John Cobb (Parkes, National Party, Minister for Community Services) Share this | Link to this | Hansard source

On behalf of the Parliamentary Secretary to the Minister for Health and Ageing, I present the explanatory memorandum to this bill and move:

That this bill be now read a second time.

The Aged Care Amendment (Residential Care) Bill 2006 proposes a number of amendments to the Aged Care Act 1997 (the act). The bill gives effect to changes to the treatment of income streams and assets that have been disposed of under the assets test for entry into permanent residential aged care. The bill also clarifies current delegation practices in relation to aged-care assessment teams.

Since coming to office in 1996, the Howard government has worked consistently to ensure that older Australians needing long-term care have access to a high-quality and affordable aged-care system capable of meeting their needs and preferences.

This bill brings the treatment of gifting and income streams for aged-care assets testing purposes into line with their treatment for pension assets testing purposes, as announced in the 2006-07 budget. This builds on the government’s changes to streamline administration in aged care that responded to the recommendations of the 2003-04 Review of pricing arrangements in residential aged care.

The changes are designed to simplify the interaction of the aged-care and pension arrangements for greater transparency and to facilitate wise financial planning for older Australians. They will also improve the sustainability of the aged-care financing arrangements.

Currently, assets gifted by prospective residents are excluded from assessment for aged-care assets testing purposes but are included in the pension assets test and such gifts can reduce the amount of age pension received. The current arrangements apply until 1 January 2007 and therefore people entering or moving between residential aged-care homes up to and including 31 December 2006 will not be affected.

People who enter residential aged care or move to another aged-care home from 1 January 2007 and who seek an assets assessment through Centrelink or the Department of Veterans’ Affairs will have any gifts they have made from 10 May 2006 that exceed the allowable amounts included in that assessment.

The allowable amounts are those that currently apply for the pension asset test as well as for pension and aged-care income assessment purposes—$10,000 in any financial year or $30,000 over five years.

Currently complying income streams are fully exempt from the aged-care assets test. The government has listened to feedback from consultation with stakeholders and this exemption will now continue for all complying income streams purchased prior to 20 September 2007.

This bill also amends the act to allow for the Secretary to the Department of Health and Ageing to delegate to members of the aged-care assessment teams (ACATs) the secretary’s power to extend the maximum number of days per year on which a person may be provided with residential respite care. This change will remove any uncertainty about the role of ACATs in this process.

The bill was referred to the Senate Standing Committee on Community Affairs, in order to ensure the maximum transparency and input from all interested parties. The committee recommended in its report of 9 October 2006 that the bill be passed without amendment.

In speaking to the bill in the Senate on Monday 16 October, the opposition spokeswoman on ageing, Senator Jan McLucas, advised that Labor was in support of the amendment.

However, in spite of this, and in spite of the advice of the Senate Standing Committee on Community Affairs, the opposition saw it necessary to propose an amendment to the bill. The opposition amendment, however, bore no relevance to the bill, and introduced some completely new and unrelated suggestions, about issues that are already under consideration by the Howard government.

The opposition amendment proposed to legislate a requirement that all aged-care homes be subject to at least one unannounced support contact visit per year by the Aged Care Standards and Accreditation Agency. The amendment went on to further suggest that aged-care homes must not be given any prior notice of support contact visits, and that such visits must assess all 44 of the accreditation standards.

The Howard government has an excellent track record in aged care, and passage of this bill will enable this to continue.

Julia Gillard (Lalor, Australian Labor Party, Shadow Minister for Health and Manager of Opposition Business in the House) Share this | Link to this | Hansard source

The minister at the table, the Minister for Community Services, is correct in saying that the purposes of this bill are twofold. Firstly, the Aged Care Amendment (Residential Care) Bill 2006 is to amend the Aged Care Act 1997 to harmonise aged-care and pension assets tests in relation to income streams and asset disposals through gifts. Secondly, the purpose of the bill is to amend the act to allow the secretary to delegate to specific members of aged-care assessment teams—ACATS, as they are called—the powers under the Residential Care Subsidy Principles 1997 to increase the maximum number of days allowed for a care recipient to receive residential respite care.

As we know, when someone enters into residential aged care, an aged-care assets assessment is undertaken to determine whether that person is eligible for subsidised accommodation costs. The assessment also helps people to work out the maximum of an accommodation bond or the maximum daily accommodation charge they may be charged for entry to a residential aged-care service. Under current arrangements, the total amount of gifts—assets given away prior to entry to residential aged care—are excluded when calculating the value of assets under the aged-care assets assessment. Schedule 1 of this bill enables gifts and income streams to be treated in the same way they are treated under the Social Security Act 1991 and the Veterans’ Entitlements Act 1996 for the pension assets test.

Given that the intent of this amendment is to treat gifted assets the same way as those included under the pension assets test, this bill improves equity. Consequently, Labor supports this provision. Obviously it is a better arrangement to have consistency across federal legislation about the way in which gifts are to be treated. The issue of the treatment of gifts is that there ought not to be a scheme of arrangements where people can, by way of gifts, deliberately divest themselves of valuable assets in order to qualify for subsidies that they would not otherwise have qualified for. That is the purpose of the way in which gifts and income streams are treated under the Social Security Act and the Veterans’ Entitlements Act. Now the Aged Care Act 1997 will be harmonised with those tests.

Schedule 2 of the bill amends the act to allow the Secretary of the Department of Health and Ageing to delegate to members of the aged-care assessment teams the ability to extend the maximum numbers of days of respite for families who are in need. I think there would not be a member in this place who does not have issues related to respite care raised with them frequently and, obviously, an extension of the maximum number of days of respite for families in need is something that ought to be supported. But in introducing the bill the minister at the table asserted that the Howard government has an excellent record when it comes to aged care. I regret to advise the House that, of course, this simply is not true. There are currently just over 160,000 people in nearly 3,000 aged-care facilities across Australia, and the frailty levels of those going into residential aged care are increasing significantly, with 67 per cent of permanent residents in 2005 requiring high-level care, compared with 58 per cent in 1998.

I think that this is something that people have personal experience of or may know about through friends and family. Indeed, I started my working career in an aged-care institution. That is of course some years ago now, and there is no doubt that the levels of frailty of people who then admitted themselves to residential aged care was much different from the level of frailty now. It is conceivable now for people to remain at home for a lot longer, and obviously community expectations have changed about when it is appropriate to go into residential aged care. So we see that the statistics verify what I would have thought we intuitively knew: the level of frailty of residential aged-care residents is increasing over time.

In addition to those with increasing levels of frailty who are in residential aged-care places, we know that every day there are hundreds of frail older Australians in acute hospital beds because the Howard government has failed to provide sufficient aged-care places. It is possible, in fact, for acute hospital beds to be taken for a long period of time by people who are in need of residential aged care. This is a dreadful result for the patient involved—the frail aged person—because I think all of us know that there is nothing worse than being in an acute hospital bed if you do not need to be there. If you do need acute care, of course, you want timely access to an acute hospital bed but, if you are not in need of acute care, an acute hospital bed is not a pleasant place to be—and frail Australians are left with no choice if they are not in that acute hospital bed. Because of insufficient supply of residential aged care, they will not be in a circumstance where they can be cared for.

On my travels I remember meeting an older gentleman at Wangaratta hospital who had been in an acute hospital bed for 14 months because of problems accessing a residential aged-care bed. I do not seek to suggest that is the norm; that obviously is an extraordinary case. But the fact that there is any case like that is something that we ought to be concerned about. Apart from being bad for the frail elderly Australian involved, it is a dreadful thing for our health system. There is nothing more expensive in our health system than an acute hospital bed, and there is nothing more prized than an acute hospital bed. A lack of availability of acute hospital beds causes blockages in emergency departments, where people end up for unacceptable periods on trolleys. They cannot be admitted to an acute hospital bed on a ward because no such bed is available. Also, a shortage of acute hospital beds means that people can be on elective surgery waiting lists for unacceptably long periods.

We are all familiar with the stories of people who have waited a long period in the public system for so-called elective surgery. It is elective surgery in the sense that, by definition, the conditions they have are not life-threatening, but the surgery they require would make a very big difference to the quality of their life. If you are largely immobile because you are waiting for a hip or a knee operation, then that is really causing a major problem to the quality of your life and to wait in that state for many months, perhaps years, is a very difficult problem. Of course, people also wait for other things—they wait for stent operations to alleviate heart conditions and the like, and the waiting is a very worrying period.

The Howard government would have us believe that this is all to do with state administered public hospitals and, consequently, it is all to do with the performance of state governments. But a pressure comes on our public hospitals as a result of the Howard government undersupplying aged-care beds. That pressure arises because people who should be in residential aged care cannot get there. They are stuck in acute hospital beds, which is bad for them, and those acute hospital beds cannot be used to assist in alleviating pressures on other parts of the system, particularly in emergency departments and elective surgery waiting lists.

A lack of residential aged-care beds is bad for aged Australians, but it is actually bad for our whole health system. Consequently, all Australians should be concerned about it. Even if you are nowhere near the age where you personally would be concerned about residential aged care, even if no-one in your family is in the age range where they should be concerned about residential aged care, you ought to be concerned about it. It is putting pressure on our public hospital system and no-one in this country, given the unpredictability of life’s circumstances, knows when they will need attention in a public hospital and need it in a timely fashion.

The recently released June 2006 stocktake of residential aged-care beds in Australia shows that the provision of aged-care beds continues to fall. At the December 2005 stocktake, there was an undersupply of 3,209 beds across the country. This undersupply has now risen to 4,613 beds. So, far from the grand assertion by the Minister for Community Services—who is at the table—that the Howard government has an excellent record in aged care, when you have an undersupply of aged-care beds and the dimension of that undersupply compared with demand is growing, that is not something one should be crowing about. It is a problem that one should be directing the government’s attention to and seeking to fix.

In the 10 long years that the Howard government has been in office, it has managed to turn a surplus of 800 aged-care beds in 1996 into a shortfall of 4,613 beds in June 2006. The stark picture painted by those statistics is that we are going backwards on the provision of residential aged-care beds. That simply is not good enough when we are talking about the pressures on older Australians when they need residential aged care and the knock-on pressures on our public hospital system.

The government will no doubt argue that it has increased the number of community packages. Labor supports and welcomes the provision of community care, but this should not be at the expense of the provision of aged-care beds. With the ageing population, and the increasing levels of frailty that go along with it, when someone needs a bed, they need it quickly and suggesting to people that they can wait in those circumstances obviously poses all sorts of difficulties.

Indeed, according to the Productivity Commission the time people wait to access a bed in aged care doubled from 2000 to 2005. Not only do we have a growing undersupply of aged-care beds as compared with demand but in five years of this government’s administration we have a doubling of the amount of time that people are waiting for aged-care beds. They are not statistics to be proud of and not statistics that support a grand boast by this government that it has an excellent record in aged care. As I said, that is simply not true.

