Kerry Nettle (NSW, Australian Greens) Share this | Hansard source

The Australian Greens support the Aged Care Amendment (Residential Care) Bill 2006 as a governmental response to some of the recommendations proposed in the Hogan review in 2004. Today I want to highlight two areas in which the aged-care sector is not adequately dealing with the specific needs of two particular communities. One of those areas was highlighted in the Hogan review—that is, people who are from culturally and linguistically diverse backgrounds. The other area is people who are in same-sex relationships and members of the gay and lesbian community. These are two areas where much can be done by government to improve the capacity of the aged-care sector to deal with the specific needs of these two communities.

I will deal firstly with the issue of people who come from culturally and linguistically diverse backgrounds. Back in 1992 the government commissioned a report by the Australian Institute of Health and Welfare entitled Projections of older immigrants: people from culturally and linguistically diverse backgrounds, 1996-2026, Australia. It reported that the number of older people from culturally and linguistically diverse backgrounds was expected to increase by 66 per cent over a 15-year period, while the Australian born population was expected to increase by only 23 per cent. The report said that by 2026 it was projected that one in four people over the age of 80 would be from culturally and linguistically diverse backgrounds.

The government has a number of different programs that deal with these issues in aged care, but there continues to be concern expressed by a number of ethnic communities about the need for an effective, over-reaching strategy to deal with the growing number of people from these communities who require the services of the aged-care sector. The Greens share these concerns and have heard them raised many times by people from particular ethnic communities about whether or not their needs are being met.

The challenges for older people going into various care facilities and also for those people providing the care primarily stem from the difficulties that people experience in suddenly being in a different culture, in a different environment with different attitudes, different food and, of course, a different language. The Hogan report dealt with this issue and said that there were difficulties faced by even some of the most highly educated multilingual people. The Hogan report said:

Older people from culturally and linguistically diverse backgrounds are more likely to experience language reversion—that is, to forget their acquired English—if they have a cognitive impairment. This may increase demand for alternative aged-care services and may increase the complexity and cost of those services.

That is dealing with the fact that, as people become older, they may forget the English language skills that they have acquired whilst they have been living here in Australia and may revert to using the language of their childhood. The issue is to do with making sure that the aged-care facilities and the people in those services are able to meet the needs of those people who lose their English skills in that process and begin to speak in a language that other people may not be able to understand.

These cultural and communication difficulties not only detrimentally affect the older people themselves but also impact on families, friends and the support networks and on the capacity of the service to provide those services. The Hogan report discusses evidence that it concludes strongly suggests that people from diverse language and cultural backgrounds currently underutilise aged-care services. This may be because they are not able to get their special needs catered for or it may be because they come from a community where some of the aged-care facilities that we have in Australia are unfamiliar to them and they are not as comfortable in them as others.

The difficulties specific to ethnic communities in Australia have been further complicated by the general patterns that we see within the aged-care sector. The push toward the privatisation of the aged-care sector has resulted in changes that compound the challenges for people from culturally and linguistically diverse backgrounds as they enter aged care. I have spoken previously in the chamber about how the privatisation policies of the government in the aged-care sector have led to widespread concerns about quality as well as issues with respect to low wages for staff, staff shortages and lack of appropriate professional development training for people working in the sector. When you have staff who are working under increased pressure, it is little wonder that some corners are cut and that the special requirements of some older Australians are inadequately met and dealt with.

In a conversation that I had recently with the Federation of Ethnic Communities Councils of Australia, they spoke about the overall workforce shortages that we see in the aged-care sector. When we are dealing with these issues about pay rates and conditions for staff in the aged-care sector, we need to recognise that many aged-care facilities are already having difficulty in getting appropriately trained staff to fill positions. If they then want to ensure that their staff have had cultural awareness training or are familiar with working with people from culturally and linguistically diverse backgrounds, that will further compound their difficulty in finding experienced staff. It is particularly a problem in remote and regional parts of Australia, where, again, workforce shortages may mean that those staff that you can get do not have that experience of cross-cultural awareness training and familiarity in working with people from a whole lot of different backgrounds.

One approach we often see is that government programs deal with this area. As I mentioned, there are a number of them. Sometimes we find that they are meeting in particular the needs of the larger or more established ethnic communities here in Australia—those long-established communities for which there are large numbers—and they have their needs addressed in that way. I have received a number of representations from people who come from smaller communities or newly emerging communities who are concerned that the needs of their particular community and the older Australians in their community are not being as well met in the aged-care sector as are those of the longer and more established immigrant communities in Australia. The government needs to look at and monitor the changing needs that come about as result of the different fluxes or waves of immigration that we have to Australia and to ensure that we have services that meet the needs of these changing cultural and linguistic groups and that there are resources for those smaller groups, who otherwise can just fall through the cracks in terms of having their needs addressed.

So the Greens call on the government to improve workforce planning strategies to develop widespread staff training in cross-cultural awareness and care strategies for all providers. The Commonwealth could do a range of different things, such as offering incentives to service providers that do give language and cross-cultural awareness training to their staff working in the aged-care sector. There are a number of things that the government can do. We call on the government to look at this area to make sure that it is doing proper monitoring of whether the needs of people from particular communities are being addressed. My understanding is that currently the way in which that is measured in the aged-care sector is not about the needs of a particular community. When the government looks at the numbers of people in facilities, it looks at them overall, asking, ‘How many people from culturally and linguistically diverse backgrounds are found in our aged care and are using aged-care services?’ rather than asking, ‘Of the people from Mauritius or from the Italian community, how many of those are able to have their needs met?’ So proper mechanisms for being able to monitor and understand whether or not particular ethnic communities are using aged-care services are a more helpful way for governments to assess whether or not they are adequately meeting the needs of these particular communities.

