Tony Zappia (Makin, Australian Labor Party) Share this | Hansard source

I, too, rise to speak in support of the Aged Care Amendment (2008 Measures No. 2) Bill 2008. This is a very welcome bill and a bill which will go a long way towards ensuring that people who are admitted to nursing homes can be admitted with a lot more confidence not only for them but for their family members.

In the years ahead the number of older people who will need to be cared for in Australia will rise substantially. The previous speaker, the member for Grey, made that point as well. But I just want to reiterate some of the statistics in respect of the ageing nature of our population in Australia. It is expected that in about 40 years from now 25 per cent of Australia’s population will be over 65 years of age. That is an almost 100 per cent increase on the present figures of around 13 per cent of our population being 65 years of age and over. My understanding is that the number of Australians aged 85 years and over—and, again, the member for Grey made reference to this—will increase fourfold, from around 400,000 people today to around 1.6 million in 40 years time. That figure is particularly relevant because those people are more likely to be living in nursing homes if they reach the 85-year age mark. So it is clearly the case that caring for Australia’s ageing population is becoming a critical policy area for federal, state and local government. Again, I commend the member for Grey for acknowledging that all three levels of government do have a responsibility when it comes to caring for our aged.

It is even more critical because in about 40 years time the ratio of working Australians to older people, which is currently about five to one, will have dropped to around three to one. That is, for every older person aged 65 years and over who has retired there will only be about three working people, and so the economics of it all has to be factored into government policy development over the years to come. Compounding the problems for the government is that not only is the ratio of retired to working people increasing rapidly but also, with most households having both husband and wife in the workforce, there is less ability for family members to care for older people and enable them to remain in their own homes for longer. So you can see that all of these changes will add to the demand for the provision of additional retirement villages and nursing home places for older people.

Former Governor-General Sir William Deane said that how we treat our most vulnerable and disadvantaged is the ultimate test of our worth as a nation. The aged are some of the most vulnerable within our society. It certainly will be a test of our worth as a nation when in years to come we look back at how we as a nation cared for the aged in our community. It certainly is particularly the case that elderly people who are cared for in nursing homes are vulnerable. If they could take care of themselves, the reality is that they would not be living in a nursing home. It is because they cannot and they need assistance that they are there in the first place, so they are truly some of the most vulnerable.

Those who are in nursing homes should be cared for with the compassion and dignity they deserve. Again, it was interesting to hear some of the other comments, including those of the member for Grey when he referred to the baby boomers looking ahead to what they might have to expect when perhaps one day they are put into a nursing home. It is sad to think that perhaps the changes and the improvements that we are seeing in this sector are driven by our own selfish needs. I would have thought that they should be driven more because we are a compassionate and caring society. I quite often use a simple test when looking at the way we treat people. I simply say: treat people the way you would like to be treated yourself. If, in what you are proposing, you can pass the test of that question, then clearly you are doing what is fair and reasonable.

This bill addresses a number of inadequacies in existing legislation relating to the provision of aged-care services. In particular, the bill streamlines the assessment of frail older Australians to ensure more timely, consistent and quality assessments. It ensures that any accommodation bonds or like payments paid by frail older Australians for entry into aged-care services are fully protected under the Accommodation Bond Guarantee Scheme. It modernises the legislation so that it applies to all approved providers regardless of their corporate structure—and if I have time I will talk about that later on. And it links approved provider status to the allocation of aged-care places. The objective of the legislation is to provide better protection for the health, wellbeing and interests of care recipients. The bill is part of a package of reforms that are designed to ensure that approximately one-quarter of a million older Australians who are either in residential care or receiving community care services in their own homes can have greater confidence in the system.

It is interesting to note that this government has allocated some $40 billion over the next four years to funding aged-care and community care services in this country. That is a substantial amount of funds. Of even greater note in respect to this bill is that some $28.6 billion of it is going into nursing homes and hostels, so it is clear that this government is making a significant commitment in responding to the needs of the aged people within our community.