Then we have the issue of the quality of care that is provided when people are in a residential aged-care institution. Too many of our aged-care facilities fail to reach the 44 quality outcomes of the Aged Care Standards and Accreditation Agency. We know that, as a result of the failure to reach these 44 quality outcomes, there can be risks for residents at aged-care facilities—risks such as what would happen in a fire? That can be a problem. One can imagine what would happen in a fire in a residential aged-care institution, with frail elderly people needing to be evacuated on an emergency basis. Obviously, maximising the ability to so evacuate those people is critical.

In June, in an embarrassing admission of incompetence, the Howard government was forced to reveal that more than 400 aged-care homes still have not complied with fire safety standards even though the deadline was 31 December 2005, and 20 of those homes had not even met the most basic local and state requirements such as organising an inspection of fire extinguishers. I think it would shock many people listening to this debate that we could be in a situation where 20 aged-care homes have not even done the most basic thing of ensuring that fire extinguishers have been inspected so that one can be confident that they are going to work in case of emergency.

We know the Howard government has handed out over $500 million to aged-care providers to meet the 1999 fire safety standards. The deadline to meet those standards was last December, as I indicated, but now some aged-care providers will have until the end of 2007 to comply. So there is a real issue here about quality and safety for the residents in residential aged-care facilities, and that is something this government ought to be concerned about.

There has also been the question of abuse of elderly Australians in aged-care institutions. We know that there have been horror stories. There have been horror stories about kerosene baths, which was something that was very comprehensively discussed in this parliament—as it should have been. There have been concerns raised about sexual abuse, which of course would shock and appal all Australians who hear about it. There have been concerns about poor and inadequate food, and there have been concerns about physical abuse such as beatings. The thought that any elderly Australian in a residential aged-care institution would be at risk of these things—of not being fed properly, of being physically or sexually abused—I think would horrify all right-thinking people. Everyone has heard the stories and read them in the media. This is an issue of quality that needs to be addressed. We need to do more to protect these frail aged Australians. That is our job as the national parliament.

The unanimous report of the Senate inquiry into aged care handed down in August 2005 recommended changes to the operation of the complaints system. The Hon. Rob Knowles, the current Commissioner for Complaints, has himself requested broader investigative powers. The Senate inquiry also recommended the protection of whistleblowers, but it was not until July that the government finally announced a package of measures aimed at combating abuse in aged-care homes. We need to be clear about that time line. We had a Senate inquiry that recommended changes in August 2005. The voice of that Senate inquiry was joined by the voice of the current Commissioner for Complaints, the Hon. Rob Knowles—who would be known to those Victorians listening as a former minister for health in the Kennett government.

Ms Catherine King (Ballarat, Australian Labor Party, Shadow Parliamentary Secretary for Treasury) Share this | Link to this | Hansard source

He is a Ballarat person.

Julia Gillard (Lalor, Australian Labor Party, Shadow Minister for Health and Manager of Opposition Business in the House) Share this | Link to this | Hansard source

The member for Ballarat reminds me that Rob Knowles is a Ballarat person, and she is an expert in such matters. He lent his voice to the need for broadening investigative powers. There was also a recommendation for the protection of whistleblowers. But not until April 2007 is the Howard government finally going to get its act together and do something to address these issues, which are all quite basic in terms of making sure that elderly Australians are protected. We have to have a complaints system that works. We have to have investigative powers that are adequate. And whistleblowers have to be able to come forward, certain in the knowledge that they are going to be protected; otherwise whistleblowers will not come forward.

I will go on now to talk about a third problem with aged care. I have talked about quality in terms of fire safety standards and I have talked about issues to do with protecting aged-care residents from abuse. The third issue is of course the issue of not having enough workers. This is a chant, if you like, that is heard right across our health system and aged-care system, and of course the two are interrelated. The acute sector in particular, and even our primary care sector, is in competition with the aged-care sector for nurses. In circumstances where we are short of nurses, it can be very difficult for aged-care facilities to hold their workforce. We know that the Productivity Commission report into Australia’s health workforce highlighted the significant shortage of nurses and care workers in aged care. Our residential aged-care workforce is ageing and decreasing in size. The stark reality is that this is only going to get worse if the government continues to avoid dealing with the issue.

Any national health workforce strategy must include the need for trained healthcare workers in residential aged-care and community care facilities. Some years ago the Senate community affairs committee inquiry into nursing identified aged care as the area of nursing in greatest crisis—with the acute shortage of nurses having led to increased use of unregulated workers to the detriment of quality care. That situation is worsening, not improving, and this is an issue that lies directly at the feet of the Howard government. The Howard government do so much to try and duck and weave and deny responsibility in health. The Howard government have made an art form out of blaming others. Indeed, I have thought from time to time that they spend more time in the ministerial wing of this building working out who else to blame than they do on any other single task that ministers attend to. Certainly that is true in health. The minister for health always has a very creative explanation as to why it is nothing to do with him when something is going wrong in our health system.

There is one thing that the Howard government most certainly cannot walk away from—in reality they cannot walk away from a lot of what is wrong with our health system. What is unambiguously clear is their failure to train enough Australians to make sure that we can properly staff our health and aged-care system—that is entirely the responsibility of the Howard government. They fund the university system in this country which produces many of the professionals we need. They have shared responsibility in a funding sense for the TAFE system, which produces many of the workers that the health system needs. The continued neglect of these sectors and their systemic underfunding has put us in a situation where we now have a health and medical workforce crisis.

There is no sector of our health and aged-care system where this shows more clearly than in our aged-care institutions. I am sure members in this place routinely visit aged-care institutions in their electorates. If staffing is not one of the first issues raised with them when they walk in the door then I would be very surprised. It is an issue raised with me consistently.

Concerns about our aged-care system motivated the shadow minister for ageing, Senator Jan McLucas, to move a substantive amendment to this bill in the Senate. The minister at the table, the Minister for Community Services, has referred to this substantive amendment in critical tones, but I think it warranted proper consideration from the Howard government. Unfortunately, it did not get it. The amendment would have legislated for one unannounced annual spot check on all residential aged-care facilities in Australia. The amendment provided that this spot check would be conducted on all 44 quality outcomes of the Aged Care Standards and Accreditation Agency.

That, in fact, is what the Minister for Ageing promised earlier this year following allegations of sexual abuse in three aged-care facilities. Once again, we have hollow words from the Howard government—something promised but not delivered. We provided in the Senate, through a substantive amendment, the legislative vehicle by which this could have been delivered. But of course the Howard government is not known for honouring its word and it did not honour its word on this occasion. It refused to support this substantive amendment.

Labor’s amendment would have enshrined a Howard government promise in this legislation, and the Howard government voted against it. It makes you think about what, really, a Howard government promise is worth. The amendment Labor offered in the Senate gave the government the language and the legislative instrument to deliver on what they had been saying. The community has a very strong understanding that every facility in this country is given a spot check every year. People think that happens. But what does a spot check mean? It should mean that it is unannounced. Everybody in the street knows what having an unannounced check means. It means someone turns up without telling you. But that is not what is going on now with the checking of residential aged-care facilities in this country. It is what should be going on, but it is not going on now.

I think every person who has some basic common sense would know that you only really find out what is happening if you turn up unannounced. If you turn up having given notice that you are going to arrive at a particular time, then people will tidy up—it is a human instinct. They will do a series of things that they do not do on an ordinary day. Some of that will be motivated by the goodwill of putting on the best possible face, but, in residential aged-care institutions that have problems, some of that will be motivated by covering up problems on the day that the aged-care accreditation people turn up. To take a simple example I have referred to during this speech, if food quality and food quantity is an issue, that can obviously be resolved for the day that the planned check happens. If you were not properly feeding residents in aged-care facilities, you would obviously put on a special meal when the people who do the checking come around. Once the people who have done the checking leave the building, you go back to your ordinary ways. The only way of making sure that we get a genuine check of what is served on an ordinary day and what is done on an ordinary day, how people are treated on an ordinary day, is to turn up unannounced for an opportunity to view what happens on an ordinary day. That is what Labor’s amendment would have done.

We have been told by the government that it is too expensive to undertake the spot checks against all 44 quality outcomes and that providers would not like it. A spot check system is about protecting people in the aged-care area and assuring that there is quality of care. It is not an opportunity that should be missed by the Howard government. We can only assume from the Howard government’s failure to support the substantive amendment in the Senate that it really does not care enough about honouring its word for unannounced spot checks, that it really does not care enough about the quality of what is happening in our aged-care facilities to make sure that these annual unannounced spot checks happen as a result of a legislative requirement. There are 166,000 residents in residential aged care who deserve better. With that, I move:

That all words after “That” be omitted with a view to substituting the following words: “whilst not declining to give the bill a second reading, the House condemns the Government for:

(1)

failing to protect our vulnerable aged population by ensuring that all residential aged care facilities receive at least one unannounced spot check every year; and

(2)

rejecting amendments to this bill that would have ensured the promised annual unannounced spot checks were enshrined into legislation”.

Harry Jenkins (Scullin, Australian Labor Party) Share this | Link to this | Hansard source

Is the amendment seconded?

Ms Catherine King (Ballarat, Australian Labor Party, Shadow Parliamentary Secretary for Treasury) Share this | Link to this | Hansard source

I second the amendment and reserve my right to speak.

Wilson Tuckey (O'Connor, Liberal Party) Share this | Link to this | Hansard source

I will first address the opposition amendment to the Aged Care Amendment (Residential Care) Bill 2006. It is not a bad idea to advise those present, as they were not around previously, that prior to 1996 there were no inspections; there was no legislation that required inspections of the type applied today. Nor was there a publication of failings, as there is today. In the early period of the Howard government, I sat here and listened to the complaints of the opposition—I think it was the member for Jagajaga at the time—about what they had read on the internet. Having conducted the inspections and identified the faults, the Howard government thought it proper to publish the findings. All of a sudden it became an issue for the opposition. Those opposite never gave the matter a thought when they were in government. They did not do anything.

It is all right to stand up here in this place and move these types of amendments, contrary to the proceedings that occurred in the period when the opposition was in government, but the reality is that those opposite forget, and they insult, a lot of the very dedicated workers who run the nursing homes and aged persons homes. History shows that most of them do an excellent job. I might add that, as we as a government have had to respond to the nagging of the member for Jagajaga, in particular, the reality is that a lot of smaller homes are now overburdened with paperwork, as we require, and that is to the detriment of the service given to the elderly residents. There has to be a balance.

The government has already responded in what I think is a satisfactory fashion. We have an agency—virtually a statutory body—responsible for the oversight of nursing homes in a very independent way. The agency and the department have signed a variation of the deed of funding agreement requiring the agency to conduct at least one unannounced visit to each Australian government subsidised home annually—and to conduct more visits if required. Contrary to the remarks of the member for Lalor, the reality is that a process is in place. It is not legislated, it is not hidebound by that legislation, and it is not run on a stopwatch; it is there as a measure that can be varied as the need arises. In addition, the agency is required to maintain an average visiting schedule of 1.75 visits per home per year.

The agency commenced these visits on 1 July 2006. Residential aged-care facilities must not be given any prior notice of the support contact. Currently legislation requires the agency to give the approved provider written notice of the intention of a visit. That is for a residential aged-care facility. The agency process for unannounced visits is to give short notice of its intention to visit—often as little as five minutes prior to the visit being undertaken—and to present a written notice requesting entry to the home at the time of arrival at the home.

