Darren Chester (Gippsland, National Party) Share this | Hansard source

I rise to speak in relation to the Aged Care Amendment (2008 Measures No. 2) Bill 2008. In doing so, I congratulate the member for Charlton on his thoughtful contribution to the debate. I also seek to highlight the need for a whole-of-government commitment to meet the challenges of our ageing population. There is a growing awareness in the community that providing for the needs of our ageing population is a critical issue for our nation’s future. My electorate of Gippsland is following the demographic trends which have been recognised in a wide variety of reports. We have an ageing community and, with the continuing influx of sea-changers attracted to our magnificent coastal and country areas along with the Gippsland Lakes, the demand for services is expected to grow in the future.

Australia-wide, the number of people aged 65 and over is expected to increase from 13.4 per cent of the total population to 25.3 per cent in the next 40 years. In terms of the very old—those aged over 85, who tend to be the major users of aged-care services—the increase is equally stark, with a jump from 1.7 per cent to 5.6 per cent of the total population. I am reluctant to use too many figures when we are talking about aged-care services and the needs of an ageing population, because we would be wise to remember that each one of the about 150,000 people in permanent residential care is someone’s mum, father, best friend, uncle or auntie. These are individual people that we are talking about, and providing the best possible care for them in their later years is a challenge that we must all embrace. They each have individual needs and expectations, and providing those quality services, particularly for the frail and aged, in the most appropriate manner to meet their individual requirements is going to demand more flexibility and innovative thinking from us as policymakers in the future. I think it will also require a recognition that a one-size-fits-all approach simply will not work, particularly as it applies to regional areas. We will need to have more flexibility in funding and service delivery arrangements to meet the needs of different communities throughout Australia.

I believe that aged care is an issue that must be above party politics. In my early days in this place I do despair at times at the lack of genuine bipartisanship on a range of issues. In desperation to destroy the legacy of the previous government, the current administration is prone to overblown rhetoric about the achievements of the past. It is foolish and quite juvenile for members to claim the Howard government ignored the needs of older people or failed to do anything to improve aged-care services. But, equally, it is foolish and juvenile for members on this side of the House to suggest that everything has been destroyed in just 12 months. I think the two propositions are ridiculous and hold no weight in the wider community. People are looking for results from us and not endless bickering on such an important issue. The Howard government did make some significant improvements to aged-care services. It is up to the current government to build on them and to look towards the future challenges rather than focus on the past.

The Productivity Commission released a research paper in September this year titled Trends in aged care services, and it makes for very interesting reading, to say the least. The commission effectively sets out the challenges ahead for the government and it has found that there will be many more older Australians requiring the provision of aged-care services in the future. The models for providing those services will need to change to reflect the expectations and demands of the next generation of older Australians. The aged-care workforce will need to expand to meet the increased demand, and governments will need to ensure that the profession is well trained and suitably paid to attract workers in the future. I do not seek to be an alarmist on this issue, but I am concerned that our aged-care system is not well placed at the moment to meet all of those future challenges.

The Productivity Commission has highlighted many other concerns. The changing pattern of disease among the aged is expected to increase the proportion of frail and older people. As medical advances are made we can expect to live longer, often despite the existence of more than one serious health condition. The health needs of these people will become more complex and the training required to manage those conditions will become more onerous. The oldest and frailest will increase in number and it will require additional facilities and resources to provide care. Mr Deputy Speaker—without wishing to reflect on you at all—we all have a vested interest in ensuring that care is well organised for us when we get there in the future.

With the increase in the aged population, I think the natural tendency for people to remain in their own homes will continue to rise, and the range of services that will need to be provided will increase accordingly. We need to be planning now and taking positive action and the practical steps required to meet that increased demand. Our approach to the ageing population will require a whole-of-government response across every agency. There is no room for cost shifting, buck passing or the blame game when it comes to providing care for older Australians. I think all levels of government have a role to play and all departments need to be conscious of the needs of an ageing population and need to make their services, if you like, age friendly.

