Annette Ellis (Canberra, Australian Labor Party) Share this | Link to this | Hansard source

I rise this evening to speak on the Aged Care Amendment (Residential Care) Bill 2007. This bill seeks to replace the old RCS classification system with a simplified system. It also seeks to give the secretary of the department the power to stay the suspension of a service provider. It will remove the requirement to reassess aged-care residents when they have changed facilities and will also remove the requirement that residents be reassessed every 12 months. Reassessments will now be optional in these circumstances.

Almost five years after the Hogan review into pricing arrangements in residential aged care was announced, the government has finally brought to this parliament some legislation to deal with aged-care affordability and changes to the classification system. This bill is another example of this government sitting on its hands when recommendations have been made. We have seen it with climate change and with other policies, and we are seeing it again. For more than six years, we on this side of the House—I in particular—have been calling for action to be taken, particularly in relation to the RCS. The aged-care industry has called for action to be taken as well. Since coming to office 11 years ago, this government has had, amazingly, seven ministers responsible for aged care. I have not checked, but one would suspect that there could be a revolving door on that ministerial office. In fact, I think two of the previous ministers are in the chamber at the moment. That record is appalling and it is a clear sign to older Australians about the level of importance that this government attaches to aged care and the people who are in aged-care facilities. Just how important is this portfolio that we have such a revolving door for the ministers? However, we are finally here to debate some of the changes recommended in the Hogan review.

Over many years, I have been very critical of this government regarding the RCS, or residential classification scale. The lack of flexibility under this assessment instrument has hampered aged-care facilities in delivering quality aged care specific to client needs. It could have been much easier and far less stressful for many people working in those facilities if the RCS review had occurred earlier. Furthermore, the red tape attached to the RCS has been a real impediment to aged-care providers doing what they do best—providing good patient care, not assessing and reassessing clients with reams and reams of paperwork.

Accountability is critical in the aged-care industry, and I do not debate that for one moment. After all, this industry looks after many of our community’s most vulnerable people—our aged and infirm and sometimes our younger people, who find that they have nowhere else to reside but in an aged-care facility. We need a balance where clients are protected and aged-care providers are not devoting scarce resources to comply with what has become overly onerous paperwork.

In the past we have seen some horror stories about aged care. However, I want to make it very clear that the vast majority of aged-care providers and their staff work very hard to provide the best care for their clients that the system in which they find themselves can possibly allow. Many staff choose to work in this field—and thank heavens they do—despite lower pay compared with other parts of the medical or health sector. Generally speaking—in fact, I think overwhelmingly—they do a fantastic job. Like many in this place I have personal experience to back up those claims.

Let us have a look at what the industry has had to say about this government’s pace with regard to reform in the aged-care area and what it has had to say in relation to this bill. In an undated media release that was put out following this year’s budget announcements, one of the peak bodies representing aged-care service providers, Aged Care Association Australia, ACAA, has said that it:

... remains disappointed that the Government has not listened to the advice of Professor Warren Hogan and addressed what Hogan estimated to be a $6 billion funding shortfall by financial year 2022 unless the fundamentals of the current scheme are changed. The package announced in February ... does not address Hogan’s projected shortfall and unfortunately, nor does this budget.

In my view, that is a pretty damning assessment of this government’s performance in this area. But it gets even worse. Mr Rod Young, the CEO of ACAA, went on to say:

Aged care providers across the country have been signalling to the Association that financial year 2006-07 has been the most difficult they can recall ...

That is the legacy of this government on aged care. The system of aged care has really suffered in recent years with regard to the reforms that are required. That is not me saying it; it is the peak body for the aged-care industry—an organisation that I am sure we all realise knows a thing or two about aged care. Mr Young had another couple of comments to make. He said:

... they (providers) are not prepared to make further substantial investment in the industry until Government is prepared to address the fundamentals surrounding operating and capital income streams.

Surely members opposite must start to wonder what is happening in their own electorates. Do they have a shortage of beds within their own electorates? If so, why? Are sufficient new facilities opening in their local area? Are those facilities correctly geared to the needs of the people within their community? The answers are quite simple.

I am strongly of the view that the government should have responded more quickly with the reforms that were required and that have been spoken of so much by the industry and, more importantly, by the people working within those facilities and within the industry who really do have the hands-on experience of what needs to be done. I think back to a statement that I think the Prime Minister made when he announced in February the ‘securing our future’ package. Its ‘unintended consequence’ was that it ripped out nearly $300 million in capital and care to providers over the life of that package. In the budget, the government then had to fix that up by reinstating the two subsidies that they abolished only four months earlier.

This bill will replace the burdensome RCS with a new assessment tool to be known as the Aged Care Funding Instrument, the ACFI. The ACFI will have fewer basic funding categories than the old RCS and will have attached to it two new supplements aimed at better targeting funding towards those with high-care needs, especially residents with dementia and other challenging behaviours and those who have complex care needs like palliative care. Probably the most sensible reform in this bill is the abolition of the requirement to reassess residents every 12 months. Under this bill, service providers have the option of reassessing a resident after 12 months but are not necessarily required to do so. This reform will take the pressure off service providers and their staff and allow them to focus on the more immediate needs of residents. Additionally, the removal of the requirement to reassess a resident when they change facilities has been removed, with the new provider being able to accept a classification given by the previous provider of aged-care services. Again, this is a sensible change that should reduce the overly onerous paperwork burden on those hardworking health professionals.

Another sensible reform in the bill is the ability of the secretary of the department to stay the suspension of a service provider for failing to correctly assess residents in a proper manner, subject to the provider meeting certain obligations. I understand that these obligations would be remedial in nature, such as appointing an adviser at the provider’s expense or undertaking appropriate training.

One area of concern that I have is in relation to the levels of funding attached to each classification level. My understanding is that the aged-care industry itself has not yet been provided with this information, and we are debating the bill relative to it. I would ask the minister how any industry, let alone this one—which is very complex and challenging—can be kept in the dark over what levels of funding will be available to them under the new system. How can they plan for future investment, how can they conduct business modelling and how do they know that they will be able to afford to keep operating in the fullness of time? As I said, we are debating the legislation and yet I understand that information has not been made available. As the quotes from ACAA which I mentioned earlier indicate, providers cannot invest with security, they cannot conduct business modelling and many do not know if they can afford to keep operating in the way they have been. It is ironic that one of the certainties in life for many lucky ones is ageing, but there seems to be very little certainty in the aged-care sector under this government.

In closing, I want to emphasise—and probably every member in this place would endorse what I am about to say—that the people who choose to work in the aged-care sector do so with our thanks. They do it with difficulty. They do it as virtually a calling. Many of them—and I know this from my own experience—take on what I would call extracurricular activities and services within those facilities purely because they enjoy what they do and they enjoy seeing the joy that those added services bring to residents within the facilities. I applaud every one of them for that.

Our job in this place is to ensure that the legislation that looks after the aged-care sector is open and fair, gives every possible encouragement to those care providers and relieves them of any of those burdensome bureaucratic arrangements that have been in place to date. I welcome these changes. I am sure there are many more that we would welcome if we could see them come forward. Of course, the other big question—which we are not debating today but which I make note of—is the increasing cost to people in the aged-care sector and what we can do to ensure that the aged-care sector has a full and healthy future.

Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for Northern Australia and Indigenous Affairs) Share this | Link to this | Hansard source

As we know, the Aged Care Amendment (Residential Care) Bill 2007 seeks to amend the Aged Care Act 1997 to introduce a new arrangement for allocating subsidies in residential aged care, the Aged Care Funding Instrument. The bill also alters current arrangements under which classifications expire after 12 months and removes the requirements for providers to submit reappraisals, but it gives providers the option to reappraise residents after 12 months. Another area of amendment allows a provider to accept a resident’s current classification when a resident moves from one home to another, rather than being required to submit a new appraisal. To me that is an eminently sensible suggestion.

The bill, in essence, is designed to reduce the amount of documentation generated in aged-care facilities which is required to justify the funding classifications for each resident. We welcome the stated objective of reducing paperwork for aged-care staff and hence liberating them for essential tasks in actually caring for residents.

The fact that our country has a progressively ageing population is well known, and in this it is similar to other Western nations. There are 2.5 million Australians, approximately 13 per cent of the total population, who are currently aged over 65. By 2051, the proportion of the population aged over 65 will represent one-quarter of the nation’s population, barring any major changes in immigration intake. Currently, across Australia there are some 3,000 nursing homes, which cater for 160,000 people. The demand for care is, as we know, increasing dramatically. It has been estimated that by 2019 there will be a need to provide care for some 970,000 people.

While the population as a whole is ageing quite rapidly, the situation is even more pronounced among Indigenous Australians, particularly in my own electorate. Earlier this year, Charles Darwin University put out some research findings on the projected rate of increase of the Northern Territory’s Indigenous population. You would know, Madam Deputy Speaker, that almost 40 per cent of the voters in my electorate of Lingiari are Indigenous Australians. According to that report released by Charles Darwin University, there are currently 62,669 Aboriginal Territorians, with 40,000 of those living in regional areas. By 2031, this number is expected to have increased to about 98,052, representing a 56 per cent jump. The research also found that the number of Aboriginal people in the Territory aged over 65 is set to increase from 1,576 in 2001 to 4,375 three decades in the future, representing a 177 per cent increase.

Whether or not we will see that increase and what factors have been assumed in getting to that figure is of interest, I think, because we know of the appalling mortality rates in Indigenous communities—the low life expectancy of Aboriginal Territorians. To see that the number of people over the age of 65 will increase by 177 per cent is a strong indication to me of an expectation that we will achieve much more than we have in terms of improving the health status of Aboriginal Territorians so that they do actually have a life expectancy beyond the age of 65, because currently that is not the case for the average Aboriginal Australian.

The Department of Health and Ageing annual report of 2005-06 provides figures on the ratio of aged-care places, allocated and operational, per 1,000 persons aged 70 and over. The figures cited for the Territory are quite high relative to the rest of Australia, partly because, recognising the demographic of the Northern Territory, they incorporate any Aboriginal Australians aged 50 years and over. In the case of Alice Springs there are 368.6 allocated places per 1,000 persons aged 70 or over if they are non-Indigenous and 50 or over if they are Indigenous. In the Barkly region—and, as you would know, Madam Deputy Speaker, the major centre for the Barkly is of course Tennant Creek—the number of allocated places per 1,000 persons is 516.9. In East Arnhem Land there are 532.1 allocated places per 1,000 persons, and that reflects the significantly high proportion of that population who are Aboriginal Territorians. Again it goes to the point that these places are allocated for Aboriginal Australians aged 50 and over, and the number of allocated places rises dramatically as a direct result. For the Territory as a total, there are 244.8 allocated places per 1,000 persons, again reflecting the demography of the place, whilst the average across Australia is 117.9 allocated places per 1,000 persons.

I have had difficulties with census data in the past and I still question the accuracy of some of the data that is used to calculate some of these figures; I do wonder whether or not they give an accurate picture of the situation in remote communities. It raises a significant question about whether elderly Australians—in this case, primarily Aboriginal Australians—living in isolated areas are getting the proper level of care that they require. I think that is very open to question, and a little later I will talk about some of the facilities that exist in the Northern Territory through which services are being provided in remote communities. But, significantly, in many major Aboriginal communities across the Top End of Australia, aged-care services are extremely limited.

The aged-care funding package Securing the Future of Aged Care for Australians was launched by the Prime Minister in February this year. On face value, at the time it did seem that the government had finally dealt with the underfunding of residential aged care. However, it was quickly ascertained by the aged-care sector that the proposals were seriously flawed. Mr Wayne Belcher, the Chief Executive of Churches of Christ Homes and Community Services Inc. in Western Australia, said that the package ‘lacked clarity, substance and equity for residential aged-care providers’. He continued:

The level of funding can no longer support the development of accommodation required to provide appropriate residential care. It fails the test of reasonableness.

He went on to say:

The Australian government has failed to meet its reasonable commitments to residential aged-care funding through these recent announcements ...

Even the former minister came out and admitted that some facilities could be worse off because of unintended consequences. The recent budget did patch up this flawed securing the future package to some extent. However, it is does not provide an answer for aged care into the future, least of all for aged care in the bush. It does little to reverse the slow and steady decline of aged care under this government. In 11 years the Howard government has turned a surplus of 800 aged-care beds in 1996 into a shortfall of 2,735 beds in 2006. In 1995, there were 92 aged-care beds for every 1,000 persons aged 70 years and over. In December 2006, there were only 86.6 beds for every 1,000 persons aged 70 years and over.

In the Northern Territory, it is true that there are issues to deal with the provision of aged care. It could be argued that there is a question of the concentration of population and the lack of critical mass, which make it difficult for the provision of aged-care places, particularly being spread across the region in small communities. But that raises a serious question of a danger of an ‘out of sight, out of mind’ mentality developing—because you cannot see people, because you do not visit them, you do not understand they are there and you do not provide them with the services that they require. There is a need for places in communities, because people have a right to live in those communities and be close to their country and loved ones.

I had a recent visit to Docker River, a small community in my electorate with an aged-care facility that has been there for at least a decade or so. It is not an accredited aged-care facility; however, it is funded and provides a socially and culturally sensitive aged-care service for people who live within that region. The community and the staff are highly motivated towards providing an appropriate service which meets the needs of clients, provides some respite facility for people who live in adjacent communities, who might be some hundreds of kilometres distance from this particular place, and, at the same time, provides the possibility of high-care service for particular clients.

If you looked at the standards in this place in the context of what might be provided in aged-care facilities in some of our metropolitan areas, you would say, having visited this particular facility, ‘This is a bit rough.’ While it is true that the buildings could do with some additional resourcing, the fact is that the service which is supplied by the people who are responsible for doing it appears to suit the needs of the client group and is most sensitive to their cultural needs. That to me is a very major test for any service which is provided to remote Aboriginal communities.

I am most concerned that there are probably many individuals who would qualify for aged-care services in the bush who have not been identified. I do know that aged care in Lingiari has not been considered as an area of priority by government because there are many non-Indigenous Territorians who on reaching retirement have historically left the Territory—although I am pleased to say that that trend is changing. Many have left the Territory at the end of their full-time working life. This leads to a catch-22 situation because many of those people leave the Territory or have left in the past because of their concern about the level of aged care and medical services for seniors. On the other hand, because they leave, governments often apparently do not see the need for services because most working Territorians may factor into their retirement plans that they will not be permanently living in the Territory once they retire.