We have progressed from the policies of the previous government—of doing nothing—to a situation where an adequate visit, agreed with the government department, is conducted by the agency to ensure the wellbeing of the residents of these facilities. In my mind, this is quite an adequate arrangement, and it operates under a flexible system. Legislation can sometimes be an unnecessary burden. It can limit the department and the agency in how best to respond.

We have all heard of the black book. No doubt the agency is well and truly aware of where it is most likely to find breaches of the act. I do not think that they would be very often found in the many small facilities that exist in my electorate, which happen to be run, to a great degree, in terms of policy and practice, by a voluntary committee—hardworking local people who give of their time for that purpose. It is unnecessary to put those people under additional pressure.

I—and I am sure the government is of the same view—will reject these amendments as unnecessary and somewhat hypocritical considering the stance that was taken by the opposition when it had the opportunity to do these things anyway. We have to be extremely careful that we do not so burden the workers in aged-care facilities with paperwork that they have no time to address the real problems confronting people, particularly those who are bedridden and others. The member for Lalor talks about kerosene baths and sex abuse. The kerosene bath issue was posted on the website after our inspectors discovered that it was happening.

I would like to mention some aspects of this legislation. The legislation is primarily to harmonise the pension entitlements and the access to subsidised aged persons facilities so that the means tests applicable are consistent. I find nothing wrong with that. The government has decided that the arrangements will not commence until September 2007, and it will make them consistent with new superannuation laws. That seems eminently sensible.

In a more general way, I am anxious to talk about the opportunities for more dementia facilities in the rural centres that I represent. The other day, I had representations from residents of the town of Quairading, pointing out the situation of a family that is almost rusted to the town of Quairading. They are great citizens. The wife of that couple has gotten to the stage where her husband can no longer look after her. Her condition is such that it is beyond the aged-care facilities in that town. This example cannot be responded to in time, but it has brought to the attention of the community how badly their small community needs a dementia wing associated with the facilities they provide.

When we start to allocate these facilities, I think we have to be a little careful, and we have a standard guide that says that if you do not have 10 inmates you cannot make it a commercial success. A lot of communities would rather give of their own money for smaller facilities that would service their own community. There is, I guess, nothing worse than asking people who have lived a lifetime in a small community to pack up and go. I remember well that in my community of Carnarvon many years ago a couple went to Perth to get adequate facilities because one of them was in that situation. Shortly after their move, that person died and left the other person in a completely strange environment. That really sharpened me up as a local government person at the time to move our community towards having better facilities.

The government has provided quite a generous funding package in this regard. It is a special aspect of our current policy to give high priority to dementia sufferers and the facilities they require. I am hopeful, therefore, that the minister will, in due course, look very closely at small communities where the need for dementia services is quite high and see that some of those funds are directed to them, because it is very important.

Criticism of this government for neglecting the aged is not supported by the statistics. At 30 June 1995, there were 93.8 operational aged-care places for every 1,000 people aged over 70. By 30 June 2006, this increased to 105.8 operational aged-care places for every 1,000 people over the age of 70. This represents a 49 per cent increase in the number of operational aged-care places—from about 137,000 places in June 1995 to 204,869 in June 2006. That is not a government neglecting the aged. You can do a lot with statistics, but in every regard this area seems to have been well addressed by the government.

We have given assistance for 15,750 aged-care workers to access recognised education and training opportunities, such as certificate level III, certificate level IV and enrolled nurse qualifications—in other words, upskilling those people so they can better care for the people they serve and so they can improve their own employment prospects. We have a provision for 8,000 aged-care workers to access the Workplace English Language and Literacy program and provision for 5,250 enrolled nurses to access recognised and approved medication administration education and training programs.

Some of the administration is conducted by state governments. The last I heard was that a registered nurse could not give an injection in New South Wales. If that still applies, it is an amazing situation. I stand corrected if that situation has changed but, if the skills cannot be gained to apply that simple technology, one does not have to look too hard to see why we have some problems in operating these types of facilities. I have not tried it on a human, but a lot of my racehorses say that I am very effective in that particular area. I am sure it is not a skill that requires a medical practitioner.

We have established 1,600 new nursing places at universities and have created 1,000 scholarships to be offered to encourage more people to enter or re-enter aged-care nursing, especially in rural and regional areas—and I have already made some comments about that. There has been a significant effort on behalf of the government, and I welcome those efforts. For instance, over 21,000 new aged-care places will be allocated over the three years from 2006, including 6,387 for 2006-07 alone. With these new places, we will have allocated 95,200 places between 1996 and 2007-08. There are also many other issues of that nature—for example, the number of CACP and such packages available nationally increased from 4,431 in June 1996 to 32,941 in June 2005.

I gave an indication to the opposition that I would not be using all my time, and I should keep to that promise. The legislation is sensible, and I understand that there is no objection from the opposition in terms of the major intent of the legislation. I do, however, reject the opposition’s attempts to try to make political capital on something that they failed to do themselves and something which I think is very adequately maintained today—that is, the announced and unannounced inspections. To suggest that the process needs to be toughened up is to suggest that everybody who runs a nursing home is some sort of crook. They are not. They are very decent people. The ones who do fail in their responsibilities would become well known to the department and the agency over time—and I bet they are the ones who get the most inspections.

Julie Owens (Parramatta, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Aged Care Amendment (Residential Care) Bill 2006. This bill is not particularly controversial as far as it goes. It makes a couple of important amendments to the Aged Care Act 1997 and Labor supports these amendments. Schedule 1 of the bill seeks to harmonise aged-care and pensions assets tests in relation to income streams and gifted assets under the assets test for entry into permanent residential aged care. This follows a recommendation made by Warren Hogan in his report Review of pricing arrangements in residential aged care, handed down in 2004. Two years later it is good to see the government finally responding.

Under current arrangements and under the new arrangements, people moving into residential care are offered assets tests to determine if the government will contribute to the cost of accommodation through a concessional supplement and help the person work out how much accommodation bond or accommodation charge they might be able to pay. These assets tests are undertaken by Centrelink, and by the Department of Veterans’ Affairs for veterans, and are necessary when a person moves into a facility or changes to another facility. So far as that goes, the assets tests remain as they are under the new amendment. But the change occurs when assets have been given away immediately prior to the assets test by a person needing residential care.

Under the old arrangements, assets that have been given away by a person needing residential care are not counted in the aged-care assets test. They are, however, included in the pension assets test that may reduce the amount of pension a person receives. So, under the old system, there is a difference between the way gifted assets are treated in the assets test for residential care and that for pensions. This bill brings that back into line and counts assets that are given away in the assets test for residential care.

Schedule 2 amends the Aged Care Act 1997 to allow the departmental secretary to delegate to specific members of the aged-care assessment teams the power under the Residential Care Subsidy Principles 1997 to increase the maximum number of days allowed for a care recipient to receive residential respite care. Under the old act, a person can access a maximum of 63 days respite care per financial year. However, the secretary or a delegate of the secretary can increase that amount by a period of 21 days where there is a need to do so. This proposed amendment makes the system simpler and quicker and reduces red tape. It is very welcome. The proposed amendment allows the secretary to delegate to members of the aged-care assessment teams the power to formally approve these respite care extensions—again, a small but important amendment that will make the process for people needing extra respite care easier and quicker and will reduce the amount of red tape involved. These amendments are widely supported by stakeholders in the aged-care sector, and they are supported by Labor.

It is regrettable, though, that the government missed an opportunity to do something more than tinker at the edges with technical amendments. Labor moved an amendment in the Senate, which was voted down, which would have ensured that each residential care facility would receive at least one unannounced spot check each year. All we were seeking to do was to put into legislation a commitment that this government has already made more than once and failed to meet. The member for O’Connor made much of Labor’s call for this amendment, but all we are doing here is calling on the government to do formally what it has said it will do on more than one occasion and absolutely failed to do.

After the infamous kerosene bath incidents in aged-care facilities in 2000, the then minister, the member for Mackellar, announced that every aged-care facility would receive at least one spot check each year. There are around 3,000 facilities in Australia, and last year there were a grand total of 563 spot checks made. That is significantly less than 20 per cent. The government commitment back in 2000 was that every aged-care facility—that is 100 per cent—would receive at least one spot check each year. The achievement last year was 20 per cent, much less than the 100 per cent commitment. After six years, this government has managed less than 20 per cent of what it said it would do in a year. That is simply not good enough—not good enough by the government’s own standards, Member for O’Connor.

In fact, between 2000, when the announcement was made, and last year there have only been 2,167 spot checks made in total. That means that in the six years since this commitment was made the government has not even achieved one spot check per facility—not even one per facility in six years—let alone the one per year committed to in 2000. It is disgraceful that the government continues to treat the situation lightly by voting down Labor’s amendment.

After the sexual assault allegations made earlier this year, the current Minister for Ageing, Senator Santoro, again reiterated that each facility would receive one spot check a year. The government reannounced its commitment. The fact that the minister voted against imposing this as a legislative requirement shows what his commitment to the issue really is. There are currently around 170,000 places in aged-care facilities, and this is expected to more than double over the next 25 years.

We have to have the right systems of checks and balances in place to ensure that this growing sector treats its residents with dignity and compassion. The people in residential aged care are the people who helped build our nation, and now in their retirement and their need we need to be there for them as a community and as a country. Contrary to the comments made by the member for O’Connor, this is not an attack on every single aged-care facility, but it is a recognition that, in the range of aged-care facilities around this country, there are some that are not doing the right thing—there are some whose standards are below par—and we as this parliament need to ensure that those are brought to account. It is a perfectly reasonable expectation that spot checks take place, particularly when the government has committed to it.

Interestingly enough, it is something that a number of my constituents have asked for in the last couple of months. In fact, it is quite a common request. One hears stories of facilities that sometimes do not have a registered nurse on duty and where sometimes patients are taken to hospital when, if a registered nurse were present, they could easily have been treated locally. The people who helped build our nation deserve our support in this, and they deserve at least that the government do what it has been saying it would do for the last six years.

We all know that ours is an ageing population. Since the 1970s the number of people in Australia aged over 65 has increased by a massive 143 per cent. Improved medical techniques have increased life expectancy dramatically. These, in conjunction with decreasing birth rates, have meant that the percentage of people aged 65 and over as a proportion of our total population has increased dramatically and will only continue to grow. We as a nation need to address this. If the government can only look out for around 20 per cent of residents in aged-care facilities now, in spite of their six-year commitment to do better, how can they possibly expect to cope when there is a doubling of the number of residents?

When it comes to the provision of aged-care beds, it is not just in its failure to meet its own target of spot checks that the government is falling behind; it is also in the number of beds available. When Labor left government in 1996 there were 92 residential aged-care beds for every 1,000 people aged 70 and over. In spite of the fact that we have known about the ageing of the population for at least the 10 years of this government and before, today that figure has fallen to 85.3. So, in spite of knowing about the ageing of the population, this government has allowed the servicing of our aged population to decrease from 92 residential aged-care beds per thousand people to 85.3 per thousand people. There are fewer beds available now than are necessary, and that situation is worsening week by week. In the five years from 2000 to 2005, the amount of time people spent waiting for aged-care beds doubled. In the last five years of this government’s term, the amount of time people have spent waiting for aged-care beds has doubled, in spite of the clear knowledge that the ageing of the population is one of the most significant problems this country faces.

