Nick Xenophon (SA, Independent) Share this | Hansard source

I rise to indicate my support for the Aged Care Amendment (2008 Measures No. 2) Bill 2008, but wish to note my concerns about the handling of aged care by both this and previous governments. This bill seeks to strengthen the aged-care regulatory framework and, in the words of the explanatory memorandum, ‘to address current legislative inadequacies and maintain effective regulatory safeguards for ensuring high quality care for older Australians’. Caring for our elderly is one of the most important responsibilities for Australian society and in turn for Australian governments.

As a senator for South Australia, which has a population that is relatively older than that of Australia as a whole, I know that we feel the pinch of these responsibilities, perhaps earlier and more so than in other states. Many South Australians have found their encounters with aged care to be confusing, stressful, emotional and at times painful experiences. There is the highly emotional tearing of ties, where an elderly relative is forced due to poor health, and often against their will, to leave their home of many years. Due to a shortage of places, many of these relatives have to take whatever placement can be found, often a long distance from their home, and there is the confusion and disorientation that results from relocation to a new place later in life. Added to this is the stress that is felt by families as they seek to find not only any place, but the best place, for their loved ones. No-one wants to have to explain to their children why their grandpa or grandma is so miserable in their later years of life. And having as children shared their home with their elderly grandparents, many adult children now feel extreme guilt as they place their parents into care. Times have changed, more people work and people are living longer, meaning that staying home to care for your parents is not a viable option—something an elderly parent may often not understand.

Then there is the heartbreaking separation of life-long partners being forced to live apart because there are not enough high-care places provided with nearby low- to medium-level care. When a partner most wants to be near their loved one—as their health declines—they are forced to be apart. As people who ourselves are not yet in care, we cannot help but wonder what sort of care will be available to us in not too many years time—or in my case not too many years time! These are real concerns and are only reinforced by the regular media reports that portray the current aged-care situation as being stretched to the limit—and they reflect the reality.

In the Sydney Morning Herald on 10 November Mark Metherell reported:

The Government’s failure to deal with the financial woes hitting nursing homes will result in a drought in places for frail elderly people on low incomes …

In short, those who can afford it will have to outlay bonds ‘of more than $180,000’. Those who cannot will miss out.

Martin Laverty, the CEO of Catholic Health Australia, which represents the biggest not-for-profit aged-care provider in Australia, explained in the same article that government regulations prevent aged-care operators from charging a consumer the actual cost of care, yet government funding is insufficient to cover operating and capital costs. He warned that the result is a real risk that the 37,000 new beds that were recently announced by the government will not be taken up as providers cannot take the financial risk.

Similarly, Jim Toohey reported in the Courier Mail on 6 October that there is an aged-care crisis looming. His article reported how older Australians are increasingly finding themselves in hospital beds when aged care is not available. That, clearly, is just not good enough. Mr Toohey also highlighted the findings of the Productivity Commission report into the future of aged care, namely, that, without significant changes to aged-care funding, service standards will struggle to match current levels. This crisis will not be fixed by the repeated tightening of regulations; it requires real investment—tens of thousands of new places at a cost of hundreds of thousands each.

As my office has consulted representatives of the aged-care sector over the last few months, these reports have proved indicative of the experiences of aged-care providers. These providers report that the cost of inflation is hitting the sector hard and it is making it ever harder for aged-care providers to remain viable.

There is a shortage of high-level care places and, while there has been some investment in medium- and low-level care in recent years, this shortage is worsening. Exacerbating the situation is the inability of aged-care providers to use bonds to help fund the provision of more infrastructure and high-level care places, thus making it less financially feasible for both for-profit and not-for-profit providers.

Adding to this is the growing pressure to get nurses and carers into the profession. With low pay, demanding conditions and limited long-term career prospects, it is hard to attract and keep quality people. Estimates put the cost to aged care of matching the wages and conditions of hospital staff at around $450 million a year. Further, as Australia’s baby boomer generation becomes older and requires more intensive aged care, there will be an explosion in demand for places.

Australia’s aged-care sector is heading for tough times. My concern is that this government, along with the one before it, have been far too focussed on tightening regulations and have not paid enough attention to adequate funding. Building new aged-care facilities costs about $200,000 per bed but the government provides only $76,000.

While proper regulation of this industry is vital for the safety of those in care, repeatedly stricter regulation should not be used as a catch 22. Providers who are pushed to meet ever stricter standards and secure ever more stretched funds are, in so doing, undermining their capacity to highlight the system’s inadequacies. Should sector representatives claim that there are problems, a minister can reply, ‘What problem? The sector is becoming more efficient and you are still meeting standards,’ or words along those lines. This is not long-term vision; this is short-term cynicism, and this is my broad concern in relation to this bill.

I am aware that the numbers are in favour of the swift passage of the bill, and I do not, in principle, oppose a stronger accountability framework, but more needs to be done. I wish to put on record that I will be watching with great interest the government’s future initiatives in relation to the looming aged-care crisis, particularly as it has significant implications for my home state of South Australia.