John Forrest (Mallee, National Party) Share this | Link to this | Hansard source

I am pleased to have an opportunity to offer some comments in regard to a very important subject, aged care, in the context of this bill, the Aged Care Amendment Bill 2011. In all my time as a member of the federal parliament representing the good people of Mallee, aged care has been the issue that has kept the office busiest in ongoing representation both directly to the operators of aged-care facilities and to governments in all places. It is certainly a top-of-mind issue across the north-west of Victoria. In fact, in my own case, going back many years before my time in parliament, I had to find accommodation for my late father, way back as far as 1990, through the terrible nineties. I remember my mother saying to me, 'Son, someone must go to Canberra and get this fixed up,' as we waited, like so many families wait, for the place and acceptable care that we as a family wanted for someone we loved dearly. Sadly, my mum has now passed on as well.

It is somewhat refreshing to be able to say that the nature of the workload has changed over the years, although some very deep concerns remain. That is especially the case for the baby boomer generation that is coming on, which probably includes me, which has very high expectations for the standard of accommodation it will receive. Another, very serious issue is that of finding suitable accommodation for dementia patients across north-west Victoria.

I am in general support of the legislation—it is necessary—but I support the coalition parties' amendment, which highlights and gives us an opportunity to talk about the restrictions that apply with regard to regulation and to express our disappointment at the government's broken promise to the sector, made at the last election, that it would relieve some of the intense paperwork. I recall the government's commitment that for every new regulation it would find one it could repeal. When I spend time with the excellent nursing staff and professional people who look after our aged-care residents, I find their constant complaint to me is about the amount of time they spend attending to the paperwork, relating to the particular plan of care for a patient, that is needed for accreditation. It is fairly rigorous and it is time consuming. It takes them away from the ward and from the beds where they are needed most to ensure that the clients of aged-care facilities are well looked after.

Mallee would probably have the largest number of aged-care facilities of all the electorates in Australia—there are 47 in total. I have not had time to check every other constituency, but that is a huge number and reflects the fact that every small community across the north-west of Victoria has a small aged-care facility. Some of them are very small, their bed numbers can be as low as 10 or 15, which makes sustainability a challenging issue for them. In fact, as a result of the recent redistribution in Victoria, Mallee has grown yet again. The member for Mallee now represents the fine rural city of Stawell, which means two more aged-care facilities there—the Macpherson Smith nursing home and Eventide—will become part of his responsibility.

The 47 aged-care facilities in Mallee are of a mixed nature. They are predominantly community owned organisations. A lot of them come out of the old post-war bush nursing hospital model—they are basically owned by communities. There are only two professional, for-profit aged-care facilities run by private operators in my entire electorate, which are in the strong provincial city of Mildura. The rest are operated either by government agencies or by not-for-profit church groups and community owned organisations.

The compliance issues, as I have mentioned, are a chore. I have been very alarmed at the willingness of health departments, particularly in Victoria, to launch into punitive action for what I consider to be minor breaches of the paperwork trail. I have been disappointed with that and have expressed that disappointment to the department. Over the last two or three years, three of my organisations have been put into one level of sanction, not because they did something wrong, not because someone's rights were abused or they suffered some terrible incident in the nursing home, but because of the potential for that to occur. I think that is a bit harsh and sends very strong signals to my organisations. As a result, they have been spending an inordinate amount of time, I believe, on the regulation and the paperwork, when their attention really ought to be at the coalface. They should be making sure that those people who are in nursing homes and hostels are enjoying their twilight years and that their families are content that their loved ones are receiving the best possible care and attention.