Those needs will naturally vary according to locations around Australia. If I may, I will speak for a moment about the electorate of Gippsland and the aged-care needs of my community. If we begin with the starting point that the overwhelming majority of older people seek to remain in their own homes for as long as possible then we need to provide services to allow that to happen. Gippsland has many rural and remote areas, and I accept that it is often difficult to provide services in parts of those types of electorates. Having said that, I also note that it is far more expensive to provide full-time residential aged care than it is to deliver services that allow people to remain in their own homes for longer. As long as it remains safe for them to do so, we need to provide services to allow people to enjoy their later years in their own homes.

If possible, older Gippslanders need to have the option of remaining in the community that they love, the community where they may have friends and family who are close at hand. This may require more innovative solutions to local problems. For example, public transport services are virtually non-existent in many parts of my region and in other parts of rural Australia. If we are going to encourage older people to hand in their driving licences when they become less capable of handling a vehicle then we will need to provide some form of alternative transport. Normally, it has not been seen as a federal government responsibility but our state governments have not always done their job in this regard. We need more frequent, flexible and more diverse public transport options to support older people in their communities. Community buses which have the flexibility to pick up and drop off at residential addresses may need to be funded, particularly in regional areas, through possibly liaising with the existing taxi industry or through better use of department of education funded school bus contractors.

Better servicing of our smaller regional communities will also demand consultation with the local centres. I am a strong believer in developing local solutions to local problems. We need to draw on that local knowledge; we need to draw on the practical experience and the common sense of people who live in these communities and engage them in the development of ideas and service delivery that will suit their community needs.

Public transport is just one of the issues facing older Gippslanders. We also need to support our carers, who are saving our nation a king’s ransom by caring for family and friends. The selfless work of carers needs to be better recognised and better supported in the future. It is often older women who take on the caring role, doing an outstanding job caring for partners or older relatives with only limited support from taxpayers. I was heartened to read recently that the Prime Minister is considering a new superannuation scheme for carers. We need to remember that these carers find it almost impossible to hold down full-time jobs. They are not in a position to make a contribution to their own super and when they reach retirement age—if they are not already there—they do not have the financial capacity to look after themselves. So I endorse the position taken by the government in this regard and I encourage the government to continue exploring opportunities to assist carers.

The recent announcement of a one-off bonus payment as part of the $10.4 billion economic stimulus package will be well received. I am surprised that, with a lump sum payment such as that, the government has not provided financial guidance for some people who are perhaps not used to receiving such a significant amount of money. Some families will receive $4,000 or $5,000 in one lump sum. It might be worth while in the future, if we provide those types of packages, to provide some extra support and guidance in the community to assist people in ensuring that they use the funds as wisely as possible.

In relation to pensioners and carers it strikes me as a bit bizarre that the government could never justify this payment as a matter of pure social justice but, when we have an international financial crisis, it is justified on an economic basis. Having said that, I note that I have consistently supported the provision of extra support for pensioners, carers and people with disabilities—certainly during the Gippsland by-election campaign and since then. I think the member for Charlton in his contribution referred to a down payment on long-term pensions reform. It is a much needed reform right throughout Australia and, I would imagine, it will have the support of both sides of the House in the future.

The need for better support for carers, including increased opportunities for respite, is a critical issue, particularly in regional areas and particularly if people are to have the capacity to remain in their homes for longer. There are already some excellent examples of service delivery directly to the home, and the district nurses who work throughout Gippsland are a classic illustration of my point. I had the personal experience in recent times of my father being terminally ill with cancer. The palliative care provided by the nurses in our family home made it much more comfortable for my father to be among family and friends at the time of his passing. The demand for these types of services in a compassionate home environment will only increase in the future. We need to be ready for it and we need to be training the staff and making sure they have support for what is a very stressful job.

One step removed from carers is the army of volunteers who are directly involved in providing aged-care services in our community. The Productivity Commission has rightfully acknowledged that volunteers will continue to play an important role in the provision of aged care. The commission noted that the potential pool of volunteers is actually expected to increase in the future. The challenge for aged-care providers will be to compete for volunteers and utilise them effectively. As the baby boomers age, we can reasonably expect to have more people in a position to volunteer their services. Although many of the boomers are in a better financial position than the previous generation, the cost of volunteering is an issue, particularly in rural and regional communities. For example, putting fuel in your car to assist with Meals on Wheels can be very expensive in some of our rural constituencies where there are routes of several hundred kilometres. We need to recognise that the goodwill of those volunteers can only extend so far, and reasonable reimbursement of expenses is something that I believe will be sought by volunteers in the future and be appropriate in many circumstances.

