Dick Adams (Lyons, Australian Labor Party) Share this | Hansard source

I heard the member for Ryan praising the previous government. He did not praise the present government for implementing its election promises. The Hogan report was a little bit lightly done by the previous government. It was a work commissioned by the previous government, but it did not act on the recommendations in a very big way. I do not think that the honourable member should praise the previous government very much, because I do not think that it really did get on with the work. But the Rudd government has started to do so by meeting its obligations under its election promises. The minister should be praised for the work that she has done in getting the Aged Care Amendment (2008 Measures No. 2) Bill 2008 to the parliament.

The bill seeks to amend the Aged Care Act 1997 and the Aged Care (Bond Security) Act 2006 to strengthen the aged-care regulatory framework so that it reflects the current structure and nature of the aged-care industry. Aged care in Australia is largely regulated by the Commonwealth government and has changed over the years. The Commonwealth funds the provision of aged-care services through subsidies of the costs of residential care as well as capital grants. However, state and territory and local government regulations also reflect on the provision of aged-care services in matters which include: building planning and design—the spending of those capital grants that the Commonwealth provides; occupational safety, which is an important area covered by state regulations; food preparation, which is also of vital importance; and consumer protection. Those are all covered under state and territory laws.

The Australian population is ageing. Currently, older Australians, aged 65 years or over, make up 13.4 per cent of the population—that is, 2.8 million or one in seven Australians. I am told that the Productivity Commission estimates that by 2050 one in four Australians will be aged 65 years or over. That is the difference: presently one in seven, soon to go on to be one in four. Those are very interesting figures. As individuals age, some form of assistance with personal and everyday activities is usually required. The latest available data indicates that 32 per cent of those aged between 65 and 74 years and 86 per cent of those aged 85 years and over require some form of assistance. Consequently, there has been an increase in the number of people seeking access to aged care. A further trend relating to an increase in the number of people seeking to access aged care is that family structures have changed, whereby the family unit may no longer be a primary source of aged care for increasing numbers of people as it was in the past. Another emerging trend is that people are entering residential aged care requiring a higher level of care. I think that is because people stay in their homes longer. We notice this trend in an electorate like Lyons, which I have the pleasure and honour of representing, where many country and regional people stay in their homes until much later in their lives.

As mentioned earlier, when the act was initially enacted the typical business structure was one where the owner of the aged-care facility was also the operator of those facilities, and the regulatory regime of the act reflects that type of structure. On the other hand, the owner and operator of a facility now have distinct and at times separate roles and responsibilities. In addition, there has reportedly been an increase in the level of investment in aged-care services by large corporate entities and in aged-care services being combined with other kinds of services within the same facility. The aged-care regulatory regime provided for in the act does not at present adequately address these changes.

The bill proposes amendments to the act to address the different business structures currently involved in providing aged-care services, to improve and extend the regulation of aged-care providers. First, the bill proposes to amend the act to clarify that the act regulates aged-care services and that approved provider status relates to approval given for the type of aged care and specific services provided, and for the allocation of places. Second, the bill proposes to amend the act by expanding the entities involved in providing aged care which are subject to scrutiny and regulation, thereby trying to address the current limitations on the secretary to consider the record of related entities and those who influence executive decision making of the aged-care facility. It is pretty important that we have that regulatory role defined so that we know who we need to address concerns to or who is responsible for not meeting standards. In the current situation, obligations under the act cease when approval status is no longer in force, thereby excluding former approved providers from the regulatory regime and including an entity whose approved provider status is not yet in force because the entity has not yet been allocated any places in the regulatory regime.

The bill also proposes amendments expressly focused on the protection of the needs of the aged-care community, as well as aged-care recipients’ health and welfare and, of course, all their interests. Within the context of increasing numbers of people seeking to access aged care, the bill proposes amendments to streamline assessments by the ACATs, allowing for more timely and consistent assessments for aged care. Also, this bill proposes amendments to the Aged Care (Bond Security) Act to ensure that the bond guarantee scheme would apply in relation to both current approved providers and former approved aged-care providers who continue to have outstanding bonds.

Now I just want to touch on some aspects of aged care as they affect my electorate, the great electorate of Lyons. Aged care is becoming more and more sought after as families try and cope with an ageing parent or parents who can no longer look after themselves. We all face these situations in our own lives as we get older, and those of us who have faced these situations with our parents know the issues. It is a terrible wrench to have to make a decision for one’s own family, and sometimes government policy stands in the way of making the right decision. This bill helps to ensure that the provisions of the current act accord with changes in the aged-care industry, as well as addressing certain gaps in the current aged-care regulatory framework. I agree wholeheartedly with this bill.