So, in looking at these issues of standards for service providers in planning, resource allocation, monitoring, workforce standards and ongoing research into changing community needs, they are all important. Increased financial assistance will also be required to meet ever-increasing needs. We talk about one in four people over the age of 80 in 2026 being from culturally and linguistically diverse backgrounds. It is clearly a growing problem, and there needs to be an investment in ensuring that we can meet those needs.

The other particular community who are currently raising concerns about the aged-care sector not dealing appropriately with their needs are those people from the lesbian, gay, bisexual, transgender or intersex community. I have a proposed amendment that has been circulated in the chamber that deals with this issue. One part goes to the objects of this bill—which talk about the need to ensure that people are not discriminated against in accessing aged-care facilities, on a range of different considerations—and adds into that the issue of sexual orientation, to ensure that people are not discriminated against in aged-care facilities because of their sexual orientation. I am hoping to receive support for that amendment so that we can rule out this area of discrimination. It is an issue that people in the gay and lesbian community have been paying increasing attention to in ensuring that facilities do meet their needs, and it is an area where unfortunately there are many sad stories about older Australians trying to access services and not having their needs met, not having their sexual orientation accepted by those facilities. The fact that we currently allow for aged-care facilities to discriminate against people on the basis of their sexual orientation is something that we can fix and should be fixing here today.

I have one friend who with her partner applied to 18 different nursing homes—and she made it quite clear in the applications that they were a same-sex partnership—and only heard back from one of them. There are many other stories like this throughout the sector. There are reports within the gay media about discrimination or homophobic attacks that people have experienced from fellow residents or from insensitive or poorly trained staff. There have been reports of nursing homes run by religious organisations bound by doctrines denouncing a homosexual lifestyle that also create great difficulties for people in these communities. There was an article about this last year in SX News in Sydney that went on to say:

... returning to the closet in old age is a reality for many. Stories abound of people who have been able to live openly throughout their adult lives, going into retirement villages or nursing homes and having to fabricate stories about their life, the death of their wife, and similar reasons why they do not have a family support network like other residents.

This is something that we would like to see changed. That is why I am proposing this amendment, which goes to the objects of the proposed act. The objects of the proposed act are ‘to facilitate access to aged-care services by those who need them, regardless of race, culture, language, gender, economic circumstance or geographic location’, and the Greens amendment adds ‘sexual orientation’ into this as one of the areas on which people should not be discriminated against in their access to aged-care services.

The second part of the proposed amendment arose from the experience of someone I know who was seeking to have herself and her partner entered into a nursing home facility. They were looking at their assets held collectively to see whether their family home was considered exempt from the assets test, in the same way that family homes of other people are. The advice she received was that because of her circumstances—that is, she is in a same-sex couple relationship—the family home would not be treated as exempt when they were looking at assets. I ask whether the minister is able to deal with that issue. When I looked through the legislation to try to find out why this may have happened in the circumstances of this couple, I looked at section 44.10(2) of the act, which says:

In working out the value at a particular time of the assets of a person who is or was a * homeowner then, disregard the value of a home that, at the time, was occupied by the partner ... of the person ...

That is the issue we are dealing with in this bill—that is, the exemption of the family home from assets. I then looked up the definition of ‘partner’ in the Aged Care Act, which states:

“partner”, in relation to a person, means the other *member of a couple of which the person is also a member.

I then looked further, at the definition of what a ‘member of a couple’ is, which is found in section 44.11 of the act. It says:

“member of a couple” means:

(a) a person who is legally married to another person, and is not living separately and apart from the person on a permanent basis; or

(b) a person who lives with another person in a marriage-like relationship, although not legally married to the other person.

To me that could include people living in a same-sex relationship who live ‘in a marriage-like relationship’, but are ‘not legally married to the other person’. The advice my friend received was that her circumstances did not fit into this category, but I would appreciate hearing from the minister about that. To me the wording could include same-sex couples, but it is unclear. So what this second part of the proposed Australian Greens amendment seeks to do is to make it clear that this includes same-sex couples. I will be interested to hear from the minister and the government on this issue. My reading of it is that, at the moment, it could include same-sex couples. I do not know whether the government or the minister is able to give an indication of how that has been interpreted in other circumstances.

The understanding of my friend is that it was quite clear from the forms and the face-to-face interviews that she had had with people that it did not include people in same-sex relationships; indeed, she thought it also may not include all de facto couples. If the minister could clarify that, it would be really helpful. The proposed Greens amendment is just about making clear that it should apply to same-sex couples and that the family home of same-sex couples should be exempted from the assets test, in the same way that it is for a heterosexual couple.

Those are the two areas that I have wanted to focus on in relation to what needs to occur to ensure that the needs of people from culturally and linguistically diverse backgrounds are met by our existing aged-care sector and also that people from gay and lesbian communities in same-sex relationships have their needs met within the aged-care sector.

I wish to conclude by saying that the Greens believe the skills, life experience and diversity of older people enrich our entire community. The government must play a central role in the enhanced provision, regulation and support of aged-care services. A one-size-fits-all approach does not suffice. Just as in the broader community, diversity must be respected and any particular concerns of a diverse community must be adequately dealt with, older people from culturally and linguistically diverse backgrounds must be respected, and this government must urgently address the needs of this community in the aged-care sector. Similarly, issues related to the sexual diversity of older people must also be dealt with in the area of aged care to ensure that all forms of discrimination against same-sex couples are eliminated.