Last week, I had representations from a family from Mildura. Their loved one has a very severe case of dementia and is so disoriented he becomes violent. They were very concerned because three accommodation options have been tried for this man and it looks like he may have to move as far away as Bendigo, which will require a 5½-hour car drive when the family visits him. He needs really particular care because his dementia is so disorienting that he becomes violent with anybody who tries to manage and offer care to him. It is a very sad situation. I am advised by Alzheimer's Australia that dementia is going to be a massive challenge for the nation in the next 30 years. In fact, last year they said to me that the likelihood is that Mallee will have a dramatic increase in the number of dementia sufferers, which reflects what they predict will happen for the rest of the nation. They predict that dementia will tip 246,000 people in Victoria by 2050. Unless there are some medical breakthroughs that can meet the challenge of understanding why this disease occurs, the impacts on my constituency will mean a 443 per cent increase in dementia sufferers in north-western Victoria. That is a frightening concept. On top of the challenges that my aged-care facilities currently endure, meeting a demand like that is going to be a huge challenge. It will mean a huge amount of capital. It will be the responsibility of this place to ensure that the parliament can assist them in a task like that.

I remember from my own family's experience that it is a terrible and traumatic time for families as they go through finding suitable and acceptable accommodation for their loved one. It is a terrible time and loved ones do not necessarily think or express themselves clearly. I have noticed in the last few months, particularly with the events that have occurred in north-western Victoria with the floods and now the loss of two aged-care facilities—one in Donald was flooded and basically has to be rebuilt and the other was in Charlton; that is about 80-odd residents that are now scattered across north-western Victoria trying to find alternative accommodation as the community and governments decide what the future of Charlton and Donald really is—the number of representations coming through to my office increasing as a result of that as families are faced with the prospect of a two- or three-hour drive to see their loved one. That is just not acceptable.

I am calling on particularly the Victorian government to find a quicker resolution to the challenges in Charlton. It needs a new hospital, it needs a new medical surgery and it needs a new aged-care facility. They were all in one complex that was completely wiped out in the January floods. And that was their third flood in less than six months. That has put pressure on the issue of aged care in Mallee, and I am looking forward to working with both governments to find a much readier solution to that issue there.

I would like to put on the record my appreciation for the tremendous staff who support and provide the care in these facilities. I often say that there are two professions that have my enduring affection. One is school teachers, who spend more time with our children than we as parents do, and the other is nurses. That is not because I am married to one; it is because of the wonderful work they do. Sometimes it is tireless, sometimes it is in the middle of the night and sometimes, with the nature of the illnesses of aged people, it is the same old thing over and over again. Yet, there they are, tending in a caring way. It gives enormous comfort to families when they see their loved ones being treated well.

This legislation makes it a little easier for a complaint to be made. Often the complaints are minor but the residents are reluctant to make them. I remember at one institution—I will not say where it was—where all the resident wanted was to have bananas in her diet on a regular basis and was frightened to ask, reflecting the nature of country people, who do not like to be considered troublemakers. All she wanted was banana in her diet on a regular basis. I was able to put that question and have it fixed. But if patients and people who are in these facilities have a reluctance to put their case then I do not think that is fair. Often unhappiness could be avoided if the process for making a complaint was much easier and the person making the complaint was confident that there would not be repercussions.

I support this legislation. I am appreciative of the fact that it has come forward. It is confirming and making much clearer the responsibilities for the huge number of deposits that are now in place for aged-care homes. I think it is in the order of $12 billion. It is accumulating all the time. I think access to that level of capital is helping to alleviate some of the problems of limitation of capital to improve the conditions in some of the facilities across my constituency. I am generally in support of the bill and I thank the government for putting it forward.

Bob Baldwin (Paterson, Liberal Party, Shadow Minister for Tourism) Share this | Link to this | Hansard source

I rise today to address the Aged Care Amendment Bill 2011, which proposes changes to the Aged Care Act of 1997. This bill is designed to strengthen protection for those who pay accommodation bonds to aged-care providers. It is also designed to improve complaints handling processes when it comes to aged-care providers that are funded by the Commonwealth. If passed, the amendments will take effect later this year.

One of the functions of this bill is to ensure that accommodation bonds paid to our aged-care providers can be used to support the sector itself. It is right that this government should do something to help support our nursing homes because it is a sad reality that our aged-care providers are struggling to survive, despite their vital role in our community. In fact, a Grant Thornton aged-care performance survey in November 2007 found that almost half of our nursing homes were operating in the red. Almost half were in debt.