Labor has a range of policies developed for the aged-care sector. In September this year Labor’s shadow minister for ageing, disabilities and carers, Senator Jan McLucas, released Labor’s goals for an ageing Australia—activity, quality and security. It includes a wide range of policy proposals addressing a significant number of issues in ageing and was developed after an exhaustive consultation period with stakeholders and other interested people in the community. It is a plan about going forward and tackling the issues that exist now and those that have been identified as being significant in the years ahead. It is not about tinkering at the edges. It is not about making commitments and then making them again and then not meeting them; it is about actually doing something—not talking about it for 10 years. Labor has a plan. We have a track record. I urge the community to examine both track records before the next election and decide for themselves which one stands up and is worthy of support.

Kay Hull (Riverina, National Party) Share this | Link to this | Hansard source

I rise today to support the Aged Care Amendment (Residential Care) Bill 2006 in the House. As announced in the 2006-07 budget, the amendments in this bill will align the treatment of gifting and income streams for aged-care asset-testing purposes with the treatment of gifts and income streams for age pension asset-testing purposes. The changes are designed to simplify the interaction of the aged-care and pension arrangements for greater transparency and to facilitate wise financial planning for older Australians. This bill will also improve the sustainability of aged-care financing arrangements.

The purpose of the bill is to respond to concerns raised in consultations with the community that prospective residents who purchased an income stream after 20 September 2004 could possibly be disadvantaged. Some investment products that generate income streams are purchased using a person’s assets, and currently the money used to buy these income streams is fully exempted from the aged-care assets assessment.

But if you listened to the comments of those opposite in this debate you would not understand that the bill was in fact to simplify and address agreements with respect to assets testing. Those opposite are all about scaremongering. This is all about trying to present something which is not there. It is all about smoke and mirrors, using and playing on words to frighten frail, vulnerable and elderly people and, indeed, scaremongering amongst their families. I have witnessed the kind of scaremongering that we have seen in the House today in the comments that have been made with respect to the second reading amendment the opposition have proposed to this Aged Care Amendment (Residential Care) Bill 2006 that we have sitting in front of us. The opposition’s amendment says that ‘whilst not declining to give the bill a second reading, the House condemns the government’ for these absurd allegations:

(1)

failing to protect our vulnerable aged population by ensuring that all residential aged care facilities receive at least one unannounced spot check every year; and

(2)

rejecting amendments to this bill that would have ensured the promised annual unannounced spot checks were enshrined into legislation”.

For goodness sake, the minister has implemented so many comprehensive protections for people involved in the aged-care system and their families. We have the Aged Care Complaints Resolution Scheme, which was supported by the Charter of Residents Rights and Responsibilities. It forms a significant part of the comprehensive accountability framework for Australian government aged-care homes.

This second reading amendment speaks of the failure to have spot checks. Yet we had a media statement some weeks ago from the Minister for Ageing announcing ‘Aged care spot checks already under way’. The media statement clearly states:

The Howard Government is delivering on its commitment of at least one random spot check for every residential aged care facility every year.

The government has in fact:

... allocated more than $100 million to deliver on a range of commitments ... announced earlier this year to increase the security of residents and ensure the standard of care in aged care facilities. These measures include at least one random spot check per year in each facility.

Again I reiterate there are absurd allegations and claims in the debate on this Aged Care Amendment (Residential Care) Bill 2006. It just shows that the opposition really have no understanding or concept of aged care and its requirements. Their only concern is to get out there and make statements that are scaremongering in the least and simply not acceptable in my Riverina electorate. Then you have the aged-care providers and the nursing home operators having to come out—I did not have to come out and decry Senator Ursula Stephens’s allegations in my electorate of Riverina—and reject Labor Party claims that residential aged care is going backwards in the Riverina-Murray region and that there was a shortage of 187 beds.

Of course, Country Labor is a fallacy in that I have never seen Country Labor vote against city Labor, so I am quite disturbed about Country Labor and how it works. Let Country Labor vote against city Labor occasionally. When there are things that are going to impact on country areas, such as the sale of the Snowy Hydro Scheme proposals et cetera, we did not see anyone coming out and supporting Country Labor and we did not see Country Labor voting against their city counterparts’ desire to sell off assets to get funding to run a campaign in the city areas where their majority vote is. But I will come back to—

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

I ask the honourable member to return to the bill.

Kay Hull (Riverina, National Party) Share this | Link to this | Hansard source

I am returning to the issue of Country Labor’s Senator Ursula Stephens’s allegations in my electorate. She said that the June 2000 stocktake of residential aged-care beds in the Riverina-Murray found the region needed more places to cope with demand. As reported in the Daily Advertiser on Thursday, 19 October, the Forrest Centre’s chief executive, Neil Stubbs, said the need for beds in Wagga ebbed and flowed. Of course it ebbs and flows. That is something that obviously Senator Stephens and the opposition do not understand. You cannot determine when a person may vacate a bed or when a person may require a bed. If you have all of these vacant beds, somebody has to pay for it and it is just simply not good business sense. Yet the Forrest Centre says that there was no dramatic shortage of beds for the elderly. The reality is that, as Mr Stubbs says, there are ups and downs in demand because you do not know when people are going to get sick. He said there have been occasions in Wagga Wagga where there has been no waiting list. We are not hearing any horror stories of people waiting in hospital for months to get a bed. They should know—they are the people on the receiving end. Mr Stubbs, as quoted in the Wagga Wagga Daily Advertiser, said it was important that the number of beds continued to increase as the baby boomer generation aged and needed some level of care. But I can assure you the beds have increased substantially.

In fact, Australia’s current operational ratio of 105.8 aged-care places per 1,000 people aged 70 or more is the highest it has ever been. It compares with the ratio of just 92 places per 1,000 people aged 70 or more when Labor was in power. Labor has a short memory in this House. In addition, Mr Stubbs’s analysis in the Daily Advertiser was backed up by the Haven’s general manager, Shane McMullan, who said there were times when he had a few people on his expressions of interest list but there were also short periods when he had empty beds. Again, we hear the debate in the House. This is all about scaremongering.

When you look at complaints and user rights we have the Australian government and the minister who have responsibly instituted a quality framework which includes the Aged Care Standards and Accreditation Agency, the Aged Care Complaints Resolution Scheme and user rights initiatives including the National Aged Care Advocacy Program and Community Visitors Scheme. These are fabulous schemes and enable more transparency—a concerted amount of transparency—in the industry. All homes are required as part of their accreditation framework to have an internal complaint-handling process and people may choose to use the home’s internal process before contacting the scheme. But there is support and a safety net where this does not resolve issues.

The Australian government also funds a scheme to assist residents and their families and friends or any other parties to resolve complaints about the care or the services provided in Australian government funded aged-care homes. Even in July 2006 the minister, who is doing a fabulous job in this portfolio, announced a commitment of $90.2 million over four years by the Howard-Vaile government to strengthen the arrangements for the handling of aged-care complaints. The new arrangements will replace the current Aged Care Complaints Resolution Scheme with more robust arrangements for dealing with complaints and compliance, including compulsory reporting of incidents such as sexual abuse or serious physical assault and whistleblower protection for those people who report.

The reforms will replace the existing scheme with a new Office for Aged Care Quality and Compliance within the Department of Health and Ageing. These people will have significant power. Again I come back to the debate on the Aged Care Amendment (Residential Care) Bill 2006 and the allegations made therein. I consider them to be absolutely absurd when we are looking at a departmental area that will oversee compliance. They will have significant powers of investigation for all complaints and information. They will have nationally centralised intake and prioritising of all contacts by high-level, specifically trained staff. They will have the powers to determine whether a breach of the approved provider’s responsibilities has occurred and, where a breach is identified, they will have the power to take appropriate action to remedy that breach. They will have the capacity to issue notices of required action to providers who have breached their responsibilities and also to take compliance action where the provider fails to remedy the issue. They will also provide feedback to the complainant on the outcomes. So you will no longer have a person who makes a complaint sitting in the dark. They will know what has taken place, what action has been taken and what penalties, if any, have been imposed. What more could you ask for?

The Australian government and this minister have established a new aged care commissioner who will provide an independent review mechanism. This commissioner will have wide-ranging scope to hear complaints about action taken by the Office for Aged Care Quality and Compliance from care recipients, carers, aged-care staff, providers of aged care and members of the community. This measure is coupled with the announcement earlier in the year on the introduction of police checks. The minister moved quickly and assertively to ensure that no elderly person would be in a position whereby their security and safety could not be investigated and the families, particularly, of elderly people could not feel assured.

Many times when I go to accreditation presentations I am in awe of the efforts gone to by the staff and the management of the facilities. I did one at Heyday just recently. The staff’s dedication to the residents of Heyday is absolute. I was so proud of them because they work in conditions that sometimes are challenging in an outback community. It is difficult to get qualified staff in many of the areas, but here we have community members who are caring for their elderly. They have probably known them since birth and they are out there making sure that the days of an aged Australian are quality days. When I go to these aged-care accreditation presentations, as I have said, I am in awe of the efforts of the staff in ensuring the safety of elderly people and in ensuring peace of mind for family members who have to put an aged person into a facility because they may be working full time and unable to care for that person at home or for a variety of reasons.

Earlier this year, in April, after we had some issues recognised, the minister introduced police checks and additional unannounced visits to aged-care homes by the Aged Care Standards and Accreditation Agency. It will provide a greater capacity to ensure that we deliver improved and quality of care to recipients of government subsidised aged care. We have so many programs it is almost taking up all of my speaking time just to refute this ridiculous amendment that is not for the purposes of good but for the purposes of mischief making and scaremongering, as happened just a few weeks ago in my electorate.

I do not appreciate the people of the Riverina being scared and concerned when there is clearly no need to be. We in the Riverina have offered an enormous level of service and assistance to Riverina residents and beyond in aged-care facilities, and I am very proud of our achievements as a government. I am very proud of the additional beds that we have been able to allocate in Cootamundra, Hay, Moree, Leeton and Wagga Wagga. I am so proud of all that this government has done to fill a vast void of care and concern that was left over from 13 years of Labor rule—and that was an inadequacy of beds for the aged and really no policy platform or forward planning and thinking to determine how we were going to meet the needs of the aged Australians who have contributed so much to our economy, to our lives and to Australia in general. They did not deserve a forward plan of thinking when Labor were seeking to be elected in 1996.

I will move on to the National Aged Care Advocacy Program. To support residents, this government and this minister have funded the National Aged Care Advocacy Program. This is an aged-care advocacy service that operates in each state and territory—with two in the Northern Territory—to assist people to exercise their rights through various advocacy processes, including advice and support. These advocacy services are operated by community based organisations. Who better to look after the interests of ageing people than people from the community who, as I have indicated previously, have sometimes great knowledge of the residents in these homes? These advocacy services encourage policy and practices which protect our consumers. They also promote the rights of consumers through educational programs and information provisions. Advocacy services complement the role of the Aged Care Complaints Resolution Scheme within the Australian government’s quality assurance framework. Advocacy services are available to all consumers of government funded aged care, as well as their representatives and their families. What is more important is that advocacy services are free, independent and confidential.