The aged-care sector is, as other speakers have noted, both growing and evolving. It is an industry that is learning as each year goes by how we can better look after the elderly within our community. The aged-care industry recognises that and is responding to the changing needs of society. Government regulations must also therefore be adapted so that they properly respond to the changes occurring in the aged-care industry, and this bill quite properly has been the result of extensive consultation with the aged-care sector.

Over the years I have had many discussions with providers in the aged-care industry and I have visited most of the aged-care facilities within my region. It is my observation that most providers provide a high level of service and care. It is also my observation that many providers operate on minimal profit margins and in recent years many have found their resources and finances stretched to the limit. They find themselves doing more with less. Ultimately, however, the care recipients will suffer if this trend continues—and government regulations, while essential, are not the only response required.

One of the issues raised with me in a visit to a nursing home in my electorate recently was the wage differential between aged-care staff and hospital staff. Hospital staff receive higher remuneration. Aged-care operators compete for the same staff as do the hospitals and they find that they have difficulty recruiting and maintaining quality staff. If they are to pay staff higher wages then either fewer staff will be employed or another service will be cut. Either way, the end result is not good for the care recipients. In that respect I am pleased to see that the Rudd Labor government has committed some $41 million over the next four years to create an additional 7,700 training places for aged-care and community care workers. This is an important step because it will enable aged-care facility providers to recruit staff that they desperately need and perhaps they will not be competing with the hospitals for that staff. This is just one of the many issues raised with me in the course of my discussions with a range of aged-care service providers. On another occasion I might talk about some of the other issues that have been raised.

The consistent message from all of the providers is that it is becoming increasingly difficult to remain viable. Financial pressures inevitably lead to cost cutting and in turn to a lot lower standard of service. I noted with interest a newspaper report earlier this year reporting that in Western Australia some 360 bed licences on offer from the federal government were not taken up because the capital costs of establishing the beds could not be justified by the return expected. The same report stated that Western Australia had a 2,000-bed shortage. So on one hand we have a shortage; on the other hand we have bed licences on offer that are not being taken up because the return is clearly not there. I do not know whether those bed licences have since been taken up but, given the general shortage of beds, it is evident that claims by the aged-care industry that the sector is struggling financially have some validity.

I am also aware of and have sympathy for claims by the industry that bed licences are sometimes wrongly tied to geographical regions. Again, I could talk about a personal case that I dealt with in that respect. At the very least there should be more flexibility in determining who the bed licences are awarded to, albeit that geographical location may be one of the relevant determining factors. It should certainly not be the only factor.

I want to turn to some of the specific measures addressed in this bill and I will begin with the improvement in the assessment process. I am aware of many examples where people were waiting lengthy periods to be assessed or reassessed for admission to a retirement facility. Admission to a nursing home is often a last resort for family members who have been caring for a person and who as carers have put themselves under incredible hardship and burden. Most turn to a nursing home when they simply can no longer cope because they cannot provide the care and support needed by the recipient. Often that occurs because the care recipient’s situation degenerates quickly and unexpectedly. The inability to relocate the person into a nursing home causes huge stress on the carers and more suffering on the person in need of the care. Streamlining the assessment process will be a very welcome measure for both the recipient of the care and for the families concerned.

I take this opportunity to raise a matter relating to the accreditation of aged-care facilities. Currently, the accreditation of such facilities is carried out by a private agency which acts on behalf of the Commonwealth. It is my view that the accreditation and the inspection of such facilities should be carried out by government departmental officers and not by private agencies. It is my understanding that facility licences are issued for a three-year period. If that is incorrect I stand to be corrected, but that is my understanding. Prior to a licence being issued an inspection of the facility is carried out to ensure that all relevant standards are complied with. Ad hoc inspections are also carried out during the licence period. It is also my view that, where an inspection of a facility is carried out within the licence period and the facility is found to comply with all the standards, that facility licence should be extended for another full term from the date of that last inspection.

The member for Grey referred to the number of inspections and compliance measures that nursing homes have to go through on a regular basis, and I certainly share some of the concerns that he raised about that. The administrative workload and therefore the costs that could be saved by both the Commonwealth and the provider are considerable, and those resources could be put to better use.