In terms of residential aged care, I believe the professional workforce remains a critical link. Without a well-motivated, well-trained and caring workforce, everything else will fail. From my experience in Gippsland, the workforce in the aged-care sector is doing a remarkable job in often very trying circumstances. As a new member of parliament, I have not actually visited every aged-care provider in my electorate, but I have been to several of them and I am endeavouring to get around to the rest of them as soon as possible. I have visited facilities in Sale, Maffra, Heyfield, Traralgon and Morwell. Without exception the staff have impressed me with their professionalism and their compassion for the people in their care. Theirs is not an easy job by any stretch of the imagination. They are confronted on a daily basis by the emotional and physical challenges of working with people who can be very frail or who are suffering the effects of dementia and other conditions. The people they look after do not always appreciate the work that they do, but I can assure them they are extremely valued in our community. The aged-care workforce in Gippsland often goes the extra mile to provide a happy home for the people in their care. I recently attended the AGM of the Sale Elderly Citizens Village, or Ashleigh House, as it is better known to the locals. A highlight of the meeting was the presentation of the staff long service awards for 10, 15, 20 and even 30 years of service. These are dedicated, hardworking staff who are making a difference in their daily roles.

It is with some hesitation that I note the bill provides for all staff to undergo police checks before working in aged-care facilities. I understand, of course, the motivation for these tough measures and I fully endorse the sentiment that the care and safety of residents must come first, but it gives me a vague feeling of unease that we live in a society of such distrust that such measures are deemed necessary. The Minister for Ageing in her second reading speech also spoke about a tougher enforcement regime, including an increase in the number of unannounced visits. We are right to have a tightly regulated aged-care sector with strict standards, and these accountability measures are an important aspect of the industry. Family members and friends must have confidence in the residential aged-care sector, and they need to know that their loved ones are safe and are being well cared for. Having said that, I also say that we need to make sure that families are not unduly alarmed when breaches are detected.

We had the recent experience of the Department of Health and Ageing imposing tough sanctions on the Lakes Entrance Aged Care Facility in my home town in East Gippsland. I would like to acknowledge the minister’s willingness to liaise with my office and to keep me informed on the situation. In small towns, where everyone tends to know everyone else, loose comments can be misinterpreted and may reflect poorly and unfairly on the staff involved and cause enormous stress within the community. I think the need for accurate and open dialogue in these situations is obvious. I do not wish to pre-empt what may occur in the future in relation to the future ownership of the facility in Lakes Entrance, but I simply make the point that it is highly regarded by the local residents. They are extremely keen to see the Lakes Entrance Aged Care Facility remain in place in the future. Naturally, the health and safety of the residents will be of paramount importance in that endeavour.

As I mentioned at the outset, meeting the needs of the aged-care workforce is one of the biggest challenges we face going forward. Retaining and attracting quality staff will demand more competitive rates of pay in the future and will also demand improving the work environment as much as possible. Although we are forecast to enter a period of increased unemployment, in the longer term we can expect a tighter labour market. There will be great competition among professions for a well-trained workforce. The aged-care sector must be in a position to offer its staff a reasonable salary with good working conditions and the opportunity to obtain the necessary training and qualifications for a successful and rewarding career.

The Minister for Ageing recently announced increased funding for aged care, and that is a good thing. It is claimed that 7,700 training places will be provided over four years for aged-care and community care workers, at a total cost of $41 million. As long as no-one pretends that we have solved the problem, this should be viewed as a step in the right direction. More steps will be needed in the future, particularly in relation to the financial viability of the aged-care providers.

I refer to the Grant Thornton aged-care survey, which examined the changes that have taken place since 2004 and received feedback and financial data from 700 nursing homes and hostels. Among the key findings was the statement that the average return on investment for modern single bedroom facilities was approximately 1.1 per cent. It is a major area of concern when you consider that consumer demand for increased privacy has led to the expectation that modern aged-care facilities will provide these types of rooms. I have visited many of the older facilities in my region and it is abundantly clear that people are expecting a single bedroom facility and a separate ensuite. The rooms that we may have built in previous decades do not necessarily meet the current demands in many cases. That does not reflect on the standard of care by any sense—the service provided by the staff is still outstanding. But there is an expectation that new facilities need to be built in the future to meet the demands and the needs of the ageing population. The increased cost of construction will also be an issue. It is hard to see the private sector getting too carried away about returns of 1.1 per cent per year.