I will move on to the very popular visitors scheme. Our Community Visitors Scheme is working a treat in the Riverina. We are very proud of the way in which Riverina people always rally. They always raise the most money; they always put up their facilities when they have not been able to be delivered in other areas. This Community Visitors Scheme enriches the quality of life of residents in our aged-care homes who may be socially isolated or lonely.

Some of our aged-care residents live extraordinarily lonely lives because their families do not live in their town anymore. I am proud that my daughter-in-law is a volunteer for the Community Visitors Scheme. She has made an amazing difference to the lovely lady she visits and cares for and to whom she provides nurturing, understanding, conversation and genuine, true friendship and affection. This lady does not have any family members. She has never married and has not experienced a lot of care from extended family members. I would like to thank the minister for the bill and, again, say that the amendment is quite absurd.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

I too rise to speak on the Aged Care Amendment (Residential Care) Bill 2006. There seems to be a bit of a carers theme in this chamber this week. Yesterday, we spoke on a private member’s motion acknowledging Carers Week, and I took the opportunity to speak in this House yesterday on the care given to children by their grandparents. Today, we speak about the care given to many grandparents in Australia who are perhaps in aged-care homes.

I was interested to hear what the member for Riverina had to say—how everything is smelling of roses in this area. It is certainly not that way in the electorate that I represent, the electorate of Hindmarsh, which is the oldest electorate in the country, with the highest number of aged people in the country. In the electorate of Hindmarsh, which covers the western and southern metropolitan area of Hindmarsh, there has been a continuous shortage of beds since the government started to count the number of beds in 1998. We have had a constant shortage of approximately 200 to 300 beds. Those figures came straight from the minister in reply to a question on notice that I put to him asking how many beds were in those regions from 1996 onwards. He could not give me the figures for 1996 or 1997 but he certainly could give me the figures from 1998 onwards. There has been a constant shortage of beds in the western and southern region of Adelaide’s inner west, in the metropolitan area, where the seat of Hindmarsh is.

I would like to note the amendment contained within schedule 2 of the bill. This amendment allows the Secretary of the Department of Health and Ageing to delegate to members of the aged-care assessment teams the ability to extend the maximum number of days of respite care for families who are in need. Ordinarily it has been a maximum of 63 days of respite care per year, or around five days per month. The flexibility made available by this amendment increases the potential days of respite to a maximum of 84, or seven days per month—a noteworthy increase which will be of substantial benefit to those who need it most.

The flexibility to extend respite care for senior Australians whose families need assistance is something that I believe many people around the nation will view as a substantial shot in the arm. I note that all three submissions received by the Senate committee investigating this bill were supportive of this measure. Submissions were received from the AMA, National Seniors and the Department of Health and Ageing. The amendment puts into legislation the government’s previously announced spot-check activity. In fact, the government has announced universal annual spot checks on nursing homes on a couple of occasions now, but the history of this level of quality control has been seen to be more about the announcement, as we see in many areas with this government, than the actual practice of implementation.

After the kerosene bath exploded under the former minister some six years ago, it was announced that each and every one of the 3,000-odd aged-care facilities in the nation would receive a spot check each year. That has never, ever happened. Last year, only 563 were graced with such assistance. This commitment was repeated at the time of the budget this year in the wake of the sexual assault allegations earlier on in the year. The extent to which the industry is assisted through the presence of departmental agents conducting spot checks is subject to what they actually check, of course. Given the government’s history on this point over the last six years, it is regrettable, but perhaps par for the course, that it is envisaged that only a number of the 44 Aged Care Standards and Accreditation Agency quality outcomes will be assessed at any spot checks. I think this is very regrettable. I believe we owe it to our senior Australians to do what we can to assist them to enjoy their later life in satisfactory surrounds and with the appropriate support they need.

The assistance potentially available to residents and nursing homes through spot checks was identified by the minister recently when a facility in Victoria was assessed as failing to meet 30 of the 44 standards by the Aged Care Standards and Accreditation Agency’s assessment team—an assessment that was overruled by the agency, which reportedly offered the facility the opportunity to immediately take necessary measures to bring its standards up to scratch. I am sure that all concerned would appreciate that managing facilities is not an easy job but would still identify the meeting of standards as important and would wish the facility in question every success in maintaining the improvements one would hope they have made at this point.

If the government does not agree with this approach, with assisting facilities to identify areas that need improvement in accordance with all 44 standards, if the government is proposing that the human resource cost of assessing facilities against 44 standards is unduly onerous and substantially reduces the number of facilities that can conceivably be visited in a year, and if the number of visits by assessment teams is more important than what they are able to positively contribute to the industry and the facilities therein, I wonder whether the government should be reducing, perhaps consolidating, the number of standards. Fundamentally, we all want the industry to continue to develop into a stable and sustainable element within the broader Australian residential and health service sectors, and I am sure the majority of service providers do a very good job in difficult circumstances. Within and close to the electorate of Hindmarsh, from what I have seen in existing facilities and even on paper in the odd blueprint and funding application we see, I certainly believe this to be the case.

I would like to note that the current coverage of spot checks would be even more limited if the government managed to provide the number of facilities required to meet their target of 88 beds per 1,000 people aged 70 or over. The recently released June 2006 stocktake of residential aged-care beds in Australia shows that the provision ratio of aged-care beds in Adelaide’s western and southern suburbs has fallen since the Minister for Health and Ageing took over the Ageing portfolio nine months ago. I mentioned, at the beginning of my speech, the undersupply of 287 beds in areas of the federal electorate of Hindmarsh, as at the December 2005 stocktake. Since then the situation has worsened to a shortfall of 315 beds in June 2006.

The government will claim that they have put millions of dollars into aged care and allocated numbers of beds, but allocating a bed and having a bed come to fruition are two completely different things. And in an electorate like Hindmarsh, which has one of the oldest populations in the country, the population is ageing at a faster rate than the rate at which beds are being allocated, and therefore we are constantly playing catch-up; we constantly have a shortage of beds.

As I said, the operational ratio of residential aged-care beds in each aged-care planning region in Australia should be 88 beds for every 1,000 people aged 70 years and over—and that is according to the government’s own figures. The target ratio and the ratio which is realised are not of as much concern to the public as the availability of satisfactory accommodation and care when it is needed by some of the most vulnerable members of our adult Australian community. But regrettably the government has not even met its own benchmark. Worse, the position is actually deteriorating in my electorate.

For all the minister’s promises, bed numbers in proportion to need within Hindmarsh, as defined by the government itself, have actually fallen by 28 since December 2005—that is virtually 10 per cent in less than one year. In 10 long years, this government has managed to turn a national surplus of 800 aged-care beds in 1996 into a 4,613 shortfall by June 2006. We are going backwards under this government. This is just not good enough.

As I said earlier, in my electorate since 1998 there has been a constant shortage, and that shortage is growing. The aged-care minister will argue he has increased the numbers of community packages. Let me put it on record that Labor supports the number of community packages and we support the increase in the number of those packages. We welcome the provision of community care but this should not be at the expense of aged-care beds.

The minister has also stated that the identification of the government’s sub-par and worsening record is no cause for alarm, as the government’s target will be met in 2008. This is of little comfort for those people who need beds now and their families. It is of very little comfort. What faith can the community have in this administration reaching its target when in six months the shortfall has ballooned out by as much as 10 per cent? How can any concerned observer or future service recipient have any faith in such a government or take any comfort from its record of turning a national surplus of 800 aged-care beds in 1996 into a 4,613 shortfall by June 2006?

With the ageing of the population and the increasing levels of frailty that go along with ageing, when someone needs a bed they need it straightaway. According to the Productivity Commission, the time people wait to access a bed in aged care doubled in the period from 2000 to 2005. I am continually seeing the effects of the Howard government’s policies in the faces of ageing constituents and their families. I am hearing it in their voices and seeing it in their eyes.

Regardless of the rosy picture painted by the member for Riverina, two constituents of mine come to mind. The first is a 90-year-old woman who waited 12 weeks in the Flinders Medical Centre—a public hospital—because they could not find an aged-care bed in the western region for her.

The second is a woman who came to see me. Her husband had been in a public bed in the Royal Adelaide Hospital for nine weeks waiting for a nursing home bed in the western region. Both these people were very distressed. In fact, the first woman I spoke about, who was in the Flinders Medical Centre in Adelaide, had been a volunteer for many, many years. She drove one of the community buses. If this is the way this government treats our elderly it is a sign of what sort of prosperity we have. We might talk about economic prosperity but there is also a social prosperity—and on social prosperity this government fails.

People make much of the baby boomer generation, which is rapidly approaching retirement in very substantial numbers, and the comparatively low value of superannuation contributions much of this generation will, in the first instance, be expected to live on. People look to the future with something approaching dread but also something akin to a sense of inevitability, especially in terms of the financial security—or lack thereof. People are looking into the almost immediate future and seeing hundreds of thousands of Australians facing increasingly tough times for, in most cases, a highly substantial and significant proportion of their lives.

With little behind them but the family home and limited means of generating post-preservation-age income, people are asking what this government has done for 10 years. Alan Fells and Fred Brenchley state that the current administration itself may appear due for retirement as a result of not having addressed the community’s concerns, given the ample time that they have squandered in the last decade. And—I say it again—in the western suburbs of my electorate of Hindmarsh they are actually falling further behind in terms of aged-care beds.

What does it say about our society if we do not even provide sufficient care for our parents or our grandparents? We, as a society, owe it to our senior residents to make proper care available. These are people—I have said this many times—who have fought in wars and who have worked all their lives to build the foundations of our nation. They have paid their taxes. We are hitting them with another tax, the GST, in their old age. We should be offering them all the assistance we can so that they can live out the remainder of their lives knowing that they will be cared for in an aged-care facility, if that is what they need.

Finally, coming back to schedule 1 of the amendment bill, gifting is being brought into line with rules applied through the Social Security Act 1991 for age pensioners and the Veterans’ Entitlements Act 1986 for the calculation of testable assets. It is broadly held that this consistency promotes equity of access by giving people with greater capacity to pay their way the responsibility for doing so and targeting available government assistance to those most in need. This is a principle with substantial history in Australia and is generally supported as being fair and reasonable.

Chris Hayes (Werriwa, Australian Labor Party) Share this | Link to this | Hansard source

Our ageing population necessarily dictates that policies aimed at delivering high quality outcomes to our aged will receive an increasing focus as the years roll by. This is an important area of public policy and should be driven by the notion that our elderly citizens require respect having regard to what they have developed and continue to develop in their own communities and what they have achieved through their contributions to the nation as a whole.

I am sure that in the coming years there will be many controversial decisions and much debate about the future policy programs to deal with the issue of an ageing population. I am sure that everyone in this place will have the desire to avoid the mistakes of the past which have led to the much-reported scandals that have taken place, some of which were mentioned only a moment ago by the member for Hindmarsh. Such scandals should not be allowed to occur and, quite frankly, these are matters that should be dealt with. I will make a contribution on what the Aged Care Amendment (Residential Care) Bill 2006 should have been looking at a little later.