In my electorate, mainstream services are provided in Alice Springs, Tennant Creek and Katherine. In Alice Springs, the two major providers of aged-care services are the Old Timers Homes and the Hetti Perkins Home for the Aged. The Old Timers Homes are operated by the Uniting Church Frontier Services and have been in operation since the late 1940s. I recently visited the opening of a new wing. It currently has 68 nursing home places plus a number of cottages. One of those cottages is currently occupied by a 94-year-old good friend of mine whose name is Peg Nelson. Peg is a significant Territorian in her own right but she is also the wife of a former member of this place, Jock Nelson, who served in this parliament between 1949 and 1966 and was later to become the Administrator of the Northern Territory. Peg is a wonderful woman. She lives in pretty well idyllic surroundings. She is a woman of great capacity and has as her neighbour another great friend of mine, Frances McKechnie.

Frances was a member of the Uniting Church and operated in a ministry in the Uniting Church for many years. She is someone who has chosen to come to live in Alice Springs in this aged-care facility. They live independently but within the facility. I know that they are very comfortable where they are. It is a great tribute to Frontier Services that they are able to provide the level of support and care required not only to Mrs Nelson and Ms McKechnie but also to those people who are their clients in the nursing home and the hostel.

The other facility in Alice Springs is provided by Aboriginal Hospitals. Hetti Perkins is a hostel which has over 30 places and largely provides services for people from the bush. Up the track in Tennant Creek, there is the Pulkapulla Kari Hostel, which is also operated by the Uniting Church’s Frontier Services. Further north in Katherine there are two aged-care facilities. There is the Katherine Red Cross Centre operated by the Red Cross NT Division and the Rocky Ridge Hostel operated by the Uniting Church’s Frontier Services. All of these places provide an excellent level of service with limited resources. Often the demand for places outstrips supply, but I have to give great credit to those people who work in these places for the care they give to their clients and to the organisations for taking on what is a very difficult task. It is a high-cost exercise delivering these services in the bush and they do it very well.

There are other services which are provided in remote communities. There is one at Yuendumu which is—as you would know, Madam Deputy Speaker Bishop, with your extensive knowledge of the Northern Territory—some four or five hours drive north-west of Alice Springs up the Tanami Road. It is a pretty corrugated road, I have to say. But again it is a service which is supplied as a result of funding from this government, one which was most needed and which provides support and care for a great group of people. Again the carers need to be recognised. There is another facility in Nguiu on Bathurst Island and it too provides an excellent standard of services. But these facilities are too rare.

The problem we have is that, with a very large population dispersed over a very great area, the resources for looking after the aged are extremely limited. As the demographers tell us, an increasing proportion of the population is reaching the age of 70. In the Aboriginal community, hopefully we will see a far greater proportion of their population age so that they can die gracefully in their 80s and 90s, as we would like to do. Hopefully we will be able to provide them with the standard of service that they require. We need to know that for Aboriginal Territorians, unlike some of those I referred to earlier who, once they finish their working life in the Territory, relocate to the coast to another community, the Northern Territory is their home and they will not be leaving. We have to make sure that we provide them with the services that they need as they get into their latter years. Again I make the point that it is extremely important that aged-care workers are sensitive to their cultural values.

I want to acknowledge the work of the Northern Territory Aged Care Planning Advisory Committee, the chair of which is Lee Oliver, in providing information and advice to the Department of Health and Ageing on the appropriate distribution of aged-care places across the Territory. I do want to commend all of those people who are involved in the aged-care industry across the electorate, but I say that they do so with a great deal of goodwill. I forgot to add that there is also a very good aged-care facility at Maningrida.

Labor’s policy development process is well underway in the lead-up to the federal election. The policies which we will take to the election will encompass the views of older Australians, service providers and representatives of the aged-care workers. A Rudd Labor government will ensure that older Australians enjoy the prosperity which they helped create for all of us. I am pleased to support this legislation.

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

At the commencement of my contribution to the debate on the Aged Care Amendment (Residential Care) Bill 2007, I would like to acknowledge many of the statements made by the member for Lingiari. I have visited quite a few aged-care facilities in the Northern Territory. I have been to Docker River and I understand the problems that they have out there. The thing that really impressed me the most about the way aged care is done in the Northern Territory is that the people involved in the industry try to be creative and culturally aware of the needs of the Territorians, particularly Indigenous Australians. I would have to say that the member for Lingiari has really got his finger on the pulse when it comes to aged-care issues in the Northern Territory.

I believe—and I suspect, Madam Deputy Speaker Bishop, that you might share my belief in this area—that aged care and ageing generally within Australia is probably one of the most important issues facing us as a society. Today we are looking at issues surrounding aged care but I do not necessarily believe that ageing per se is all a negative for our community. I think there are a lot of positive things that we as a parliament and a nation can do to improve the situation in relation to ageing. I note that Madam Deputy Speaker is nodding in agreement. I have had the pleasure of hearing her speak on this topic on a number of occasions, and on a number of things we have very similar views—although, of course, not on all.

We on this side of the House are supporting the legislation before us today. I am actually quite pleased about some of the changes included in it. Over a long period of time, providers within the aged-care industry have experienced a number of difficulties. I have a very close relationship with a number of facilities within my electorate. They have been forced to cut costs in order to survive. This has led to staff being cut and there have been a number of problems experienced by aged-care providers.

The issues that have been raised with me time and time again by aged-care facilities and providers include the fact that they feel like they are drowning in a sea of red tape and that they constantly face bureaucratic hurdles. I see that this legislation will assist in addressing some of the issues surrounding red tape. In the last parliament, I was a member of a House of Representatives committee on ageing and we looked at a number of issues surrounding aged care and ageing. One of the issues that came up time and time again was red tape. But, unfortunately, one of my worst experiences in this parliament was associated with that committee’s report, because we did not table a full report before the election in 2004. It was very hotchpotch and only a draft report was tabled. I do not think it homed in on all the issues.

The bill before us today introduces a new arrangement for allocating subsidies in residential aged care. It is designed to reduce the amount of documentation—in other words, red tape—that is being generated in aged-care facilities. That red tape is about justifying classifications. In the 2004 budget the government said it would implement a new funding system for residential aged care in response to a recommendation from the review of pricing arrangements that was conducted by Professor Warren Hogan. The new funding model draws partly from work undertaken in the RCS review of 2002-03 and projects arising from the RCS review, such as the reduced RCS questions project. The new system will have fewer basic funding categories. That will be much welcomed by providers. Time and time again, the committee I was involved in was told that the number of categories and the burden that that placed on the staff in facilities was far too great. The new system will also include two new supplements. The new supplements are intended to better target available funding towards the highest needs—in particular, residents with dementia and challenging behaviours, and residents who have complex health and care needs, including palliative care needs.

Stepping away a little bit from residential care, the extension to the number of EACH places that are now available is a positive innovation. I visited an elderly person who was a very active community worker prior to becoming quite frail. He had an EACH package and was able to live in his home on his own and everything was designed around him. I think that we should be doing whatever we can to enable people to stay in their own homes for as long as possible, but the fact of the matter is that some people need to have residential aged care. The health of the constituent I was talking about a moment ago finally deteriorated to the extent where he had to move to a high-care residential aged-care facility. That is why it is so important that we do the right thing in the area of aged care, not only because of my constituent but because of the needs of all older Australians.