That rings giant alarm bells for my electorate of Paterson, where we have a large number of older residents. According to the 2008 census, there are almost 25,000 people aged 65 or over in my electorate of Paterson. That is one-fifth of the entire population of Paterson. Now, of course, not all of these people will rely on aged care. However, many of them well. And many more will choose to retire to our area because of all the wonderful things we have to offer. I have met hundreds of people who have moved to the Paterson electorate from Sydney and other areas after their retirement. It is vital that we get this right now so that the problem does not continue to grow.

The aged-care system is struggling to meet the demand as it is. As we know, Australia's population is rapidly ageing and the demand on aged-care services will continue to expand with it. This crisis was highlighted in the Sydney Morning Herald on 25 February this year. Mark Wetherell wrote:

Baby boomers taking a seachange in their dotage face the prospect of widespread shortages in aged care, revised projections of the impact of dementia show.

Australia will be 279,000 aged care places short by 2050 without significant policy changes, and hardest hit will be coastal areas popular with retirees, a study by Access Economics has found.

Paterson is one of those areas that Mark writes about—on the coast and popular for retirement. As a consequence, it promises to be one of the hardest hit by a shortage in aged-care places. As the article goes on to explain:

The expected growth points in elderly populations show that sea-change locations such as Port Macquarie, Tweed Heads and the NSW south coast would experience shortages of 2000 or more aged-care places by 2050 without a change in policy. In the Paterson electorate in the Hunter region, the shortfall would be just under 3000 places.

When I was first elected to this parliament in 1996 there was already a crisis in aged-care accommodation. If my memory serves me correctly, there were not much more than 500 aged-care beds in the electorate of Paterson. Since then, through government support and the allocation of bed licences to my electorate, that list has massively grown. We now have Great Lakes Nursing Home in Bulahdelah which expanded its operations under the coalition; Regis The Gardens, formerly known as Port Stephens Gardens, based at Corlette, a new facility opened by the now Deputy Leader of the Liberal Party, Julie Bishop; Lara Aged Care at Dungog, a great community facility which has grown but is addressing all of the challenges that are faced by a community aged-care facility; the Bill King Aged Care Facility at Fingal Bay, a great facility which combines retirement living and aged-care provision and which has grown and developed since the coalition government came to power; the BCS Kularoo Centre at Forster, locally known as Kularoo, which has also grown an expanded; Barclay Gardens in Forster; the Myall Lodge, which started off as a community facility but had to be transferred to much larger management because of critical mass considerations and the cost of providing care—it does a tremendous job at Hawks Nest; Largs Lodge at Largs; Raymond Terrace Gardens Nursing Centre at Raymond Terrace, a nursing home that was pulled down, totally redeveloped and expanded; Salamander Bay Aged Care Facility at Salamander; Harbourside Haven Nursing Home and Hostel at Shoal Bay; Stroud Community Lodge, which was built by the community with community support and is still run by the community of Stroud; Tanilba Bay Hostel, formerly started by the local government at Port Stephens but sold and passed on to Catholic aged care; Beaumont Terrace, another site at Tuncurry, which has been completely redeveloped an expanded; and Glaica House at Tuncurry, another project which has expanded its operations.

With all these expansions there are still not enough beds to cope with the demands that will be coming in the future. One of the sad things for nursing homes is that immediately after they expand their operations they spend an awful lot of time with empty beds until the demand grows in that local area. But, as the article I quoted says, Paterson's shortfall will be just under 3,000 places. The article also says:

In Victoria, similar shortages would be experienced in the Mornington Peninsula-Flinders area, the Gippsland coast and districts along the Great Ocean Road. In the Flinders electorate, the shortfall would be 2870.

As the shadow minister for regional development, these things concern me just as much as their local member. These are shortages of both nursing home care and community care packages. The most important question is: what can we do about the shortages? Decreasing the amount of regulation in the aged-care industry would be a start—it is the common complaint that I get from the operators of nursing homes. Only through deregulation can we start the ball rolling to make the industry viable. That is why the coalition has pledged to reduce Commonwealth regulation by $1 billion a year. Our Prime Minister, on the other hand, promised to repeal one regulation for every new regulation; but, as this bill shows, that was another election promise the Prime Minister never intended to keep, just like her promise, 'There will be no carbon tax under the government I lead.' It seems our Prime Minister will say and do anything to stay in government.