All decisions on aged care both now and in the future should be based upon delivering a better quality of life for the residents of those facilities and providing a degree of security and surety to the families of residents and the loved ones who will benefit from aged care being provided in a proper manner. The bill, while largely technical in detail, deals with two important aspects of aged-care policy. These are important areas not only for those contemplating residency in an aged-care facility but also for families of those for whom care is considered to be essential to preserve quality of life.

Schedule 1 of the bill is aimed at amending the Aged Care Act 1997 to harmonise the aged-care and pension asset test in relation to income streams and gifted assets under the assets test for entry into permanent residential aged care. This was a budgetary announcement, supported by Labor. This measure is about equity in the treatment of assets and it was the product of recommendations by Professor Warren Hogan in his Review of pricing arrangements in residential aged care, which was handed down in 2004. Under current arrangements, the total amount of gifts—that is, assets that can be given away prior to entry to a permanent residential aged-care facility—are excluded from the calculation of the value of assets under the aged-care assessment.

Schedule 1 allows gifts of income streams to be treated in the same way that they are treated in the Social Security Act 1991 and the Veterans’ Entitlements Act 1986 for the pension assets test. Accordingly, it improves equity and is therefore being supported by Labor. The new arrangement will apply to persons who undergo an asset assessment for entry into permanent residential aged care on or after 1 January 2007; however, given that this was an announcement that was made in the last budget, any gifts made on or after 10 May of this year will be taken into consideration.

The second schedule of the bill amends the act to allow the Secretary of the Department of Health and Ageing to delegate to members of the aged-care assessment teams the ability to extend the maximum number of days of respite for families in need. Again, Labor supports this amendment. Currently people can access a maximum of 63 days respite care per financial year; however, the secretary or delegate of the secretary can increase the maximum number of days by a period of 21 days where there is considered to be a need to do so. Under the amendment proposed in this bill, the secretary will be able to delegate to members of the aged-care assessment teams the power to be able to formally approve an extension of respite care for families. Needless to say, this is a significant improvement in the process. It will cut down on red tape and certainly make it quicker for families to be able to access the additional and much-needed respite care when necessary.

I note from the outset that when considering all aspects of care for older Australians, both now and into the future, it is important that such considerations be made in light of respect for the aged in our community and that it is driven by the desire to improve the quality of life of those either in care or entering into care. Those are relatively straightforward objectives but, when considering the magnitude of the problem in the future, it is easy to see how these may translate into problematic areas of public policy.

Australia has an ageing population. There is no denying that. Like many other Western nations, due to the advances that we are seeing in various areas of life, including technology, the fact is—and fortunately so—that people will be living longer. The ageing population has significant public policy implications, particularly in the allocation of resources to service an ageing population.

The Productivity Commission projects that the share of population over 65 will rise from 13 per cent to 24.5 per cent of population between 2003-04 and 2044-45. Over the same period the proportion of the population aged 85 and over will undergo an increase from 1.5 per cent to five per cent. At the moment there is an age dependency ratio of around 19 per cent, and this is expected to rise to 41 per cent by 2044-45. What this means is that the number of potential workers for each person aged 65 and over will fall from 5.2 to 2.4. The implications of ageing under those circumstances are quite clear.

While the implications of growth in the number of people aged 65 and over are often considered through the prism of a budgetary bottom line and the resulting increases in health expenditure that future governments may be forced to face, I have to say that recently I had the opportunity to consider it in a completely different light. Recently, I had the good fortune to be invited to the Ingleburn pensioners club. I would like to thank the chair, Mrs Judy Payne, and the secretary, Mrs Freda Grant, for the invitation. What I found was a group of about 40 sprightly seniors. They get together on a reasonably regular basis. As I was speaking to them I gained some appreciation of how fiercely independent this group of seniors were. They did not want to be trapped in their age.

One thing they did emphasise to me is that they did not want to consider not living in their own homes. Part of this sprang from the concerns that I have in relation to my own ageing parents. It was probably actually good to have a number of other people clearly articulating their position to me and what their desires were, which they considered appropriate for their age. One of their desires was to make sure they were fit enough and independent enough to allow them to keep on living in the place that they have called home now for many years. It is too important an element of aged care to not reconsider aspects of this, particularly when we make considerations in the light of future investment and what sort of form it should take in community care to support our aged constituents.

As I noted at the outset, consideration of the impact of decisions of care for the aged should be borne out of considerations of respect and of improving their quality of life. In many cases the respect for and the quality of life of senior Australians, quite frankly, is premised on the fact that they want and should be able to stay, where they are able to, in their own homes. This is important to them, and it is something that we should all be mindful of when we consider the development of aged-care policy into the future, because it also has a significant impact on how we resource community care to facilitate that.

Increasing the proportion of senior Australians who continue largely to care for themselves in their own homes, with the possible assistance of community care, lends itself to an approach to health care supported by Labor—that is, considering health and aged care as part of our economic future, not simply assessing our approach to aged care on the impact it is likely to have on the budget bottom line.

There is clearly a role for expanded programs in community care. Maybe it is about time that this government started considering some health related policy solutions that do not simply result in the cutting back of expenditure and of services. Those who are already dealing with the impacts of the cuts in health by this government, whether they be through shortages in the health workforce or through what has occurred more recently in respect of cuts to the PBS, really know the sort of impact that short-term fixation on cuts and cost reductions is having on the budget bottom line—and what it is going to have, quite frankly, on the population of this country now and into the future.

Another area I would like to speak about while I have the opportunity is a concern that many Australians have when considering future care, particularly of their parents. It is related to this bill, because there were a number of amendments to this bill that were rejected when it was in the Senate. During the debate on the bill in the Senate an amendment was proposed that aimed at making sure that all aged-care facilities in Australia received at least one unannounced inspection, or spot check, each year, in which the facility would be assessed against all of the 44 quality outcomes that are prescribed by the Aged Care Standards and Accreditation Agency. This was an important amendment, and I am disappointed that the government has continued to resist the move to increase the number of unannounced inspections or at least meet the minimum that it promised on various occasions.

There have been many scandals in aged-care facilities in the last few years—and there have been many promises, but little has been delivered. To simply consider the facts, there are at the moment 3,000 residential aged-care facilities throughout Australia. In 2000-01 there were 350 spot checks, in 2001-02 there were 449, in 2002-03 there were 242, in 2003-04 there were 553 and in 2004-05 there were 563. I think the conclusion has to be pretty obvious: even after the promises to step up the program of random checks, and similar promises made by the minister earlier this year, clearly the checks are not taking place, as only about one in five facilities receives one of these spot checks.

There is a reasonable expectation on the part of seniors who are contemplating a future that may include residential aged care and on the part of families who are considering the future care of their parents and relatives that the quality and standards of care facilities will be checked regularly and be overseen by the government. It is not an unreasonable expectation that the government will do everything in its power to make sure that the standards it has set are being met by all possible providers of care, but I fear it is an expectation that is not presently being met, and will not be met, under this government.

I am very confident that you would not find in the aged-care facilities in my electorate the types of abuses that have occurred in the past, to which the member for Hindmarsh and others in this place have referred. I have been to each of the facilities. They are professionally run, and the care they afford to their residents is second to none. I have a number of facilities in my electorate, including Pembroke Lodge, Blue Hills, Frank Whiddon Masonic Home, Scalabrini Village and Maple Grove Retirement Village. These are all excellent facilities. I know that their operators have a deep commitment to providing high-quality care to their residents and a desire to provide the best possible care through their very professional and fantastic staff. Unfortunately, the reputation of aged-care facilities has been tarnished by some of the rogue operators in this industry who have captured the headlines.

I have every confidence that if any facility in my electorate had been subjected to a spot check throughout the year it would have met all 44 of the government’s quality requirements, as specified by the Aged Care Standards and Accreditation Agency. Despite the number of excellent facilities in my electorate in suburbs surrounding Liverpool and Campbelltown, there is certainly a bed shortage. Like many areas throughout the country, there is a shortage of residential aged-care beds and this is likely to increase over time. Currently in the south-west of Sydney there are more than 60,000 people over the age of 70. As at June this year, there were some 5,000 operational aged-care beds in the region but 5,423 beds were needed. So, even before the real pressure of our ageing population descends upon the aged-care sector in the south-west of Sydney, there is at the moment a shortage of 400 beds.

South-west Sydney has a relatively young population, so one can imagine that the shortage of aged-care beds will grow in the future. Imagine what will happen in the not too distant future when the proportion of the population aged over 65 reaches the projected 25 per cent and the proportion of those aged 80 and over reaches five per cent of the total population. The gap between the number of operational beds and the number of beds that are needed must be addressed, and we have to do that now.

While the provisions of this bill are sound, and supported by Labor, the government cannot simply move away from a further commitment to aged care and further support for community care in support of the aged. I welcome the provisions of the bill and I encourage all members to support them in the interests of quality—(Time expired)

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I congratulate the member for Werriwa on his very thoughtful and well-researched speech. I think he has highlighted many of the very important facts within the system at the moment, including the implications for our ageing population, the importance of independence for older people, how important it is for older people to stay at home, the need for community care and the need for health and aged care. He has highlighted how the government’s cuts have had enormous implications for older people, for workforce shortages, for pharmaceutical benefits and for people using aged-care facilities. I have not followed the member for Werriwa too often when he has made a speech in this place, but it was a great privilege to listen to his contribution. I think his constituents should be very pleased to know that their member has such an in-depth knowledge of aged care.

The Howard government’s performance on aged care has been appalling. There has been one disaster after another in a flawed system that has created problems for providers, the residents who live in aged-care facilities and their families. This government has overseen a system that has forced aged-care providers to cut costs in order to survive, which in turn has led to staff reductions and corners being cut in order to provide the service. It is a system overwhelmed by red tape and bureaucratic hurdles, and in many cases it cannot guarantee the safety of residents. It is a system that has failed to deliver security to aged-care providers, aged-care residents and the families of the people who need to use aged-care facilities.

Aged-care providers are constantly trying to re-evaluate their programs simply because of the fact of the restrictions and requirements that have been placed on them by this government, and residents are bearing the brunt. It is a system that has seen aged-care residents being given kerosene baths. It is a system that has not seen fit to properly fund aged care. I note the fact that many not-for-profit aged-care providers maintain the quality of their service only by virtue of their ability to direct money into their aged-care facilities from the charity arm of their organisation.

Having made those opening remarks, I will now go to the legislation that we are considering today. I support the legislation that we have before us in parliament. The Aged Care Amendment (Residential Care) Bill 2006 has fairly simple amendments. The first looks at bringing gifting requirements in line with those in place for people to receive social security benefits. The current system excludes a person’s assets when they are calculating the value of their assets under the aged-care assessment. This enables gifts and income streams to be treated differently, but this legislation allows them to be treated in the same way. This seems to be a fairly equitable situation. The new arrangements will apply to people who undergo an assessment for entry into permanent residential care on or after 1 January 2007, and gifts made on or after 10 May 2006 will be assessable. That is to prevent people from offloading their assets prior to that date if it looks like they will be in need of care in a residential aged-care facility. This will apply not only to a person that is entering into care but also to someone moving from one facility to another.