All government funded aged-care facilities were invited to participate in the trial that was run by the government. It is my understanding that some 678 homes participated in the collection of data, and that concluded at the end of October 2005. Based on the trial data and feedback from participants, amendments were made to the ACFI, the Aged Care Funding Instrument, in place now. I really hope it works. Some providers in my area had some concerns about the way it would work, but I think that having fewer categories can only work in favour of the residents because it will allow the staff to do what they are employed to do: spend time with residents in the aged-care facilities—the people who live there and whose home it is. Reducing the number of funding levels in residential aged care and providing subsidies for the care of residents with complex needs, including palliative care, is definitely a move in the right direction.

There are changes to the arrangements whereby classifications expired at 12 months, and the requirement for providers to submit reappraisals is removed. One of the areas that I received the most complaints about from aged-care providers in my area was the fact that they are constantly subjected to reappraisal. They feel that this is very time-consuming and that, quite often, the way it is carried out is inept. I think that that is a positive move too. A very positive move that should be embraced by this parliament is that this will allow a resident’s current residential classification to move with them from one facility to another. It will remove the need for that person to undergo another assessment. I think that is in the interests of the resident and the facility. We must never forget what aged care and these facilities are about: to provide quality care for all older Australians, whether they live in a residential care facility—a hostel or a nursing home, as they were once called—or whether they can benefit from the aged-care package, which is a very positive initiative.

One issue that I am not so happy about is that, in Shortland electorate, the number of aged-care beds we have is disproportionate to the requirement of the area. Shortland electorate falls both within the Central Coast of New South Wales, which on the last audit had a shortfall of 596, and within the Hunter region, which had a shortfall of 390 aged-care beds. Shortland electorate has the 10th highest number of people over the age of 65 in Australia. I see the member for Paterson sitting in the House. His electorate has the 13th oldest population in the country. Also in the Hunter we have Newcastle electorate, which has the 16th highest number of people over the age of 65. Charlton sits 50th on that scale, Dobell is 29th and Robertson, on the Central Coast, is fifth. So I am putting before the House that this is an area with a very old population, and we have a high need for beds both in high care and low care. We have a large number of facilities applying for beds within those areas, and I have a number that are being knocked back. Sometimes I question the way those beds are allocated, when quality facilities that are operating in the area have their applications declined and out-of-area, privately owned organisations are given beds. But that is another argument, on a different topic.

The other issue that relates very much to this shortage is the fact that a number of beds are phantom beds—in other words, they exist on paper but they are not operational. I believe that the government needs to revisit the way those beds are allocated. There is a definite argument for reforming the allocation process. There is a definite argument for changing the process. I have put my ideas on this to the government, but to this day it has not embraced them. I think that the whole planning process is flawed and the government really needs to revisit that process.

In the time that is remaining, I would like to refer to the government’s securing the future package. In doing so, I am going to refer to correspondence I have had from the Aged Care Association Australia. They point out, in this letter to me, a number of shortcomings in the package. First of all, they point out that they initially welcomed the release of the package, but once they had a look at it they found that maybe it was not quite as good as they had thought it was. That is quite often the way when you look at anything that the Howard government puts before you. On first impressions, things look a lot better than they really are.

My understanding from reading the correspondence I have before me is that the package removes the operating care supplements—the additional basic care fee and the pensioner supplement—from the care funding pool and transfers them to the capital scheme. It applies these two supplements to the capital pool as part of the additional funding, and therefore it is removing them from the provider’s service budget. That means a lot when you are operating a residential care facility. It really impacts on the ability of the provider to care for its residents. The overall financial impact of this has been estimated as a reduction in care financial support for residents, in the first year of the scheme—this is just the first year of the new scheme—of $50 million, and it is going to rise to $350 million in the year 2012-13. From March 2008—that is what we initially thought it was going to be, but now there is some thought that it may be July 2008—aged-care providers will be forced to adjust their care service, and that will lead to a reduction in staff numbers to accommodate that change. A reduction in staff numbers means a reduction in care to those residents living in the facility.

The package does not address an adequate aged-care funding index and maintains the existing COPO index. I have raised issues surrounding COPO on numerous occasions in this House. COPO is a very unfair index. It does not take into account all the costs that are experienced by residential care facilities: workers compensation, rising electricity—you name it. The COPO index is inadequate and does not work well for aged-care providers. How does this affect the residents in aged-care facilities? It means that those facilities have less money for staff, which in turn affects the care that the residents receive. The additional index provision of 1.75 recommended by Hogan and accepted by the government in the 2004-05 financial year ceases on 30 June 2008. What then? That is my question: what then?

The package makes an assumption that the construction cost in the industry is $105,000 per residential bed. I know for a fact that that is not true. I have spoken to providers in my area and they have told me that that is not the case. The ACAA has highlighted this and said:

The actual cost ... is currently estimated at $170,000.

I feel that this is going to impact once again on the quality of care received by frail and aged people. The ACAA also said:

The accommodation supplement of $26.88 to which the industry will gradually move from—

in March 2008—

will service a borrowing of $109,000, well short of the average construction cost outlined above.

I have already touched on that and the fact that in all probability it will be in July 2008. The Aged Care Association is less than happy with what the government has done in this area.

The other peak group is the Aged Care Industry Council. In a press release, they have said:

Australia’s aged care sector is facing a looming crisis and will not be able to deal with the demands of a rapidly ageing population ...

And it goes on to state:

At the start of the 20th Century just four per cent of Australia’s population was 65 or over and that figure will increase to 21 per cent by 2040.

I argue very strongly that the government is failing older Australians and has constantly failed older Australians. The government has bumbled its way from one disaster to another in aged care. It has overseen a system that has forced aged-care providers to cut costs in order to survive. What we are going to see is more of the same. It has led to reductions in staff. It has led aged-care providers to have to cut corners in order to be able to survive. It is a system overwhelmed with bureaucracy and red tape. The good thing about this legislation is that it will go some way towards cutting that the red tape. I support very strongly the changes to the resident classification system. I will be supporting this legislation, despite the failures of the government in the area of aged care. (Time expired)

Ms Anna Burke (Chisholm, Australian Labor Party) Share this | Link to this | Hansard source

I also rise to speak on the Aged Care Amendment (Residential Care) Bill 2007. The Aged Care Funding Instrument will clearly reduce the amount of documentation generated in aged-care facilities that is needed to justify the funding classification for each resident. The reduction of paperwork for aged-care staff is welcome and long overdue, and will allow staff to get back to doing what they are actually employed for and wish to do: caring for the residents in their nursing homes. However, there are a number of problems with the bill as it stands and that is why Labor has proposed amendments.

We all have a duty and a responsibility to get the provision of aged care right in this country not only to respect the dignity of older Australians and the contribution they have made to our nation—indeed, through wars and through depression—but also to make sure that current and future generations of older Australians are able to be supported. Australia has an ageing population; and while the aged sector—citizens who are 65 and over—currently makes up 12 per cent of the Australian population, this figure will rise to 18 per cent by 2021 and to 26 per cent by 2051. By 2020, the number of people aged over 65 will have doubled to four million. Aged care is therefore a vitally important issue and that is why we need to start planning and investing for the future now.