I am pleased to say, however, that there has been some positive movement on this issue in my electorate recently. As the Port Stephens Examiner reported on 25 May this year:

The Port's largest aged care provider is set to embark on a $21 million project that, when complete, will offer hospice, high care and villa-style accommodation.

The news comes after Port Stephens Veterans and Citizens Aged Care was recently granted licences for 60 new beds to create a state-of-the-art nursing home.

CEO Louise Watters said with each bed costing around $200,000 to adequately set up, the not-for-profit group will need to build extra villas to fund the project.

"The cost of the nursing home is going to be around $12 million because it is a unique style of care with the units above," Ms Watters said. "

So in order to do this we're looking to build 30 to 35 villas at Fingal Bay on land in front of the retirement village and 16 villas at Salamander Bay."

Conditions on the new bed licences require the nursing home to be operating by 2013, but Ms Watters said that it was likely the group would seek an extension to complete the project. The nursing home will provide high-level and hospice care as well as having units above in which partners can live.

She said the aim was to have development applications for the villas to Port Stephens Council by late July or early August with the villas built, complete and sold by the end of this year.

I am proud to report this investment in the House today. I only wish I could say that the government helped to make it happen. Unfortunately, not nearly enough has been done by the Gillard Labor government to help the aged-care sector grow in what we know is a market where demand will only continue to skyrocket. Under the previous coalition government we saw a record $2.2 billion funding packed for aged care. We opened new facilities such as Port Stephens Garden Nursing Centre, and helped regain control of the sector after Labor, having been in power for 13 years, had left Australia with a 10,000-bed shortfall. I urge the Gillard Labor government to do more to ensure that we are not left with a massive shortfall in aged-care beds and services this time around. That is why Labor must honour its promise to repeal one regulation for every new regulation and help make this aged-care sector viable.

Aged-care services do wonderful things in our community. I have visited the nursing homes in my electorates many, many times—more than I can count. I see the wonderful and dedicated staff at each and every facility. In fact, a dear friend of mine, Doreen Bradley OAM, recently lost her husband, Jack Bradley, who spent his final years in a nursing home in my electorate. Despite struggling with dementia, Jack was treated with the utmost respect and those at the home were always there to support Doreen. They tried to make it as much as possible like a real home and many of the staff provided immeasurable comfort to both Jack and Doreen, and for that I cannot thank them enough.

It is this amazing work that we need to foster and grow so that our elderly community gets the support it deserves now and into the future. They would not get such support if it were not for the dedication of those in our community, the staff that work in these facilities and in particular the volunteers who give of their time to make these people's lives just that little bit more comfortable. You see, the hardest part for those going into aged care is moving from their home, from their family, from their support networks and from their friends. That is the hardest thing to replicate. That is where I want to pay tribute to the volunteers who regularly go to the nursing homes and try to replicate that environment for them. What we must do is treat the elderly in our community with the utmost respect. In fact, society is measured not just by how we treat and bring up the children in our community but, in particular, how we treat those at the other end of the spectrum that are towards the end of their lives' journeys.

I want to commend each and every one of the facilities in my electorate. Since the time I came to this parliament in 1996—besides the break from 1998 to 2001—through to today, I can count on one hand the total number of complaints I have had in relation to all the nursing homes in my electorate. That shows the quality, the calibre and the dedication of those people to providing a quality service to those in our community, and I commend them for that.

This bill will have some flaws in some of the regulations. I was here in 1997 when a bill was put forward to raise accommodation bonds. I remember the hue and cry from members now occupying the government bench that this was immoral, that this was taking away the kids' futures. There were some epic speeches by people who now occupy the front bench as well as the back bench. And here they are now promoting this program. More needs to be done. The funds need to be managed better and there need to be greater incentives to increase the investment in aged care. As pointed out in all of the reports, there is a massive need to increase the amount of aged care in our community. Only if we make it viable can we maintain the quality of that aged care in our community.

