentures because they have been waiting for so long for a set of dentures that fit them properly. I am also going to talk about the nearly half a million people who end up in hospital every year with diseases that are preventable, which this government is not taking any action on.

The situation with our elderly Australians has come to the fore in the last couple of days. It is an issue that has been bubbling away for many years, but a couple of stories in the papers have graphically brought home how desperately these families suffer because the government is not making a sufficient number of aged-care beds available. When the stories are raised in the media, the Minister for Ageing—and I am sure the Minister for Health and Ageing at the table will happily be able to answer questions on his colleague’s behalf—says: ‘Don’t look at me. This is nothing to do with me.’ If an issue is raised about aged care, he immediately tries to find somebody in the states to blame.

The story in the West Australian on Monday was of an elderly woman who has been in a hospital bed for a long period, having been assessed as eligible for an aged-care bed but unable to get one. The minister, who does not even know that his government’s own department assesses that there is a 500-place shortage in WA, says, ‘I am told by industry representatives there’s a glut,’ as if therefore there is nothing that he needs to do. I know that every day in their electorates Western Australian members on our side of the House deal with their constituents’ complaints about finding a place because there is such a serious shortage.

Not only is it inappropriate care for the patients and for their families, but the cost to the community of that care is extraordinary. This story that appeared in the West Australian obviously used figures that are applicable for this particular example. The woman, great-grandmother Ann Duim, was staying in a bed at the Royal Perth Hospital, which cost $1,600 per day, with no choice of being able to get into an aged-care facility. Not only was she in a hospital setting, which was inappropriate and very difficult for her family to visit, but the comparative estimated cost of a bed in an appropriate aged-care facility is $250 a day. That is an extraordinary difference on which we are wasting collective health expenditure when we could use that money for much better purposes.

Whenever the Leader of the Opposition or I or other members of our team say that we should make sure we spend every health dollar sensibly so that we can make it go further, the Minister for Health and Ageing loves to accuse us of wanting to cut the health budget, when nothing could be further from the truth. But when his government’s decisions mean that we are spending $1,600 for one day on one person in one hospital bed—and when that person could be in a more appropriate aged-care facility which would be better for their care, better for their family and significantly cheaper for the taxpayer—surely that is something that we should be exploring. The costs across the country are not necessarily all as dramatic as that example in Western Australia, but around the country the average cost of a hospital bed is $967 a day. That is almost nine times more than the average cost of a nursing home bed. And still the government says: ‘We don’t have to worry about that. If there are nearly 3,000 elderly people in hospitals around the country who should be in aged care, that is not a responsibility for us.’

I think that it is extraordinary that the government, particularly the Minister for Ageing, does not seem to have any interest in fixing this. I am sure people on this side of the House will remember that, of course, the Minister for Ageing does not want to be the Minister for Ageing. He is the only Minister for Ageing who does not want actually to meet and talk to the elderly people in our community. I have decided that we should be calling the minister ‘Peter Pan’: the little boy who did not want to grow up. He does not want to talk to adults in the community and talk to families about appropriate care for their grandparents and great-grandparents. It is really embarrassing to have a Minister for Ageing who does not have any interest in going to aged-care facilities and talking to elderly people and their families, and to have a Minister for Health and Ageing who does not think the government should have responsibility for fixing this problem.

I am hoping that the minister might also think about the situation of a family in Townsville, the Buck family, whose father, Fred Buck, has been in respite care in Townsville. He has been unable to get a bed in Townsville and instead is going to be given a bed in Malanda. For people who do not know where Malanda is, it is in the Atherton Tableland. It is a four- or five-hour drive from Townsville, one way, for the family to visit this elderly man who is in desperate need of appropriate care. The family has estimated, generously I think, that the trip each way to make a short visit to their father—not taking into account the time and the wear and tear on their car—costs them $300 by the time they pay for petrol and accommodation.

That is a ridiculous situation. When this issue was raised in Western Australia the Minister for Ageing said, ‘No, the industry tells me there is a glut. I will not worry about it.’ Similarly, the member for Herbert—a member of the coalition—says, ‘This has nothing to do with us; the state government should fix this. Peter Beattie should fix this problem.’ I think the member for Herbert has been in this House long enough to know that aged care is a Commonwealth responsibility. He is a member of the government that can fix this problem and it is one of his constituents who is being forced into this terrible situation. He is quite wrongly blaming the states rather than saying, ‘This is an issue I should take up on behalf of my constituents. I should see the minister for health and I should see the Minister for Ageing and get this problem fixed.’

Mr Buck received a national medal for 25 years of service to the Queensland Ambulance Service, he had no sick days, he was never late for work and he was and is well-known in the community. Despite having provided that service to the community, being integrated into the community and having access to his family for such a long time, he is now being turned away from appropriate care. Surely, Minister, we can do better for our elderly citizens.