My electorate of Chisholm has a significant aged population and aged care is an important issue. The percentage of people aged 65 years and over in Chisholm is 17.8 per cent. This figure has increased by three per cent in just the last four years and is higher than the national average, which is 13.1 per cent. I receive many phone calls and letters from people who are dealing with aged-care services for themselves or for their loved ones. Deciding to move into an aged-care facility or helping a loved one to find a place at a facility can be difficult for many people. It is often a very stressful process and often people do not know where to begin or are not aware of the choices that are available to them. Many people are also not aware of how to access support services which may help them to remain in their own homes. Due to these numerous inquiries, my office produced a guide to aged-care options for my constituents because the aged-care sector is complex and not easy to understand. We have 14 terrific aged-care facilities in Chisholm and they do a great job with the limited resources that some of them have. But I am very concerned that the Howard government’s reform package, Securing the Future of Aged Care for Australians, falls well short of the mark in terms of providing enough high-care beds and securing the future of aged care in this country.

In the immediate future, we know that the rapid growth of the population aged 80 years and over will put enormous pressure on aged-care programs and facilities. Most of us see people come through the doors of our electorate offices who have to face this problem every day and know how desperate the situation is. We know what the situation will be for the population in the immediate and long-term future. There are no surprises. The policy challenge is to prepare for these changes. The Treasurer released his much vaunted Intergenerational report some time ago, but we still have not seen great action on this front. The government has conducted numerous reviews into aged care, but we still have not seen a great deal happen over the last 10 years. While I welcome the government’s announcement of $1.5 billion in funding for aged care over five years, we have had to wait 10 years or until the sector is at crisis point—indeed, beyond crisis point—for it to happen. It has taken the government far too long to act, and it is a burden for the community and for those people who are sitting in acute care hospital beds, and for the families who are trying to care for them.

I have recently had this experience, having to move my father from hospital into respite care. Indeed, I have now had to place him into a nursing home. I can speak from firsthand experience about the traumas of trying to achieve this. I am currently in the process of selling my father’s flat so that I can raise the bond for the low-care bed that he needs. This needs to be put into perspective: my father is only 70, so it is a rather daunting task for him and for all concerned. Even though I understand and can deal with bureaucracy, I found this a very trying and fraught experience. It got to the stage where I had to explain to the social worker at the hospital, ‘Indeed he is my father, but he is your patient,’ and that at some stage somebody had to try and give us all a hand in relieving this situation because he certainly could not go home. Indeed, the medical advice is that he cannot, unfortunately, return to his own home on his own. This is a very stressful time, and many people have to cope with this very complex environment.

What the Securing the Future of Aged Care for Australians package did not provide was the impetus for the aged-care sector to address key capital-raising issues. It has also meant some aged-care facilities will lose funding from March next year. This is because two key supplements—the $6.32 pensioner supplement and the $7.40 non-pensioner daily-care fee rate—are being withdrawn. This will impact significantly on some aged-care facilities. Some aged-care facilities will lose money, and the industry considers this to be counterproductive when the nation needs to encourage investment in aged care.

On top of this, the Howard government has ignored the needs of the sector and just has not done enough planning or investment in facilities. In fact, you could say the sector is crying out for attention from the Howard government because it is facing a looming crisis. In 10 years the Howard government has presided over a serious decline in the number of aged-care beds available. When Labor left government in 1996 there were 92 beds for every thousand people aged 70 and over, compared with only 85.6 now. In 1996 there was a surplus of 800 beds, compared with a shortage of nearly 5,000 now.

For the last 10 years the aged-care industry has been waiting for a decision to be made by government on funding arrangements. Since 1987 there has been a deep concern in the sector about whether they will be able to continue to provide aged-care services with the government funding arrangements that they have been receiving. Three years ago Professor Warren Hogan, in his review of pricing arrangements in residential aged care, said that funding increases had to happen. The government has only just acted now. The Howard government has created this aged-care funding mess.

Bronwyn Bishop, who was minister for the portfolio in 1997, planned to introduce bonds for all aged-care residents, but, faced with a backlash from voters, who did not want to sell the family home for this purpose, the government retreated. Since that time we have had review after review, but no action has been taken to fix the problem. We have ended up with a patchwork funding system that does not work, and we are still waiting for a response to the Hogan review in respect of pricing.

While I welcome additional community aged care, because most people want to stay in their own home and services in homes are greatly needed, the truth is that when people need a residential aged-care bed they need it straightaway and generally cannot wait. The government has consistently failed to provide sufficient residential aged care for frail and elderly Australians, and this continues with the latest measures announced by the government. While government members can wax lyrical about the progress that has been made in this area over the last few years, I can safely say that it has been too long coming and it is just not good enough.

There are still huge problems in the sector. The 2005-06 Productivity Commission report on government services, released in January, shows that waiting times to get into residential aged-care beds have increased significantly over time. Over 28 per cent of people who have been assessed as requiring a bed wait three months or more to actually receive one, compared with 15 per cent in 2000. So, even though the Howard government continually claim that they have provided more aged-care places, they have failed to keep residential beds in proportion to the increased number of frail elderly in Australia. Many government reports have indicated that there is a crisis and a shortfall in places.

We have also seen the lack of provision of funding and skills within the area. We have seen numerous reports of exploitation of care workers who have been brought from overseas to work in nursing homes because we simply have not provided enough aged-care nurses within the sector. Nor is there pay parity for those individuals. Attracting and retaining staff in aged care is one of the biggest issues facing the aged-care providers. Under the Howard government, aged-care workforce planning is non-existent and aged care is being compromised by the lack of trained aged-care workers. Consider this statistic: over the next 10 years, the Australian workforce will grow by eight per cent, but the aged-care workforce will have to grow by 35 per cent to meet demand. That gives you an idea of the aged-care crisis we are facing.

The outbreak of gastritis at Broughton Hall nursing home earlier this year represented a failure of federal government policy. Five elderly residents died because the facility had inadequate infection controls, a fact established too late after the event by an audit by the federal government authorities. In the six-day audit, it turned out that the home failed key standards, including clinical care, nutrition and hydration, continence management, infection control, staff training and regulatory compliance. Instead of accepting responsibility for the crisis, the Minister for Ageing tried to blame the state government, when it is clear that the operation and standards of Australian aged-care facilities are a federal responsibility—his responsibility. It is the Minister for Ageing’s responsibility to ensure there are proper standards in federally funded and regulated aged-care facilities in Australia. In fact, it took the Commonwealth agencies a staggering 10 days to investigate the circumstances around the outbreak, which is completely unacceptable. The minister should have accepted responsibility and given an assurance that the systems were now in place so that the situation could not be repeated. Indeed, the systems should have been in place so that the situation never happened in the first place. But instead all we got from the minister was a cowardly attempt to pass the buck to the Victorian Minister for Health.

The Broughton Hall crisis also showed the inconsistencies in the aged-care accreditation process—another Howard government policy failure. It emerged that an audit of Broughton Hall’s standards by the Aged Care Standards and Accreditation Agency following the crisis showed the facility was noncompliant on 12 out of 44 accreditation outcomes, even though it had passed all 44 accreditation outcomes a year earlier. ‘How could standards at Broughton Hall have deteriorated so rapidly within a year?’ you may ask. It was because there is inconsistency in the way the standards are applied, which is a view shared by the aged-care sector.

