Mark Coulton (Parkes, National Party) Share this | Hansard source

It gives me great pleasure to speak on the Aged Care Amendment (2008 Measures No. 2) Bill 2008 as the aged-care industry and the issues relating to aged care are very important in my electorate, as they are in all electorates. I acknowledge the contribution of the member for Braddon. I was listening to him, and prior to him the member for Gippsland, and what came to mind was that aged care is a great leveller: we can live anywhere in this wonderful country, having had different occupations, different levels of wealth and different political views, but aged care pretty well brings all Australians to the same level. The issues that our old Australians face are universal right across the country.

It is highly important that, as representatives of our electorates, we do everything we possibly can to ensure that adequate aged care is in place for our residents. One of the things that we need to be aware of is confidence in the industry. At the moment, the industry is not feeling so confident; they are looking at issues of the future, with a growing bubble of people needing aged care. A friendly word of warning to the member for Gellibrand, the Minister for Health and Ageing: she needs to be careful that her words in her role as minister show her as an advocate for the whole of the industry, unlike the unfortunate statement she made some months ago when she said that her former role as a police officer stood her in good stead to scrutinise aged-care operators. The minister has a structure in place and people who are well qualified to undertake these spot checks. I suggest she remove herself from that level of scrutiny, because the aged-care industry and the staff are looking to her as an advocate for the industry rather than as a sheriff looking over their shoulder.

I would like to acknowledge many of the wonderful aged-care facilities in my electorate. The Naroo Hostel is in my hometown of Warialda, and that is where I cut my teeth on issues relating to aged care when I became the mayor of Gwydir Shire four years ago. Naroo is owned by Gwydir Shire, and it certainly gave me a great understanding of the complexity of aged care. It is with pride that I look at it now. Naroo has had an extension of another five beds. My father was the founding chairman of the committee that started the fundraising and initially built the Naroo, and earlier this year, prior to his passing, he was a resident there for some time, so he got to experience the benefits of his hard work in previous times.

In a vast rural electorate such as mine, aged care is very important, and it is very community specific because of the distances between towns. There are some magnificent facilities in my electorate, such as Fairview in Moree; Alkira Hostel and Lundie House in Gunnedah; Koonambil in Coonamble; and Pioneer House in Mudgee, where I had the great honour of opening extensions earlier in the year. They all do a magnificent job.

One that I would like to mention as a standout is Cooee Lodge in Gilgandra. The Gilgandra community have used aged care as a method of drought-proofing their community. They showed great foresight some years ago as they picked the changing trends in aged care. Now they have a magnificent facility for a town of 2,000 people. They have individual accommodation units, a hostel, a dementia wing and, associated with the MPS, a nursing home facility. People go into the individual units at quite a young age and become acquainted with the staff of Cooee Lodge, and eventually, as they age, they progress through the different facilities there.

Cooee Lodge was one of the first to recognise the changing face of aged care. The fact is that, with facilities that were built 15 or even 10 years ago, there was a focus—and the member for Braddon alluded to this—on hostel type accommodation. But with the increase in home care packages, older people stay in their homes for longer. The need for hostel accommodation is very much reduced. There is a much greater need for accommodation for high-care patients and nursing home patients. This is causing some problems right through the industry. The fact is that, for a lot of people in this hostel type accommodation, as they wish to move into high-care beds it is very expensive to change the facilities, to get them up to that accreditation level. They were built in a different time, and now we expect higher standards for our residents. Many of these places have to have doorways enlarged and ensuites installed. In some cases, unfortunately, it is cheaper to demolish what is quite a substantial building and start again because of the accreditation and the changing face of aged care. We are going to have to address this problem as we go along.

The other issue is the fact that residents going into high-level care do not have to pay a bond, whereas in hostel care there is the responsibility of paying a bond. I think nearly all of the facilities in my electorate are run by not-for-profit organisations. Corporate aged care has not reached my part of Australia. Many of these facilities were founded on the idea of bond-paying residents and now many of them go in there without the responsibility of paying a bond.

Previous speakers have alluded to the issue of bonds. In my electorate, they range from $25,000 to $270,000. There do not seem to be any guidelines to base this on. Where you have a small aged-care facility like the one in Walgett, with 10 beds, the community out there is really struggling with how they are going to keep that going. Obviously with that number of beds it is not viable. There is a possibility that the Whiddon Group of homes may, in a benefactor role, come in and take it over and expand it. But the issue is that, if you are in Walgett and you need aged care for your partner or your parent and it is not available in the town, if you have to go to Dubbo it is 2½ to three hours drive. If you have a husband or a wife needing aged care, that is virtually separating people who have been together for 50 or 60 years. It is terribly traumatic. So, even though smaller communities struggle to have a viable aged-care facility, we in this place need to make sure that we put in adequate funding and support so that they can have aged-care facilities, to keep their elderly people in the community where they belong, where they can have their friends and family around them.

