Warren Entsch (Leichhardt, Liberal Party) Share this | Hansard source

I certainly welcome the opportunity to speak on the Aged Care (Living Longer Living Better) Bill 2013 and related bills today. However, I have to express my concern that it has taken over a year for the government to bring this legislation to the parliament, and now it wants to push it through without any further proper consideration.

There seems to be a theme in recent times, and I point to the disastrous media reform bill as the most significant example, given that most of the provisions of these bills do not come into force until 1 July 2014. And those that do come into force by 1 July this year can be enacted under current legislation. I ask the question: why the big rush?

Many issues have been raised about the complexity of the bills, but the Department of Health and Ageing are yet to answer them satisfactorily. Despite promises of reform, five years on there is very little evidence of real change on the ground. We have seen the government take on review after report after review, the recommendations of which have been ignored or used to prompt more reports. Our aged-care system needs urgent change to provide viable and effective aged-care services for older Australians. But the Living Longer Living Better package does not resolve many outstanding viability issues for providers.

The $1.6 billion cut from the Aged Care Funding Instrument under these reforms has placed substantially more pressure on this sector. The five bills only cherry pick a few recommendations from the Productivity Commission report Caring for older Australians. They also add more regulation in what is an already very highly regulated sector. I say it is a very highly regulated sector, but to highlight some of the dysfunction that exists under our current aged-care system I would like to talk about one facility and a facility that we are hoping to establish in my electorate.

The Star of the Sea Nursing Home on Thursday Island is not a new facility. It caters for around 30 aged-care and respite residents. It is perched on the water's edge—appropriately, given that the Torres Strait Islanders are a seafaring people—and overlooking the very picturesque Torres Strait towards Hammond Island. You would expect that this would be a haven for our elderly Torres Strait citizens, but unfortunately it has had a very troubled history in recent years.

In October 2010, a nursing agency temp went on ABC Radio to describe the facility as 'understaffed, unsafe, filthy and the residents are not being properly cared for'. It prompted a review by the Department of Health and Ageing and a full replacement of the board.

The facility received two sanctions from the Aged Care Standards and Accreditation Agency relating to risks to the health and wellbeing of the residents. Townsville based Congress Community Development and Education Unit Ltd took over management of the facility in June 2011, and when I visited the facility around September of that year I conceded that the situation was certainly better. But, even so, I was horrified at the standard of the accommodation and the common areas. It prompted me to write a letter to the Prime Minister in September 2011, warning that the poor state of the facility, including structurally unsound gutters, rusting doors and louvres and the absence of secure units for dementia patients—there was a lack of security in the boundary fencing, which could allow elderly patients access to the sea—could very well lead to patient deaths. I stated in that letter:

This unacceptable situation requires everyone's urgent attention in my view as it could be seen as an elder abuse issue. My greatest fear is that someone will die before this problem is properly addressed.

That was in September 2011.

After financial troubles, CCDEU handed the management of Star of the Sea over to BlueCare in December 2012. I visited Star of the Sea in April this year, and I must congratulate BlueCare for their work. The grounds are immaculate, the staff are friendly and committed, the rooms and common areas are clean, and the patients look very clean and relaxed.

However, not everything is rosy. All of the areas that I raised concerns about back in September 2011 had remained and had, in fact, further deteriorated. Eighteen months later there are still rusting drainpipes, rotten window frames, unsafe staff accommodation. In fact, the staff accommodation has been shut down for 18 months and condemned. Staff are living in units that were provided for aged care patients. So the number of clients the facility can accept has been reduced because a lot of the accommodation is now being used by staff members.

There is other stuff there too. There is one small area there that is supposed to be an activities room. It is not much larger than a bathroom and it is next door to the pan room. It is totally inappropriate. There is no outdoor area at all for clients to sit. They are confined to a very small area where there is a TV. It is also the eating area. Another area of great concern is the lack of security fencing. Stray dogs are constantly wandering through the facility and there is a very real concern about the possibility of one of these residents being bitten by one of these dogs. Also there are numerous cases of inebriated locals taking short cuts through the facility, which is hardly seen as a secure facility for people when they are in great need.

The big question I have to ask is: despite the best efforts of the staff, why have these issues not been addressed? The Star of the Sea has been waiting for $2.1 million that had been promised by the federal government over 18 months ago—$1.7 million through the Department of Health and Ageing and another $400,000 from the ACAR round. The $400,000 was to build a deck outside to at least allow the aged residents to be able to get some enjoyment by sitting outside rather than being confined to this small area, which is the only one available at the moment. The facility is being run on an absolute shoestring despite management chasing these funds from the department numerous times. They are still to materialise. It is an absolute disgrace. I had to go to the local media to try and address the situation.