I think this may get around some of the confusion that sometimes exists with Centrelink. I have, as I am sure other members of this House have, been approached on many occasions by constituents who have had problems with the assessment of assets and the assessment of the payments that need to be made by people when they move into aged-care facilities. Invariably the assessments that have been made have been incorrect. While this should help simplify the system a little, unfortunately it will not do anything to simplify the system that exists within aged-care facilities, because those systems are still very bureaucratic, which makes it very hard for the staff working in those facilities under them. That is to the detriment of those residents living in the facilities. The other aspect of this legislation that is worthy of mention is as follows. Currently people can access a maximum of 63 days of respite care per financial year. Under this legislation, the secretary can increase the maximum number by a period of 21 days where there is a need to do so. The bill allows the secretary to delegate to members of aged-care assessment teams, or ACATs.

I fully support these changes. But unfortunately one of the biggest problems in relation to respite care in the Lake Macquarie and Central Coast areas of New South Wales in my Shortland electorate is that not enough beds are available. So, whilst this legislation is potentially increasing the number of days that people can spend in respite care, the beds still have to be available. Unfortunately, because this government has been asleep at the wheel those beds do not exist.

I will quickly turn to the situation of aged-care beds in the area that I represent in this parliament. The Shortland electorate has the 10th highest number of people over the age of 65 in Australia. I might add that the surrounding electorates also have a very elderly population. By the same criterion, Dobell has the 29th highest, Robertson has the fifth, Newcastle has the 16th and I think Paterson, which is very close by, has the 13th. You would think that an area that has a significant number of people that are elderly would have a significant number of aged-care beds. But unfortunately what we have is a significant bed shortage, which I do not think bodes well for the people of the area.

In the Central Coast area there is a shortage of nearly 600 beds; it is 594 beds. In the Hunter it is nearly 400 beds; it is 381. Anyone who knows that region at all would know that it is quite spread out and that if the concentration of beds is in one end of that area then the other parts of the region will be disadvantaged, and unfortunately the people of the Shortland electorate are significantly disadvantaged by the distribution of beds. Whilst I have brought this up on a number of occasions with the government in this House, they have failed to address this issue. I have even submitted submissions when the department has been looking at the allocation of beds.

I have great faith in the aged-care providers and facilities within the Shortland electorate. I work very closely with them and I know that they are all very dedicated people. I know that they have been put under enormous pressure because of the changes put in place by this government. That pressure is only exacerbated by bed shortage.

The other aspect of bed shortage that I think is worth raising in this parliament is the number of beds that exist only on paper. It will not surprise you to hear that on the Central Coast the difference between the number of beds that are operational and the number of beds that have been allocated is 560 low-care beds and 117 high-care beds, which means that the government is duping the people of the Central Coast. They are saying that there are 2,059 low-care beds and 1,660 high-care beds on the Central Coast when there are actually 566 fewer low-care beds available and 117 fewer high-care beds available. In the Hunter there is a shortfall of 534 low-care beds and 231 high-care beds. That is less than honest, and I think the government should stand condemned for it.

The fact that we have these shortages that I have highlighted in the Shortland electorate, the area I represent, shows that this government is not providing the service that the people of the Central Coast and the Hunter deserve. Added to that is the fact that there are many people waiting for placement in residential care facilities, both high and low care, and also waiting to get aged-care packages. I have tried to find out just how many people are waiting, and the government will not provide me with that information. I have been told that it is not available. I am very unhappy with that because I think it is only fair that the community be made aware of the fact that this government is not delivering to older people.

The other thing that is having an enormous impact on older people—and younger people, for that matter—in the Shortland electorate is the chronic shortage of doctors. Apart from the fact that in many areas there is one doctor to well in excess of 2,000 people, the implications of the shortage of doctors for aged-care facilities are enormous. I have had staff in my office ring around to see if a doctor is available to take a resident of a nursing home as a patient. In a number of suburbs within the electorate of Shortland doctors have closed their books. One suburb that comes to mind immediately is Belmont. I choose Belmont because it has three low-care facilities and one high-care facility. Not one doctor can or will take a new patient. Therefore, if an aged-care bed becomes available in one of those facilities, it lies vacant. You have a list of people waiting for beds and you have a vacant bed that cannot be filled because there is no doctor to look after that patient. I find that less than satisfactory and so do the people that I represent in this parliament.

The other issue I would like to touch on is the complaints mechanism. I do not think it works. I have had a number of constituents come to see me with a complaint and we have gone through the procedure, and I do not think that anyone has been happy at the end of it. Any facility that has been involved in it has felt that the system did not work for them, and the constituents have not believed that the complaint has been resolved to their satisfaction.

What I am trying to create here is a picture of a system that does not work. It is a system with a high level of accountability for those providing the care which is less than satisfactory for those people who need the care, a system that is not transparent, a system that needs to be changed, a system that this government introduced and allowed and a system that has failed the people of Australia.

The amendment moved by the shadow minister highlights an issue of concern to us on this side of the parliament—the fact that we believe that there should be spot checks and that every facility should have one spot check a year. When the member for Mackellar was the minister, she promised this parliament and the people of Australia that the Howard government would deliver on one spot check a year. That has not happened. Of the 3,000 facilities in Australia last year, only 563 received spot checks. We do not believe that that is good enough. A spot check that occurs when the facility is not expecting someone to visit is a very important part of the system. Unless the government picks up its act and starts to deliver on those spot checks, the older people and their families—the frail aged people who need to live in those facilities—will feel that the government is letting them down.

In the Senate the government rejected an amendment that would have promised annual unannounced spot checks and enshrined that in the legislation. If the government was serious about spot checks, it would have voted for that amendment. Unfortunately, it appears that it was not serious about it. It voted against it. The people of Australia need to know that this government is not serious about protecting frail aged people and ensuring the quality of care in aged-care facilities.

I call on the government to rethink its position and accept the amendment that has been moved by the shadow minister. I encourage the government to vote to improve the circumstances of older people who are dependent on care and who need to trust the government. I encourage the government to deliver to them.

Tony Windsor (New England, Independent) Share this | Link to this | Hansard source

I support the Aged Care Amendment (Residential Care) Bill 2006. I would like to make a few comments on aged care. The legislative change that the government is proposing is quite acceptable.

I listened to the member for Shortland a moment ago. I agreed with quite a bit of what she had to say, but I remember a debate that took place in this place—probably two years ago now—where a number of people alluded to the bureaucratic expense of running the aged-care facilities right across Australia. From memory—I stand to be corrected—something like 30 per cent of the total expenditure on aged care was in some way administrative. We have to bear in mind that in delivering services to any community—whether it be aged care or care for younger people or people with disabilities—we do not want to let the bureaucratic process consume too much of the funding arrangements. That is not to say that there should not be spot checks, but if we are going to develop a system where we have 30,000 spot checks we want to bear in mind the cost that that involves and the impact that the cost may have on the provision of beds. We are all arguing for more beds for our particular constituencies.

I compliment the government on the progress that it has made in aged care. There has been a lot of progress in recent years, not only in the number of beds that have been allocated in high and low care but also with the capital works and facilities that some of our older people are now housed in. Some of the accommodation that our aged-care facilities have is by far the best accommodation that some of those older people will have lived in. There are some outstanding facilities.

In the electorate of New England, there are some wonderful facilities that the community is involved in. Those facilities are very much appreciated by people within the electorate. The electorate of New England has a number of smaller and medium-sized communities. That is not unusual for country electorates. One of the successes that I have seen in my time in the federal parliament—and I compliment the state governments as well as the federal government, particularly the New South Wales state government—has been the multipurpose service arrangements that have been put in place.

For those who do not know about these—and I am quite aware that many in the press gallery would like to be aware of this; it is good to see you here—a multipurpose service, or MPS, is essentially a hospital with an aged-care facility, with the hospital services, the acute care services, being provided by the state government and the aged-care beds being provided by the Commonwealth government. I see this model as being a very successful arrangement between the state and the Commonwealth. It is a great shame that on a number of other levels, with some health and other issues, we have not had that cooperation. There is absolutely no doubt in my mind, and I think most people would agree, that the MPS model has been extremely successful and in fact has changed the fate of a lot of smaller country communities.

I was recently in a little place called Emmaville for their hospital fete. They have a multipurpose service facility. It was one of the first that was developed. I would like to relate their story, because it encapsulates the way in which agendas can be changed if people get involved in the process.

Some years back now—about five or six years back; it might even be seven—the general thrust of arrangements at the New South Wales state government level was that smaller hospitals were becoming fairly uneconomic. To maintain some degree of viability in an economic sense, they were housing aged people who were not sick. In other words, there was a distortion of the arrangements. The Commonwealth, through the aged-care sector, from time to time suggested that these people were not sick and should not be in hospital but should be in aged-care facilities. Obviously, the answer would come back: ‘There is no aged-care facility in our town, so what do you suggest we do with them?’ Even though no-one was actually saying it directly, the agenda was that they should go away—go to a bigger centre, go to the coast or go to buggery. It was a case of: ‘Go somewhere else, but not here, because we do not have a facility for you.’ That was the message that was being sent out quite subtly.

The Commonwealth and the state came together to look at that problem. The electorate of New England had a particularly high residential ratio of aged people in small hospitals who were not sick. As a consequence of that, a number of people formed a committee under the auspices of the state and federal governments. That committee was chaired by a former member for New England, Ian Sinclair, and you would be well aware of Mr Sinclair’s contribution in this place. To his credit and to the credit of the others on that committee, the MPS model was developed as a way of overcoming this dilemma of having aged people in a community where there was no aged-care facility, but who were not sick, having to leave that community. The MPS model was put in place.

Emmaville was one of the very first communities to receive an MPS. At the time a group of women in this community was headed by a lady called Ellie Seagrave. I will never forget this woman as long as I live. She is still alive—I was with her only a week or two ago. The hospital was called Vegetable Creek, and I am sure many members have visited Vegetable Creek. Emmaville is the site of the panther and the home of Debbie Wells, a lady who could run very fast. Ellie Seagrave and her group of women decided six or seven years back that, although their hospital was getting old and the pressure of the economics of running it was increasing, they were not going to lose their hospital. These women dug in and nobody was going to take their hospital away. This coincided with Ian Sinclair and others looking at what they could put in place. I compliment the Commonwealth government and the state government for the role they played, and I also pay credit to the then state health minister Craig Knowles, who worked with Ian Sinclair. Ian had left parliament at that point but he had agreed to chair this committee.

In the end Emmaville received an MPS, which is a combination of acute care hospital care and aged care. It has been extraordinarily successful. About 18 months ago I was in Emmaville again. They have done tremendous things with their MPS. Ellie Seagrave called me to a meeting and said: ‘You’re the federal member. We need more beds. Go and get us more beds.’ I said, ‘But, Ellie, the facility hasn’t been up and going all that long. When it was put in place, the number of beds was determined by formula et cetera,’ which other members have referred to. I asked what had happened, and I will never forget this lady telling me: ‘We need more beds because people who left Emmaville to go to the coast to retire want to come back. They want to come back to where they lived.’