One of the biggest issues at the moment in the aged-care industry in my electorate is the issue of the aged-care assessments—that is, ACAT assessments. There are a couple of issues with those ACAT assessments. One is that the New South Wales government has pulled back on its funding—the state governments fund the ACAT assessors—so there are not many of them on the ground. You have got to understand that an aged-care patient’s condition can change at such a rapid rate that an assessment needs to be done very soon because they will quite often undergo an episode of ill health or some sort of trauma and so they need assessment in order to be given the appropriate accommodation and financial support.

Another of the issues is that there is up to a six-week lag to get a patient assessed. Also, quite often the assessment is very much on the cautious side and we are having many people assessed as needing low care or hostel care who very quickly go into that high-care bracket but unfortunately the provider is only receiving funding for a low-care patient. Quite often they will have someone there for several months on $34 a day, which is the low-care rate, compared to $160 a day, which would be the rate for the high-care assessment. This is causing enormous financial strain on these facilities. That is something that needs to be addressed quite soon. That has been brought to my attention by many of the assessors. I was speaking to the managers of Cooinda Lodge in Coonabarabran only a few months ago and they mentioned that.

This legislation extends the power to the secretary of the department of health to determine accommodation bonds. That concerns me. I think that that should be left in the hands of Centrelink as an independent body. The opportunity for conflict in having the department assessing these bonds is certainly a backward step, and I would encourage that this stay with Centrelink.

With the bonds and the financial situation, I feel that there are quite a few people in my electorate that are in need of aged care but their families are reluctant to go that way because they feel that they may have to sell the home that they may have had hopes of inheriting on the passing of their parent. Unfortunately, for less than honourable reasons, they are encouraging their loved one or relative to stay at home when they really need to be obtaining care somewhere else.

Also, I have a very large Aboriginal population in my electorate and the issue of aged care within the Aboriginal community is very complex. In Gilgandra we have an Aboriginal specific aged-care facility, and it is grossly underutilised. The culture of the Aboriginal community of keeping their family close and also the financial ramifications of losing an elderly relative out of the family unit and the income that they would bring in mean that virtually no-one is utilising this facility. It is a very complex issue and we really do need to address the issue of the ageing of the Aboriginal community and how we can best meet their needs.

The other issue is the ageing of people with disability. People with disability age at a much faster rate, so they age much earlier. Quite often the people with disabilities have lived in a group home or in supported accommodation and their families are their friends—the people they have lived with for many years. Quite often, by the time they need aged care their parents have passed on and they have no immediate family.

There is no age-specific accommodation for people with disabilities. I have been working with Westhaven in Dubbo trying to come up with a solution and I was very pleased that the Parliamentary Secretary for Disabilities and Children’s Services, the Hon. Bill Shorten, came out a few months ago and could see for himself the need. One of the complexities is that aged care is the responsibility of the federal government but disability services are the responsibility of the state governments. Unfortunately, when you have an issue that crosses the state and federal bounds it is very hard to get it up. I am determined while ever I am in this place to pursue the concept of ageing in place because it is very distressing for these people, having lived in supported accommodation or a group home for many years, to have to go to an aged-care facility where they feel very uncomfortable with unfamiliar circumstances and do not have a lot in common with the other residents. Sometimes I think we are going to have to step out of our squares of government responsibility and, with great will, try to come up with a solution to help these people.

The other issue that has been mentioned is the aged-care bubble that is coming our way—the baby boomers that are going to hit the system in 15 years time or less. We on both sides of the House are going to have to address that because it is going to happen faster than we can adapt to it.

The other issue is that of the staffing for these higher numbers. I would like to put in a plug for the aged-care staff because they are the unsung heroes in our society but, unfortunately, they themselves feel that they are the poor cousins in the healthcare industry. There is very little recognition of them in the wider community. I would also suggest to the minister that she perhaps place a little more emphasis on the morale of the staff in aged care, They are highly educated—their accreditation levels have always been on the improve and they are undertaking continuous education—but possibly the thing that sets the aged-care staff apart are those personal qualities, such as their caring qualities, that enable them to work so effectively with older people. I see, as I am sure every other member here does, these wonderful people who go to work in aged-care facilities in sometimes very trying circumstances, particularly in dementia wings and places like that. But they have a feeling that they are the poor cousins, and we need to acknowledge the skills that they have and their qualifications and we as a community need to give them far more support than we do at the moment.

I will conclude on that note. I think that this bill addresses some of the issues that we confront at the moment. I have highlighted that we need to adapt to the future. I would also like to acknowledge that the aged-care legislation that we have been operating under for the last 11 years has done a very good job but, unfortunately, I believe that it has run out of puff and needs to be updated. But this bill, I think, is only going to be a stopgap measure. We are going to have to continue to evolve to attend to our aged-care needs in the future.

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