The minister needs to assure the public that systems are in place to ensure standards are consistent and reliable. But a big part of the problem is that the Minister for Ageing does not really have his heart in the job—he is not really interested in his portfolio. In fact, according to the Age, at a Liberal Party fundraising breakfast attended by aged-care providers in May he described caring for the aged as an ‘unenviable industry’ and went on to tell the audience that he preferred to avoid aged-care events because he was ‘young’. Unbelievably, the minister told the Menzies 200 Club that he would rather not open aged-care facilities or attend meetings about them. ‘I’m young and have a young family, and it’s an election year,’ he said. He also cited his marginal seat and big workload as a reason to cut down travel to attend industry forums. ‘I have waited a long time for promotion,’ Mr Pyne is reported to have said. He then admitted he was less interested in aged care than in his ‘passion’ for foreign affairs. What he is saying is that aged care is not ‘sexy’ enough—that it is a portfolio that he does not welcome. It is a very serious portfolio. These comments show the minister is not really interested in his portfolio or the welfare of the 2.6 million-plus Australians over the age of 65 that he represents. This is a disgrace.

If the Minister for Ageing is not interested in doing the right thing by the senior citizens of this country, Labor certainly are. We want to fix the residential aged-care mess that the Howard government has presided over for the last 11 years. The Howard government is still not providing enough high-care residential care beds, despite the figures showing that this is exactly what is needed in Australia. A report on residential aged care released last week by the Australian Institute of Health and Welfare shows the frail elderly are still getting a poor deal from the Howard government. According to the report, 69 per cent of residents as at 30 June last year required high care; however, the government’s own provision ratio was 48 low-care and 40 high-care beds for every 1,000 people aged 70 years or older. This was recently amended to 44 low-care and 44 high-care beds—but it still does not reflect the needs in our community. In fact, the number of aged-care residents needing high-level care has jumped by almost 19 per cent in less than a decade.

Over the same period, the number of people requiring low levels of aged-care supervision has dropped from 38 per cent to 31 per cent, which coincided with a significant expansion in the aged-care package designed for the same group. There is a trend for our elderly to stay in their own homes for as long as they can before they enter residential care—something we welcome and something the community wants. As our population is ageing our elderly are also living longer, so when they finally go into residential care they are older, frailer and generally need higher levels of care. By not providing enough high-care beds, the Howard government is failing to provide for their needs. The recent budget failed to look at the bed allocation system and failed to introduce new measures for capital raising to build new facilities and keep others up to standard. This is a big issue in my electorate of Chisholm, where land is very expensive and is very built out. People want to go into nursing homes within their area so they are still accessible to their community and so their families can visit them easily.

The recent situation in the Blackburn Nursing Home, where we saw the oldest Australian having to be driven away in an ambulance because of the bungle of the previous minister for aged care, highlighted most significantly for me and my community that the aged-care industry is in crisis. Blackburn Nursing Home ended up in an absolutely disastrous situation where the owner of the building was refusing to let the licensee continue. Indeed, the minister granted to the owner of the building an aged-care licence provider number even though the man who owned the building had never ever been involved in the aged-care industry and had some dubious business dealings in the past. The licensee—who was in the nursing home providing service, who had been in the aged-care industry for many years and whose wife was the nurse in charge—had to leave the residence. By virtue of that, all the residents had to leave. It was an absolutely shocking day when the oldest living Australia, a woman of 113 years of age, was bundled into an ambulance and taken away to another nursing home. It was scandalous, and demonstrated that the various ministers who have filled this portfolio do not care about this very important issue.

If we want to properly provide for the aged-care needs of our ageing society, the allocation of bed licences needs to be backed up by rigorous analysis of care needs. A Rudd Labor government will ensure there is equitable access to aged-care beds, using thorough research and analysis of the needs of our elderly. We should be providing the greatest benefit to our elderly Australians, who have looked after us in our greatest times of crisis. The elderly within my community are Australia’s great backbone, and we should respect them. The measure of society, it is often said, is judged by how you care for the young and the elderly. On both counts under this current government we should hang our heads in shame.

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

I am pleased to rise to speak to the Aged Care Amendment (Residential Care) Bill 2007. As has been indicated in earlier debate, the amendment to the Aged Care Act 1997 is to introduce new arrangements for the way in which subsidies will be allocated for residential aged care through what is to be called the Aged Care Funding Instrument, ACFI. This is designed, quite appropriately, to reduce the amount of documentation generated within the facilities that is needed to justify the funding classification of each resident.

Anybody that has visited an aged-care facility would have heard the concerns expressed by those delivering care to our elderly about the bureaucratic burden that is placed upon people who would rather be involved in the professional care of those in their charge. Any extent to which that administrative burden can be reduced is to be lauded. The trials of the ACFI have been very positive in reducing administrative problems. It is a much more efficient system in getting agreed classifications between the provider and the department and has, therefore, led to fewer reviews of classifications. Simply put, there appears to be, on the basis of the trials that were undertaken, a great deal of hope that this will deliver what was promised by those that formulated it.

Regrettably, this is only part of the story. Those that have listened to this debate can see that aged care continues to be an area of public policy that is characterised by ideological debate. Those opposite who have entered into this debate have simply indicated their belief that the government’s ‘success’ in aged care is based on the amount of money that has been spent in this area. I often decry the way in which the Howard government has continually thought that the way to solve anything is to just throw a bucket of money at it. If members opposite indicate that the Howard government has achieved something in aged care simply on the basis of the amount of money that has been allocated to it, we have a long way to go to get proper public policy formulation. I tried to get an indication of what the government thinks it should be achieving in residential aged care. As has been indicated earlier in the debate, the best indicator—and the indicator that is used—is the number of places per hundred thousand of the population aged 70 and over. As indicated, the objective that the government has set is 88 places per 100,000 people aged 70 years and over.

In the second reading speech we did not hear mention made of that by the Assistant Minister for Health and Ageing when he introduced the bill, and throughout the whole of this debate I have not heard those opposite mention it. Mr Deputy Speaker, you might well ask: why is that so?

Simply put, the real problem is that if we use the census of 2006 as a basis for looking at what has been achieved we find that, based on the 88 per 100,000 aged 70-plus, there is a shortfall throughout the nation of 2,735 operational places. The target is said to be 174,289; there are 170,416 operational places. There has been no mention in this debate or in the budget papers of how far the government expects to move towards that target as a result of this year’s budget. As of the December 2006 census, it stands at 86.6 places per 100,000 aged 70-plus. There is an obligation when we are debating important areas like aged care to be up-front in explaining to people why that bucketload of money does not equate to a result nearing an outcome that the government has set. If you go to the budget papers and the portfolio budget statements for the Department of Health and Ageing, you find that they do not mention the 88 places per 100,000. On page 93 of Budget Related Paper No. 1.12, under the indicator ‘provision of operational aged care places’ in the column ‘reference point or target’, it says that there has been progress towards meeting the target of 113 aged-care places per 100,000 persons aged 70 years and over, with the provision of 108 operational places nationally by 30 December 2007. They have that lower target for the midpoint.

As has been indicated in the debate, because we have high-care and low-care places—the old nursing home and hostel places—all banded into one, there has been a bit of an out for the government in the way in which it has allocated those places. If we look at the Australian Institute of Health and Welfare report that was made public last week, we find that 69 per cent of residents as at 30 June 2006 would have been classified as requiring high care. The government’s ratio for their 88 residential places at that point in time was 48 low-care places and 40 high-care places. Recently, acknowledging that they have problems because they are well over that ratio with 69 per cent requiring high care, they have amended that to 44 low-care places and 44 high-care places. But that clearly does not reflect the requirements of older Australians for particular types of residential aged care. These classification tools are reflecting that need.