I was recently contacted by the operator of a nursing home in my electorate of Makin about this very matter. He told me that the time required and the costs incurred in preparing a licence renewal application were considerable. Recently, as a result of a random inspection in the midst of his licence period, he was required to respond to some issues raised during the inspection process. From the information provided to me by the operator of the facility, the issues raised appeared to be trivial and perhaps pedantic. Nevertheless, the operator has at considerable cost responded to all that was requested by the accreditation agency and had the centre reinspected. In six months time he will have to go through the whole process again, because his current licence expires in 2009. Surely we can have a better process in place. I urge the minister to consider my suggestion of extending the accreditation period in such cases.

In this particular case the operator has been operating the facility since 1982. He extended it in 2006 and now has a 50-bed facility. He spent around $61,000 in the last year alone in responding to the inspection of the accreditation agency. Most of that money went to a management agency which he had to employ to submit all the relevant documentation and go through the process. His staff simply did not have time to do it. Some $17,000 went to the accreditation agency, which charges a fee for its service. These are not insubstantial costs; they are significant costs. I certainly do not suggest that the inspections should not take place or that the centres should not be properly accredited. What I do suggest is that, if a centre has gone through this whole process and been found to comply with everything that is required, the licence period should then recommence for a full term. I ask that the minister look at this particular issue.

I also welcomed the changes which strengthen the bond guarantee scheme. As other speakers have noted, there is some $6.3 billion as at 30 June that is currently held in bonds by the aged-care sector. It is a lot of money. In the midst of the current global financial turmoil we have seen just how quickly large amounts of money can disappear and be lost. We have also seen individuals lose their life savings. Instead of being millions of dollars it might only be several thousand or tens of thousands of dollars, but when it is your life savings it means a lot to you. Knowing that their money is much safer as a result of strengthening bonds certainly makes a lot of difference to the peace of mind of those people who are possibly going to be admitted into nursing homes and to the peace of mind of their family members.

It is important that we have a viable aged-care sector which the public can have confidence in and that we have a sufficient number of aged-care beds available, but it also makes economic sense. Too often elderly people are kept in hospital because there is not a bed immediately available in an aged-care facility and they are not well enough to return home. In such cases the public daily cost of a hospital bed is far greater than that of a nursing home bed. Of additional concern is that the hospital bed is being occupied and staff time is being taken up to care for a person who would be able to receive all of the care they require if they were placed in a nursing home. I commend the Rudd Labor government for allocating $293 million for 228 additional transition care places, which will accommodate some 1,710 older Australians each year and enable them to transition from hospital to a nursing home until they have recovered enough to move back into their home.

The last point I want to make is in relation to some of the operators. I said earlier that, from my observations—and I have inspected most of the centres in my region and have worked alongside many of them in a whole range of ways—most of them are good operators. In fact, the majority of them are good operators, and the staff that I have come across are genuine, caring, compassionate people. But, sadly, that is not always the case, and I was disappointed to learn that earlier this year, as a result of some inspections, 500 employees in the aged-care sector had been underpaid by about $114,000. Whilst that money is being recouped, it is disappointing that that is going on. Unfortunately, the reality is that the regulations and the inspections that are required to ensure that that does not happen have to be worn by the rest of the industry, because, as in all cases, you have to legislate for the worst possible scenarios. It is sad that, as a result of those kinds of practices, good operators in the industry have to suffer.

As a result of that same inspection, I understand that 21 per cent of the aged-care facilities were found to be in breach of the Workplace Relations Act. Whilst the Workplace Relations Act is a matter that we can debate at another time, it is also important because it highlights this: if you are employing staff and perhaps not paying them appropriately, or if you are not paying them for the hours that they have worked, one can conclude that they are working under stress, and if they are working under stress there is every likelihood that they will not be able to provide the appropriate level of care and service for the people they are entrusted to look after.

This is an important bill and, as I said earlier, it is part of a $40 billion package of support that the Rudd government is providing for the aged in this country. It is a bill that is certainly welcome because it improves the care that will be provided and it will improve the confidence that families will have when older people are admitted to nursing homes. I commend the bill to the House.

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