There are also a couple of other points that I would like to make in this regard in relation to the bill. One is the need to consider the rural, regional or remote subsidies in the future. I fear that the smaller residential aged care providers may be financially unviable in the future. In small country towns, there is not going to be the demand to build bigger or more financially viable aged-care facilities. The government is going to need to address this issue in the future if we are going to be in a position to offer residential aged care in the smaller country towns that I have talked about. People may have lived their entire lives in those small country towns and may desire to stay there in their later years.

I also want to raise the point that others, including the member for Greenway in her contribution, have raised in relation to the assessment of care needs and the ability to make payments to aged-care providers retrospective. I understand that there is often a time lag after the assessment of whether a person needs low-level or high-level care. If a provider accepts a resident in low care and then is required to provide a much higher level of care, and if the assessment that they need high care is then backed up by an independent team, it is reasonable for the provider to be given retrospectively the higher rate for that period of care. In the interests of financial viability and the quality of service, it is important for the government to address this issue going forward.

The not-for-profit sector faces even bigger challenges when it comes to accessing funds for upgrading facilities or building new facilities. As the Thornton survey found, the not-for-profit sector has indicated that its deteriorating financial position has necessitated more commercial policies in relation to residential aged-care admissions. There is a concern that this approach has come at a cost to the financially and socially disadvantaged people in these programs. Many of the most socially and financially disadvantaged people live in rural and regional Australia. This is obviously a huge issue for regional communities like Gippsland that have a relatively low socioeconomic status. The survey found that the average anticipated building cost for new facilities was $176,000 per bed, excluding the land costs. This compares to the estimated cost of less than $85,000 per bed just five years ago.

My comments are not intended to blame or attack the current government. It is just a matter of highlighting the fact that we are facing some very real problems in relation to aged-care services in our nation. For my part, I have written to the minister to flag the concerns of my constituents. The issue of the conditional adjustment payment, or CAP funding, is a major concern for providers in my electorate. In response to the Hogan review, the previous government increased funding by $877 million over four years to provide additional financial assistance to residential aged-care providers. In this year’s budget, the current government increased the level of CAP, with the intention of providing an additional $407 million over four years. The providers in my electorate are telling me that this funding should be rolled into recurrent funding to give them more certainty in planning for the future. I understand that a review is underway and I strongly urge the minister to respect the views of industry in relation to those concerns about continuing financial viability.

I am an optimist by nature and in closing I would like to reflect on a few of the very positive initiatives that have occurred in the aged-care sector in my electorate. Just recently, I had the opportunity of officially opening the new St Hilary’s Nursing Home in Morwell. It provides accommodation and care for 51 Latrobe Valley residents and is a magnificent facility which is being provided by Baptist Community Care. There was a great deal of concern five years ago that the local community might lose St Hilary’s, and I am pleased to report to the House that the new facility is now up and running and is a credit to management and staff.

Likewise, I recently visited the Dalkeith facility in Traralgon, where there is a $50 million project underway to construct 154 independent living units alongside the existing nursing home. The first stage of 25 independent living units is well advanced, and the end result will be a village that provides a great lifestyle for people aged over 55 years. Its location, alongside the Dalkeith aged care facility, will be particularly attractive if a situation develops in the future where one partner requires a higher level of care than the other. I think it is these types of innovative solutions, which are being driven throughout regional areas, which will need to be supported by the government in the future. The village will be well equipped to help people remain in their own homes longer, and I am confident that this concept is going to be embraced by Gippsland residents who want the comfort of their own home and the security of living close to their friends and support services.

I also recently visited the new Heritage Manor in Maryvale Road in Morwell. It is another magnificent facility, with the potential for up to 95 beds. I understand that an application is pending for additional beds, and I will certainly be supporting the providers who have made such a major investment in Morwell.

Looking after the frail and the aged is a community responsibility, and I urge all members to work in the spirit of bipartisanship to achieve the best possible outcome for all Australians.

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