I think this is a critical point for regional development: a lot of people have left communities in the country not because they wanted to but because they thought there was nothing for them in their later days. We were losing people in their 30s, 40s and maybe 50s who were saying: ‘What happens if we get old here? There’s nothing for us. We should relocate to a bigger centre or somewhere else where there will be some facilities for our future.’ That is a critical message that governments should take on board. But I congratulate the Commonwealth government and the state government for the way they have addressed that process.

The electorate of New England has more MPSs than any other country electorate in Australia, I think, partly because of this anomaly with the smaller hospitals. I pay tribute to a former political candidate for the National Party who ran against me when I first went into parliament in 1991, David Briggs, who administered the health system at that time. I pay tribute to him because he believed, quite rightly, that these people should be able to reside in the communities that they had made a contribution to and, if that meant using a small rural hospital as an aged-care facility when there was not a lot of demand for acute care beds there, so be it.

New England now has an MPS at Emmaville. The MPS at Guyra was opened only about a fortnight ago. In Walcha the tenders are under way. Bingara is getting an MPS. Barraba has one. No-one, including the bureaucracy, really expected that Tingha, a small town and Aboriginal community, would receive an MPS, because of its proximity to Inverell. I think many people are aware that Aboriginal people in particular have an affinity with their place and even 40 or 50 kilometres away is too far. I remember going to the meeting in Tingha. There were Commonwealth bureaucrats there, and the hall was absolutely packed. It was only a couple of years ago. I remember the Commonwealth bureaucrats were there to break the news to the people—and the state government was complicit in a sense—that they would not be able to have something at Tingha. I think there were something like 400 people in that hall, including some of the Aboriginal elders, and that reversed the process in Tingha. Tingha will receive an MPS, with aged-care beds and a hospital facility.

I give those two examples because they are examples where people on the ground have actually changed policy, particularly the Emmaville people, because of their stand. They were not going to allow a government of any persuasion to remove their hospital. They took that stand and Craig Knowles, to his credit, actually listened. Ian Sinclair, in his time, also listened and developed a model. Those ladies of Emmaville, in a sense, changed policy that is having an impact not only on their town but on many other towns. The people of Tingha and people in many other towns across Australia probably owe something to those ladies of Emmaville. I was at the Vegetable Creek fete about 10 days ago. It was incredible to see the number of people who turned up, the money they raised and the antics they got up to.

Warialda—which is on the edge of my electorate but is partly within a shire that is housed in my electorate—is getting an MPS, and Bundarra has a slightly different, community-driven modification of an MPS. I congratulate all those people, as I did the former Minister for Health and Ageing, Kevin Andrews, when I first came into this place, and the subsequent minister, Julie Bishop. I think they did a good job within the bounds. Obviously, one does not want to stand up and say that things are perfect, but they are not bad. There is room for improvement, but some very positive things have happened in aged care. The new Minister for Health and Ageing—who I do not know terribly well—is obviously new to the job and I wish him well. But I do congratulate both the state and the federal government on the work they have done on those concepts.

I make one slightly less positive comment in relation to our old soldiers—some of whom may be in aged-care facilities; others may not—particularly people who served during the Second World War. Many of us have men now aged 85 or 90 in our electorates who did not serve where there was an angry shot fired and who did not, under the veterans’ affairs legislation, have qualifying service and therefore are not in a position to receive the gold card. The nation is currently trying to encourage young people into the Army. We are even trying to encourage them through a ‘try before you buy’ method—have a year and see how it goes.

We need people in our armed services, but we have this example hanging out there, where people who served for five years during the Second World War, who were prepared to go where their nation or their Prime Minister ordered that they go, who were prepared to put their lives at risk for the rest of us, are now being treated differently from their colleagues. If they happened to be in Darwin one day and not in Darwin the next they are being treated differently. There are people—and I am sure we have them in all our electorates—who trained to be paratroopers, who injured themselves during those jumps, learning to protect this nation, who now need help because of those injuries. To not grant these people the gold card is an absolute disgrace.

I compliment the government on the aged-care facilities, but I think the government should be damned for not providing the gold card to these people and, probably more importantly, for the way that it is treating some citizens differently from other citizens. That is having a psychological effect on many of those people in our communities.

I would ask the parliamentary secretary to convey my remarks to the Minister for Community Services and the Prime Minister. The Prime Minister is constantly saying that this is a nation that can afford to do this and that. If we cannot afford to look after our aged people, particularly those aged people who were prepared to keep this country for the rest of us to be able to live the life that we are now living, then I think it is something that we have to look very closely at.

These Second World War veterans in their eighties are dying at the rate of 800 a month, so it will not be an everlasting 50-year expense to provide them with a gold card. I think it is time that we started to have a good, close look, in a respectful way, at the way we have treated these people. Bearing in mind that we have spent a lot of time in the last few weeks talking about the psychological problems that farmers are having in terms of the drought, many of these elderly men are suffering severe psychological problems because of the way they have been treated. That is partly due to the way in which the RSL treated them after the war. It is very similar to what happened—in their minds; it might not be in ours—to many of the Vietnam veterans and the way they were treated when they came home. These people were prepared to go wherever they were ordered to go. My father served in the Middle East. If the Japanese had invaded Australia, he would have been a hell of a lot of good over there to my mother, wouldn’t he? These veterans were here to defend the nation, had it been invaded, and as older people now I think they deserve the utmost respect of our society and our government. I call upon the government to do the right thing and honour these people with a gold card.

Sharman Stone (Murray, Liberal Party, Minister for Workforce Participation) Share this | Link to this | Hansard source

I would like to sum up this debate on the Aged Care Amendment (Residential Care) Bill 2006. I thank the speakers both from the government and from the opposition who have contributed. I accept the congratulations from the member for New England on the contents of this bill. The Australian government has put an extraordinary amount of additional resources and policy improvements into ensuring that our most vulnerable Australians have a decent life and that they can continue in their communities for as long as possible in their own homes and then go into residential care, if they need it, and that that residential care is as close to their home community as possible.

The member for New England then went on to talk about veterans. Let me also stress to you that there has never been a more understanding and generous response to veterans when comparing this government with any other Australian government. The veterans in my community, and I have a very substantial proportion, are extraordinarily grateful for the standing and the empathy shown to them and the support which is given daily to all Australian veterans.

Let me say that the opposition’s amendment to this bill is, I am afraid, an example of perhaps no-one reading the bill or choosing not to understand it—that is what oppositions do: they simply say no—because, of course, one of the claims in the amendment was a concern about checks and, in particular, ‘failing to protect our vulnerable aged population’. The opposition’s amendment seeks to ensure ‘that all residential aged-care facilities receive at least one unannounced spot check every year’. The member for Shortland, in her remarks, made a great deal of this particular situation. Of course, from 1 July 2006 the Aged Care Standards and Accreditation Agency Ltd has increased these spot checks. They are conducted each year in residential aged-care homes. They have increased from 886 in 2005-06 to around 3,000 per year. The agency receives additional funding of $8.6 million over four years to conduct these additional spot checks. It is expected that the target of one spot check per home per year will be fully met. The agency also undertakes other visits and around 5,200 in total will be made to aged-care homes each year.

Further, under the new complaints handling process to be introduced on 1 April 2007, departmental investigators will have the power to conduct unannounced visits to homes. So quite clearly this bill more than understands and caters for a full and comprehensive checking process for aged-care facilities, and indeed we have already brought about a substantial improvement in the systems of old. There are a range of other measures already in place to ensure that our older Australians have the very best possible care—in fact, world best care. These include a complaints resolution scheme, an aged care standards and accreditation scheme and the payment for police checks for volunteers under the Community Visitors Scheme, which was announced in May 2006.

On top of this the Howard government has announced an additional $90 million to create a new aged care commissioner position and to create a new office for aged care. There will be new, vigorous complaints investigations—I have already referred to some of those—and compulsory reporting of abuse and legal protection for whistleblowers. We understand just how vulnerable a resident in an aged-care facility may be and we also recognise what might happen in some places that are not best practice and up to standard when someone does make a complaint on behalf of an elderly resident. So that additional $90 million can hardly be seen as anything other than a substantial additional investment in the care of our elderly, making sure they have a safe and homelike environment. I do recommend that the member for Shortland become better acquainted with exactly what is currently in place to assist our elderly and that she carefully read the contents of the bill, because it will help her no end to understand how the system works.

Let me also go on to say that the legislation makes amendments to the Aged Care Act 1997 and the effects of these amendments, as I have said, will be of great benefit to older Australians but particularly those living in residential aged care or considering entering residential aged care. In the 2006-07 federal budget the coalition government announced that it will bring the treatment of assets for aged-care purposes into line with the treatment for pension purposes in relation to limits on the gifting of assets and the concessional treatment of complying income streams. This legislation gives effect to these changes. It will enable Centrelink and the Department of Veterans’ Affairs to streamline their systems so that they no longer have to assess gifted assets differently, which caused great confusion and uncertainty in families and to individuals. These aged-care assets assessments have been undertaken on behalf of the Department of Health and Ageing. This new streamlined process should prevent a pensioner who has been assessed as eligible for residential aged care from gifting away most of their assets before entering care in order to try to avoid paying an accommodation payment so that they can become eligible for a government concessional residential supplement.

From September 2007 the treatment of income streams purchased on or after 20 September 2007 will also be aligned. Income streams purchased prior to 20 September 2007 will continue to enjoy the 100 per cent exemption from the aged care assets test that currently applies. Residents and prospective residents will be better able to make decisions about their care needs as a result of these changes because they will have greater certainty about their financial situation and status prior to entry to the aged-care facility. It is not a time for families and individuals to be worried. People will know that what applies to their pension in dealing with Centrelink or the Department of Veterans’ Affairs will also apply to their assets situation when going into permanent residential aged care.

This legislation will also remove uncertainty about the powers that aged care assessment teams, otherwise known as ACATs, have in approving extensions to the length of time of residential respite care. This legislation will allow the secretary to delegate the powers to increase the maximum number of days allowed by periods of 21 days where there is a need to do so. That delegation will go to ACAT delegates. This will make the process for approving additional respite care for individuals simpler and quicker.

This legislation also delivers on the initiatives of the 2004-05 Investing in Australia’s Aged Care: More Places, Better Care package. In particular, it addresses streamlining administration. The coalition government has a long and strong commitment to ensuring a robust and viable aged-care sector. We want to see our older Australians who built this country provided with high-quality and affordable care. We know that they are amongst the most vulnerable and needy in our country and we owe them a great deal of respect and very careful support in their older years. I commend this bill to the House.

Bob McMullan (Fraser, Australian Labor Party) Share this | Link to this | Hansard source

The original question was that this bill be now read a second time. To this the honourable member for Lalor has moved as an amendment that all words after ‘That’ be omitted with a view to substituting other words. The question now is that the words proposed to be omitted stand part of the question.

Question agreed to.

Original question agreed to.

Bill read a second time.