Mark Butler (Port Adelaide, Australian Labor Party, Minister for Mental Health and Ageing) Share this | Link to this | Hansard source

I thank the member for Paterson for his contribution to this debate on the Aged Care Amendment Bill and for his interest in aged care. I thank members on both sides for their contributions to this debate, specifically about this bill but generally about the aged-care sector, which is such an important part of all of our electorates. I am very pleased to have the opportunity to sum up the debate on Aged Care Amendment Bill 2011. This bill seeks to amend the Aged Care Act 1997 to increase protection for accommodation bonds and to strengthen complaints management in aged care as part of the government's commitment to providing better health and better care for older Australians through the National Health Reform Agenda.

Since the introduction of the Aged Care Act in 1997 there has been very strong growth in the value of accommodation bonds held by the sector. As at 30 June 2010 approved providers held more than $10.6 billion in bonds on behalf of more than 63,000 aged-care residents. The average total bond holding held by an individual approved provider was about $11.2 million and the average new accommodation bond charged during the financial year was around $232,000. This is a significant amount of funds held by aged-care providers on behalf of their residents and, as the Australian population continues to age and the demand for aged care increases, the funds loaned to approved providers through accommodation bonds will continue to grow.

This bill provides greater clarity about the uses of accommodation bonds and strengthens the link to investment in aged care. Specifically, the bill reinforces that bonds taken after 1 October this year should be used for capital expenditure at aged-care services, repaying debt associated with capital works and refunding existing bonds. The bill also makes it clear that accommodation bonds can be used for investment in a broad range of financial products, consistent with current practice. The bill proposes that an approved provider would commit an offence when there has been a misuse of bond funds and, within two years of that misuse, the provider becomes insolvent and has at least one outstanding bond balance. In the very worst of cases, offences would also apply to individuals within the organisation, such as when the individual knew bonds were being used for a non-permitted use and was in a position to take, but had not taken, reasonable steps to prevent the misuse. These changes will reinforce the significance of approved providers' obligations to their residents in dealing appropriately with residents' funds and ensuring that refund obligations are met. Accompanying these changes all restrictions on the use of income derived from bonds, retention amounts and accommodation charges will be removed. This will free up these funds for use by approved providers, reduce regulatory burden and focus the regulation on the risks of the bond principle.

The bill also proposes to enable the investigation principles to be replaced with new complaints principles. The proposed new complaints principles will describe and improve the complaints scheme for aged care, with a stronger focus on resolution of complaints. This will provide consumers with a more flexible scheme where a range of options are available for assisting to resolve a complaint, including early resolution, conciliation and mediation.

I would like again to thank members for their contributions to the debate on the bill. It has underscored the importance of the role played by the aged-care sector now and into the future across the country. It has also highlighted the importance of achieving a balance between effective regulation to protect vulnerable and elderly people and reducing the regulatory burden on the aged-care sector. These changes will promote public confidence in the aged-care industry, provide regulation that is commensurate with the risks associated with bond holding in the aged-care sector and improve the way in which complaints are managed in aged care.

The government does not agree to the second reading amendment proposed by the shadow minister. Beyond saying the amendment clearly strays beyond the scope of the bill, and indeed beyond the scope of the principal act, it simply misconceives the effect of this bill. To recap, the effect of this bill is simply to clarify the original intent of the accommodation bond system, which was to provide a capital funding stream for the aged-care sector, and it actually removes regulation about how providers will be able to use literally hundreds and hundreds of millions of dollars of income every year.

I repeat: this bill removes regulation on the way in which aged-care providers can use the income that they derive from the bond principal, it removes regulation on the way in which aged-care providers can use the retention amounts extracted from the bond principal, and it removes regulation over the way in which aged-care providers can use accommodation charges paid by residents in high-care facilities—literally hundreds of millions of dollars of income are freed of any regulation by this bill. It also removes a range of redundant provisions, including two pieces of redundant legislation. For those reasons we oppose the second reading amendment proposed by the shadow minister and commend the bill to the House.

Question put:

That the words proposed to be omitted (Mr Dutton's amendment) stand part of the question.

The House divided. [12:06]

The Speaker (Mr Harry Jenkins)

Question agreed to.