In fact, when the new ACFI is put in place it is agreed that we will have more accurate knowledge of what is really required. Is there to be a fudging of the way in which new places are made available so that they are not available on the basis of need? There is a difference between having a funding requirement attached to the person who is going to be using the service and the capital requirements of those who will be providing the service. That should be something integral to the way things are explained in a debate like this. If a hymn sheet is going to be handed around to all those coalition backbenchers for them to come in here and praise the government on the basis of how much money is being spent, they really should be asking of those who provide that information: ‘What outcomes will these measures deliver?’ When we look at this new classification tool, one of the missing ingredients is how much each classification level is going to attract. When we have problems like that in important areas like this, I find it very strange for the government to expect providers to make important business decisions.

This is a government that comes in here and says that it is only the coalition that understands business, that it is only the coalition that knows about the way that those things are run. You do not have to have great knowledge to know that if a business is not going to be told its expected income, it is going to have great difficulty in forward planning. So, at this stage, if the bill goes through the House, those providers will still be awaiting the detail that the department has indicated will be provided soon.

The other aspect is that we have had the benefit of the inquiry of the Senate Standing Committee on Community Affairs. The report of the inquiry made a suggestion of three amendments to this bill. The Labor Party have indicated that we would expect that the government would agree with the need for amendments in these three areas. The first area, whilst it is only minor in its application, is the high-dependency care leave, where there is the ability for more than one residential care subsidy when a resident is moved temporarily—usually from low care to high care and the like. There are only about 20 applications of this ilk a year, and this is a very minor thing, but the fact that this is not going to continue under the new classification is a cause for concern. Labor believe that it should be reinstated.

The second matter is the lack of clarity about what the circumstance may be in applying this new classification tool. People within the sector might have a significant loss of funds. Labor believe that an amendment should be implemented that requires the minister to determine a reasonable level of reduced subsidy. As in all things, it is proper in public policy implementation that there be a transition that allows those affected to make adjustments. The other aspect is that whilst we are hopeful, on the basis of the evidence arising out of the pilot, that this new Aged Care Funding Instrument will deliver results that lessen the amount of administrative effort and more accurately indicate the needs of the older person receiving the service, this should be reviewed in 18 months time. Labor indicate that we will require a formal review within the 18 months of implementation. Those three suggestions are not things that the government should really be in opposition to, and I hope that they will see their way clear to agree to those amendments. That will assist in the way that the new aged-care instrument is implemented.

I spoke earlier about the problems that we have with the actual outcomes. The electorate of Scullin is part of the northern metropolitan area of Melbourne. The electorates of Batman, Calwell, Jagajaga, Melbourne, McEwen, Scullin and Wills—or parts thereof—are also part of this region. There is a shortfall of 257 beds in the northern metro area. What has to be remembered—and I do not mind reminding those opposite because we have to put up with the Treasurer reminding us, based on his Intergenerational Reportis that there is an ageing of the population. I understand the government have got a bit of a problem because, as each six months of their census goes on, there are a lot more people who are getting into the age group of 70-plus. So there has to be catch-up based on that demographic shift which will not produce a movement in the ratio, and those are the things that we have to be careful of.

If we study the decline from when this government inherited an oversupply of places, based on that ratio, to there now being well under enough places, we see there is a problem. I must say—and I try not to be too churlish about this—that there comes a time, when they have been in office for over a decade, that a government simply cannot blame the opposition for the lows and say that they inherited a system that had deficiencies and the like. We can have the debate about whether that is the case. I think that we are on pretty solid ground and can indicate that that is a debatable point that they would put. But, if they are going to put that in the coalition backbenchers’ kits, let us get realistic—11 years down the track, the situation is all of the government’s making if they have had a problem keeping a steady eye on this portfolio.

I think that earlier in the debate the member for Gorton indicated that there has been a revolving door method of selecting ministers, and many of my colleagues have said that about the public attitude of the present minister. I would like to hope that it is not really true. But, basically, it is believable that, having reached the ministry, which he strove so hard to achieve,  now, when given this portfolio, he thinks it is a bit beneath him. One of the other things that I think characterises this debate is that there is perhaps no area of public policy where members of this place can be so attuned with those whom they represent than aged care—in discussions and, as the honourable member for Chisholm indicated, because so many members of this place have been involved through family in placing people into aged-care facilities or thinking of a way in which they could appropriately look after elderly relatives, whether it be through aged care or community packages.

The other nonsense that I heard during the debate was that because we on this side were concentrating on the matter that was before us, which was residential aged care, we saw that as the only appropriate way of looking after elderly people. People who are fair judges of the way in which there were movements under the Hawke-Keating years on aged care know that there was a rapid movement into programs that enabled older people to stay at home and there was a rapid movement to understand that ageing ‘in place’ was the appropriate way to go with aged care. So when the Howard government put that policy in place, there was no disagreement.

So let us not have this nonsense that this side of the place thinks that residential aged care is the only way to go. Remember that it was Victoria, through its state programs, that led the way with the HACC Program. The member for Gorton, because of his experience with municipal employees, knows that it was the Victorian local government that was closely involved in the way in which HACC Programs came into place, and Victoria led the nation. In the Hawke-Keating years, the success of what was happening in Victoria was very much borrowed. That has now moved on to the types of community packages, and the HACC Program, that are available to assist older Australians to stay at home or to not have to be shuffled between institutions and the like.

The other thing that I have to say in the context of this debate is that I get a little tired of the dismissive attitude towards Medicare Gold. There has never been a debate about the fundamental principle that was being put forward by Labor with that policy. People can have their arguments about the way that it might have been presented or the fact that they thought that the figures were not there and things like that, but aged care and the way in which it impacts on primary health care right through to tertiary health care of old people and their residential requirements begs for governments at both federal and state levels to come together to make the provision of services for older Australians that go to their health concerns seamless. That is what Medicare Gold was about.

Even people on the coalition side in this debate have indicated their understanding that some people have been classified as requiring residential aged care but, because places are not available and because of the waiting lists, are in hospital in acute beds. Regrettably, people describe these people as bed-blockers, and, emotionally, I know that that is wrong. But the simple fact is that having a person awaiting a residential aged-care place in an expensive acute bed does not make sense. It is not good public policy, and anything that can be done to avoid that situation is worth consideration and debate. Before people say, ‘There goes the member for Scullin; he wants Labor to have a Medicare Gold policy,’ I say that what is required is a proper debate— (Time expired)

Paul Neville (Hinkler, National Party) Share this | Link to this | Hansard source

I am pleased to speak to the Aged Care Amendment (Residential Care) Bill 2007, because I believe that the provision of aged-care facilities and services is one of the most fundamental responsibilities of government. Australia has an ageing population, which clearly means that we have to alter the way we think and react to the challenges of caring for older Australians. The coalition are rising to that challenge by boosting the number of fully funded aged-care beds available via community, residential and flexible care services. We are also regulating the aged-care sector to ensure that the highest standards apply, to ensure funding for training of the aged-care workforce and to ensure that there are respite services for carers.