The member for Hindmarsh was approached by a constituent, an elderly gentleman, who, despite the government’s promises about the chronic disease program for dental care, has a chronic condition and has not been able to get assistance. As I said, he is taking his dentures out to his toolshed and using a file on them to stop them rubbing and cutting his mouth because he cannot get them fixed. We have elderly members of the community at a time in their life where we should be treating them with more compassion being unable to access basic health services and aged-care beds locally.

There is an example in the Speaker’s electorate of an 87-year-old man who has to drive 120 kilometres from Portland to Penshurst—or 240 kilometres for the round trip—three times a week to see his wife, who has had a stroke. They have been married for 64 years and are unable to get an aged-care bed in their home town. Not surprisingly, their family worry just as much about their father making the trip as they do about their mother. We must be able to offer a better system. Unfortunately, the ministers responsible do not seem to be taking this issue seriously.

Excuse me—unfortunately, having shadow responsibility for the health portfolio does not give one any immunity from the flu! It would be great if the minister could fix that as well as aged-care facilities! I do not know why the health minister cannot fix the common cold. It seems to be a problem that many of the professionals are not able to fix either, so I am not sure I should hold him responsible. That is one I will not hold you responsible for, Minister, but I am afraid you will have to put up with my sniffing as I speak.

The Labor Party is aware that the figure for bed shortages around the country is now more than 2½ thousand. It would be good if the minister could confirm or deny these figures. The department’s assessments show that Western Australia is 500 beds short; Victoria, 440-odd beds; the Australian Capital Territory, 326 beds, which is a very large figure for a small population; and Queensland, 688 beds. Obviously the example in Townsville illustrates the situation perfectly. These are examples of the problems being faced by real people.

The minister might say that we have a Minister for Ageing, so I do not need to deal with this as a responsibility. But, Minister, we are concerned about it for a range of reasons. We are concerned about it because people cannot get the appropriate care they need near their homes. We are also concerned because it means that people are staying for very long periods in hospital when that is not appropriate and the cost is being met by the rest of the community. It means that people who have conditions for which they should be in hospital cannot get into hospital because the beds are being taken up by people who more appropriately should be in aged-care facilities. The minister has shown no interest in trying to fix this problem. The government often talks about aged-care places and groups community care packages together as if they were the same as aged-care residential places. We know they are not. In talking on this matter of public importance, Minister, it would be good if you would confirm the bed shortage figures. We know and hear from our constituents every day about the great crisis.

Labor made some commitments last week to fix this problem between the states and the Commonwealth. We see aged care as a key area in the blame-game argument. Things done at the federal level cost not only the community but also the states. Labor has committed to reforming the transition of patients from hospital to residential aged care as a priority for older Australians who need nursing home care. We will make reform of the interface between our hospitals and nursing homes a priority area in the forthcoming negotiations between the state and territory governments for the Australian health care agreements, which expire in the middle of next year. We will examine further whether additional transition and step-down care would assist along with other measures that might increase the speed with which aged-care bed licences can be operationalised. We would like the minister to tell us what the government is planning to do in this area rather than simply to say that this is a problem that can be left with the hospitals.

As I said, this is not an issue only in aged care given that one in 10 hospital admissions relates to dental conditions that could have been prevented. People are ending up in hospital because they cannot get dental care, Minister, because your government closed down the Commonwealth dental care scheme when it was elected. About 50,000 people now end up in hospital for treatment of dental conditions. Children as young as five and six are being admitted to hospital and having general anaesthetics to have teeth extracted. We know that the figures indicate that children’s teeth are getting worse. Australia’s dental care system used to be at the top of the pile compared to systems in the rest of the world, but we are gradually dropping. We are burdening our children with problems that we will not be able to fix without major intervention at a cost to them individually and to their families and the community.

Minister, you would be aware that the blame-game report that your colleagues unanimously signed on to, along with a number of colleagues on the side of the House, recommended ‘that the Australian government supplement state and territory funding for public dental services so that reasonable access standards for appropriate services are maintained, particularly for disadvantaged groups’.

I am wondering whether the minister might be prepared to answer in this debate why it is that the government has so far not responded at all to the report The blame game: report on the inquiry into health funding, and why it is, in announcing their dental package as part of the budget, they did not even take account of that recommendation. What they have done is put in place a specific chronic disease program which is just for private dentists and is limited in all sorts of ways; it does not supplement at all state and territory funding for public dental services. It does not ensure that reasonable access for appropriate services is maintained for disadvantaged groups. I know colleagues on this side of the House put a lot of work into that report and are still waiting for a response from the government. Minister, I am sure members on your side of the House will be wanting to know how it is that putting money into this program of yours, which has failed spectacularly so far, serving only 338 people in South Australia over three whole years and 68 people in Tasmania—are there any Tasmanians here?—is going to do anything for those people. It is about time you answered some of these questions. (Time expired)

See this speech in context