Now I think we should start thinking smarter and be more flexible in the way we look at aged care. I believe that we should be looking for more models that allow the children, in some cases, to invest in some infrastructure such as an aged-care unit as part of a complex so that people’s parents, and later the people themselves, can move into something more manageable when old age overtakes them. At the moment there are private retirement complexes, but sometimes these are not equipped to be staged through some independent living units to hostel low care and then to high care. These are left to governments to provide. Perhaps, as part of our superannuation or some other tax-saving venture, models could be developed so that working children could provide for their parents in the private sector.

Ageing is a part of life, and the fact that many government aged-care homes are bursting at the seams with long waiting lists means that some of our parents are not being looked after in the way we would like. Many families struggle to keep their loved ones at home with them despite the enormous extra workload this sometimes entails. Then problems such as Alzheimer’s or the onset of dementia drive the family to seek more permanent help. I see this in my electorate all the time. There is a lot of shifting around before a person is permanently located. But one of the comforting things for those people’s loved ones is to be able to take them to their last home every so often to reassure them that some things do not change. If, as occurs now, the families have to sell their homes to raise the bond for the nursing homes then there is no chance for the family to provide some comfort for the parent. Somehow we have a long way to go to allow people to age gracefully and have their latter years still remain meaningful and happy. Nursing homes and some retirement centres are seen as the last resort, yet they could be just another stage in one’s life that could be just as enjoyable and positive without the cares of looking after a big house or garden. We should allow people to be able to move from their houses to a nursing home and to other places such as smaller independent units without a great deal of difficulty through pension considerations, selling the home and those issues. We need to explore those avenues much more.

The question of couples being kept together is also seen as difficult. In the case of the Ouse hospital in my electorate, which was providing some aged care as well as being a very outdated hospital, the first casualty was a couple that was moved out of the region. They were separated and moved away from their friends. They were both over 90 and in reasonable health when they left. They returned briefly for the day to celebrate their last anniversary together. Within days of that, one died and was quickly followed by the other. They were in good hands when they went, but they were on their own and away from their friends and relations. They had nothing to live for. I see this repeated again and again. This should not occur as it occurred in the decisions that were made in that instance.

We must be cleverer at how we treat our older people. Many can stay in their own homes for longer if they have help. Couples could be kept together with a little bit of rearrangement and with help they can care for each other. Families can help if there are more flexible tax and superannuation scenarios so that the financial burden of ageing can be part of the family package with all contributing. Design of buildings, both homes and care places, can be critical in the comfort and safety of our older people. Such simple things as waist-high power points, no steps, and rails appropriately placed—all as part of the basic design—are so easy to do but are rarely done.

Food too is an important part of a feeling of comfort and wellbeing. Most country hospitals used to grow their own food, have a few chooks and have access to country recipes from local people employed in the kitchen. I know how good that can be because my mother, Joyce Adams, was a cook at the Toosey hospital with her sister. They not only knew the favourites of the people they cared for but their background in the sort of cooking done in the area was key to keeping not only the patients happy but the staff and surrounding workers, who would pop in for morning tea or come and visit their relative who was enjoying still being part of the community.

I support this bill and I would like to mention a couple of nursing homes that I visited recently in my electorate when I opened some extensions. One was at Grenoch in the town of Deloraine. It is a long-serving nursing home that has been amalgamated with the local hospital. They have moved forward in a very positive way. They have a great auxiliary which has put tremendous work into providing the comforts for people who reside in that wonderful nursing home. They also did some work on McNeill House, which is part of the nursing home. It is named after Brigadier John McNeill, who played an interesting role in the town. The refurbishments have allowed McNeill House to be refurbished to resemble a home from the 1950s or 1960s, which is the period in which the residents appear to be most at ease in their dementia. So that is a wonderful thought process which has achieved a great deal for aged care in that region.

I also had the honour of officially opening the refurbishment of a wing at Tandara Lodge in the town of Sheffield. There were some very excited people at the opening and it was wonderful to celebrate the 30th anniversary of the nursing home. Many people have made a great contribution to this home over the years. I was able to talk to several of the people who have been there from the very beginning.

One of the exciting things I saw in the refurbishments to Tandara Lodge was a small gymnasium. A gymnasium in an aged-care home is a new phenomenon. The equipment is not readily available in Australia. It is made in Finland and consists of rehabilitation exercise machines that are computer controlled. They told me of a woman who came to the nursing home in a wheelchair and within one month was up and walking with a walking frame. So her quality of life has improved considerably because of the hard work and clever thinking of the staff of the nursing home. I should also mention that the ethics in the nursing home are of a high standard.

I praise the minister for the work she has done in getting this bill before us. I support the bill and look forward to it passing the parliament as the Rudd government fulfils more of its election promises.

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