Given the status the aged have in Aboriginal and Torres Strait Islander society, families should have complete confidence in putting their family members in this facility. I understand that in Torres Strait culture family members tend to stay at home for much longer than they do in other cultures, so by the time they come into these facilities they have a much higher need for care.

After the article was published, I heard only a fortnight ago that some funding has actually come through. However, I was disappointed. It was not the $2.1 million promised 18 months ago but was only $1.1 million. They need something like about $4 million just to fix the existing problems there and get the staff accommodation open so that they can start to look at providing more rooms for ageing Torres Strait Islanders.

The cost of bringing this up to provide the additional high-care unit and dementia unit, I am told, is something in the vicinity $19 million. For the $1.1 million, it means it is well out of reach at this point in time. When we have a look at the commitments that we have for securing a future for our Indigenous Australians—I think this is the only dedicated Torres Strait Islander facility in the country—it is a national shame. The only reason it happens this way is because of the lack of scrutiny by the national media. I think this particular appalling situation needs to be addressed.

The second example I would like to talk about is the proposed Mossman District Nursing Home. For 14 years, Marj Norris and the Mossman District Nursing Home Committee have been fighting for the establishment of a facility in this regional town. It has been an incredibly long journey—fundraising, obtaining a commitment of land, and year after year applying through the Aged Care Approvals Round for the bed allocations and capital funding they need to proceed. I honestly do not know how Marj and the committee have done it, but as of today they are still waiting to hear the outcomes of the latest round, which they applied for back in December. The red tape and regulation that they have had to deal with and overcome are just baffling. The guidelines they have to meet are very, very rigid, extremely difficult and time consuming. DoHA do not give much notice as to when they will put out the notifications, and applicants need to provide a lot of supporting information to comply. In Marj's own words:

The issue is that we are seeing quite a dramatic increase in people with Alzheimer's, our aging population is increasing, and we are getting more and more 90-96 year olds requiring high care immediately.

This is very problematic and the government needs to acknowledge this very urgently.

We are absolutely determined to keep going because we cannot imagine any government being so short-sighted as to feel there is not a need for facilities here in the north.

Feedback from the previous Aged Care Approvals Round, in which the committee were unsuccessful, showed that the assessors had little grasp of the realities of living in a regional area. They stated that people could easily access residential care in Port Douglas or Cairns, conveniently ignoring that Cairns is a 75-kilometre journey away. While I accept that Port Douglas may be closer, Mossman is a very close-knit farming community where generations have lived within a stone's throw of each other. It has quite a different feel to the more transient tourist town of Port Douglas. In addition, the communities around Mossman, including Newell Beach, Cooya Beach and Mossman Gorge, have very strong Indigenous populations. For Aboriginals and Islanders, it is culturally important that their elders are on country when they pass. The opportunity to have dedicated beds at an aged-care facility in Mossman would be ideal.

In 2011 the committee partnered with the Salvation Army's Aged Care Plus, an extremely well-respected organisation with years of experience in aged care. The Salvation Army themselves have recognised the value of a nursing home at Mossman, and their decision to do what they can to progress this project is fantastic. Given that the nursing home has a huge amount of community support and generated more than 300 letters of support with its application, I can only hope that the outcome of this next round will be positive. It concerns me that small communities like Mossman tend to get overlooked. The needs there are very real. The families are close-knit and it is very difficult—we do not have the benefit of public transport, so it can be impossible for older family members to visit their loved ones in care. It is important, where we can, to keep them in the community.

On the aspect of Indigenous aged care, I have to say that we are not doing it well at all. I have serious concerns about a number of aspects. I am not going to have an opportunity to raise them here at the moment, but we need to start looking at a lot more culturally appropriate services for our Indigenous older citizens, particularly in the area of Indigenous traditional healing, where opportunities are being denied at the moment in our facilities. That is to the great detriment of our older Indigenous citizens. We seriously need to look at that area of care and we need to modify our models to be able to accommodate those special needs, particularly in relation to traditional and culturally appropriate healing methods, which I can assure you are very effective in this community. We also need to give serious consideration to the efforts of the Mossman community, who for well over a decade have worked very hard to get something that is very much needed within their community.

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