In 2007-08, the coalition government will implement the first stage of the $1.6 billion Securing the Future of Aged Care for Australians reform package, which will see a significant increase in the number of community care places available and will mean even more respite opportunities for carers. The government will also provide extra capital funding and payments to support people going into residential aged care. But the initiative that will perhaps help aged-care providers the most is the introduction of a simpler fee system.

I have earned a reputation as a member who vigorously pursues additional aged-care beds and services in my electorate. I make no apology for that fact. In the old Hinkler electorate—in Gladstone, Boyne-Tannum, Bundaberg, Bargara—we had 24,000 people in the Burnett Shire and no aged-care facility. I pursued that relentlessly, and now two facilities have been approved. In the redistribution I will inherit Hervey Bay—and that too has challenges. The new look Hinkler will incorporate popular retirement centres. These attract people who come for lifestyle and climate, and eventually we will have quite a deal of old people in Bundaberg, Hervey Bay, the Burrum coast, the Coral Coast and individual centres like Woodgate. This means that the electorate will necessarily experience the associated pressure on its aged-care facilities.

Earlier in the year I wrote to ACPAC to provide input into the upcoming aged-care assessment round. My conversations with local aged-care providers highlighted just how pressing the issue will become, particularly in Hervey Bay. Hervey Bay’s rapid development has led to a significant backlog of council approvals and completions allocated to aged-care places. Nevertheless, the region’s demographics indicate the current and ongoing need for more aged-care places in the Hervey Bay subregion, even beyond those actually needing completion. A quick perusal of the ABS figures indicates that in 2006 more than 7,500 Hervey Bay residents were in the 70-plus age bracket. That equates to approximately 15 per cent of all residents. However, the projections put the population of this group at 9,500 by 2011—a little over three years away. There is a big challenge there to pick up that slack. Even more telling, according to the ABS, the 80-plus age bracket for residents of Hervey Bay is projected to grow by 32 per cent, or nearly 800 people, in that time frame—another big challenge.

In my letter to ACPAC I also raised the matter of an alarming drop in the number of people working in the health services sector in Hervey Bay. I examined the various categories of all the employment sectors of Hervey Bay. Given that Hervey Bay has only one public hospital and two day surgery hospitals, and the medical and allied workforce of Hervey Bay is fairly stable, the proportionate drop in health and community care services would seem to be pointing towards aged care. Of course, I hear from the aged-care community itself about the problems of retaining certain staff. Obviously, if the proportion of facilities to population is up to scratch, the employment level will rise in response. So there is a plus factor for Hervey Bay if we can get aged-care facilities right up to scratch. When I say ‘up to scratch’ I am not talking about standards so much as numbers. I have no doubt that, in the very near future—if it is not already the case—Hervey Bay will experience a serious shortage of aged-care beds, which could develop into a chronic problem if we fail to keep pace with this extraordinary growth not only in the city itself but also in those sectors of the senior population.

As a case in point, let me talk about Fraser Shores Retirement Village. It would like to develop a complementary aged-care facility in its current retirement facility. This two-stage retirement village has an extraordinary 760 independent living units, which is quite remarkable, and every year has 30 to 40 of its residents moving into other aged-care facilities, hostels or nursing homes. That is the equivalent of one medium-sized nursing home or hostel every year from that one facility. There are great synergies in developing a stand-alone aged-care facility at such a massive retirement village. I understand that the proprietors are already well advanced in planning the project and intend to apply for a significant number of aged-care beds in future rounds. I stress that that is just one example. As you know, Harvey Bay has some really nice retirement villages. Imagine how many who come through their doors every year go into hostel and nursing home facilities. So we can see that there is a great challenge—a challenge that we must meet soon.

I note that under this year’s regional distribution of aged-care places, the Wide Bay statistical region, which includes the Wide Bay electorate and the Hinkler electorate, or parts thereof, is one of only two to have its projected bed allocation more than double between 2007-08 and 2008-09—going from 110 places to 230 places. I doubt that even that is going to be enough. I applaud that commitment to providing more aged-care beds for the Wide Bay region. It sorely needs them. When more beds become available, I encourage providers to apply for stand-alone facilities near these retirement villages.

Of course, another challenge for many aged-care facilities is operating in rural, regional and remote areas. I do not think the problems there are always appreciated. One such facility in my old electorate is the Ridgehaven Retirement Complex in Monto. Monto, I might say, has been in and out of my electorate a number of times. Earlier this year, the Deputy Prime Minister and I had the honour of turning a sod on the home’s new extension, which will give it six more low-care residential places and therefore help it to cope with the shire’s ageing population. In the past two years, Ridgehaven has received around $2.75 million to help with capital works, in recognition of the difficulty it faces in providing a high-care/low-care facility. The overriding priority when allocating funds to such facilities is to allow local people to stay in their own community and receive the care they need surrounded by their family and friends. It is a tragedy to see people having to live 100, 120 or even up to 200 kilometres away from where their family lives and where their roots are. It is a very lonely existence. No matter how nice the facility is, that loneliness really impacts on a lot of people.

I consider Ridgehaven to be one of the best aged-care facilities in regional Queensland. A lot of that comes down to its board—they are all volunteer community people—its excellent management and staff and the support of the wider Monto community. I can honestly say that I think equally highly of the vast majority of aged-care homes in my electorate, and I make a point of visiting every one of them at least once a year—which I find a salutary experience. You can tell a good nursing home the second you are in the door. Good schools and good nursing homes are instantly obvious when you walk through the door.

I also try to canvass every existing aged-care facility in my electorate when it comes to getting the ACPAC figures together, because that is the pool to which they can apply later in the year. This year I touched base with close to 30 different aged-care facilities in the current and new areas of Hinkler and what became clear was the exponential growth in administration requirements for each facility. Proprietors told me that they had no issue with complying with the new quality, care and compliance standards that the Australian government has introduced, but, nevertheless, these requirements add further to the workload of the professionals caring for residents in their facilities.

I welcome this bill because it will continue the government’s agenda of streamlining the administration of the aged-care system. The one complaint that I invariably get from any facility is the amount of paperwork. Ministers know my view on this. I think we really have to seriously work on that issue. The bill will cut the number of funding levels in residential aged care without compromising standards and provide supplements for residents with complex health-care needs, including palliative care, and residents who have mental or behavioural conditions, including dementia.

In recent years the government has worked hand in hand with the residential aged-care industry to produce an assessment and a funding instrument that can reduce the administrative burden and costs for aged-care providers. The new system that has been developed for the aged-care sector went through a thorough national trial in 2005, resulting in the government having a better insight into what was required. The bill will also reduce the number of times residents have to be assessed for funding purposes. As it now stands, a resident’s classification expires after 12 months, which has meant that staff have had to go through this reassessment process every year. The bill removes that requirement and will cut at least 60,000 instances of reappraisal every year which invariably result in no change to the amount of funding. To make sure nobody falls through the cracks, the bill will also allow residents moving to an aged-care facility from a hospital to be reappraised after six months in residence to make sure that their needs have not changed. In cases where people move from one aged-care home to another, the bill will give the new service providers the power to either accept the classification based on previous appraisals or submit a new appraisal.

So, all in all, it is a good bill, a bill that I hope will be beneficial to both the Hinkler electorate that I have represented in this term and the one that I hope to represent in the next term. Both have remarkable challenges and I am up to them.

Debate interrupted.