Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Hansard source

I rise today to speak about some of the challenges that an ageing population presents for Australia. Plenty of people have spoken in this chamber and in the other place about these challenges before. One of Labor's most unrecognised but vital achievements was passing the Living Longer, Living Better reforms.

Our commitment to older Australians has been outstanding. The member for Port Adelaide and Senator Collins and indeed their staff should be particularly proud about what they accomplished. But of course the matter of an ageing population is still something that Australia must consider carefully. We all know what problems we face as a First World country with baby boomers heading towards retirement. Politicians from across the political spectrum have repeated the statistics that many of us have heard many times before. They are sobering.

The amount we are spending on health care in this country is rising at six per cent per year. This is twice the growth rate of our GDP. Our spending on hospitals is accelerating dramatically. They are receiving some $18 billion a year more than they received a decade ago. A considerable percentage of this expenditure is of course dedicated to looking after older Australians, and this is quite simply unsustainable over time.

According to the Productivity Commission, total Australian government spending reported on ageing and aged-care services is now close to $13 billion a year. This of course will not get any easier anytime soon. As I stand here today, just over 10 per cent of the population is aged over 65, but by 2050 it will be close to a quarter. Because health costs are higher at the end of life, the vast bulk of the nation's health budget will soon be spent on older people, many of whom will be retired and not paying tax.

By the time we reach the point where one in four people in this country is aged over 65, the number of people of working age in Australia—20 to 64—relative to older people—65 plus—will fall from the current ratio of five to one to a daunting 2½ to one. The problem of attracting staff to work in residential facilities is also well known The work is incredibly taxing, the responsibilities immense and the financial reward far from generous.

The Productivity Commission has pointed out that increasing numbers of residents with higher and more complex care needs have added to the workloads of care staff in residential care settings. As we speak, some 50 per cent of the aged-care workforce is within 10 years of retiring, and it is proving particularly challenging to attract young, capable people to undertake this line of work. So I want to be absolutely clear when I say that the challenges we face in this country with an ageing population are immense. Every politician, every expert in the field, every stakeholder and every aged-care provider knows it.

But today I do not just want to speak about the problems we face due to an ageing population; I want to talk about opportunities that are right in front of us. I want to talk about how we can innovate to not only save billions of dollars in public health expenditure but also ensure that our older Australians live their lives with greater comfort, dignity and independence. I want to talk about solutions which are not only within our grasp but more than achievable if we demonstrate foresight and think creatively.

What are the solutions? What is the best way to confront this? We have to act if we are to ensure that we can properly look after our older Australians, but we cannot compromise economic growth and expenditure in other areas. I think that everyone in this chamber, in this entire building, would agree with that statement. But here is the key: improvement has to come from efficiency gains, not spending cuts.

In this context it is very much worth heeding the words of the Grattan Institute's Stephen Duckett and Cassie McGannon, who contributed the following:

Reducing health spending growth will not be easy. As Grattan's Game-changers report last year showed, Australia already has one of the OECD’s most efficient health systems, in terms of life expectancy achieved for dollars spent.

Sweeping cuts to health funding, or shifting costs to consumers, could have serious consequences. Blunt cost-cutting risks reducing health and well-being, and could ultimately lead to higher government costs due to illness, increased health-care needs and lower workforce participation.

We need to focus on targeted investment. We need to focus on innovation, not simply cuts.

Several weeks ago in Melbourne the former Independent member for New England, Tony Windsor, delivered a remarkably candid and perceptive speech at a Victorian Women's Trust event honouring our former Prime Minister Julia Gillard. Mr Windsor was discussing the virtues of fibre-to-the-premises broadband versus the coalition's model when he said in relation to the current Minister for Communications:

Malcolm talks about benefit costs … I make this plea to Malcolm—and there might be some academics in the audience … —someone should do the work on what fibre-to-the-home does in relation to the aged-care debate long term … We have a significant problem. Peter Costello—

a reference, of course, to our former Treasurer—

recognised this some years ago in terms of the ageing of the population. We are going to have a big bump of older people … coming through the system. If five per cent of those people could stay in their homes for one or two years additionally, or whatever the number you want to pick, what impact would that have on the capital costs of this bump coming through the system? What impact would it have on the operational costs of supplying those beds? What impact would it have on the psyche of the people and their families?

He went on, and this part is crucial:

It is nonsense to suggest that there is a better way of doing this. If Tony Abbott wants to be the infrastructure champion of the decade—

that is the key infrastructure issue—

that is the one thing that connects all the dots, the health, the education, the business, the social aged-care issues. It is the one thing that removes distance and remoteness as being a disadvantage for country people.

The former member for New England is exactly right. If we approach this properly, if we innovate and consider what is best for an ageing population, we can succeed in immeasurably improving the lives of older Australians whilst saving the nation billions of dollars. It is right there in front of us.

The answer lies in solutions such as telehealth. Telehealth is not something that many Australians will be immediately familiar with. Previously, when we talked about technology to help older people, we were referring to monitors which sent out an alarm if someone fell. But today we can do so much more with world-class broadband: the sky is the limit. Modern telehealth innovations allow for houses full of sensors which transmit data in real time to monitor things like health and even mobility.

What is even more valuable is the use of sophisticated consoles so that these people can speak face to face with friends and family but also nurses, doctors and specialists. Instead of admissions to hospital or residential aged-care facilities, we can have monitoring of older Australians in their own homes. They can live where they want, where they feel comfortable, and they can communicate with others in the process, combating social exclusion while having key health indicators monitored.

The technology is advanced enough that the CSIRO's Geoff Haydon, who is working on the NBN telehealthcare trial in northern New South Wales, said that the modern equipment enables professionals to:

Manage and monitor people as though they were in a retirement village, while they're still in their own home.

As those who have a relative or friend in residential care will tell you, it is an expensive and complex proposition. The amount paid depends on personal assets, but the average bond paid by new residents is now approaching a quarter of a million dollars. So once again it becomes clear: staying at home, even for just a little longer, not only is preferable from a health and happiness angle but also makes financial sense.

The Australian Bureau of Statistics agrees, noting that by regularly monitoring the health of older Australians with this technology we will not only improve their quality of life but also help prevent illness or injury. Consultations with health professionals will enable monitoring of lifestyle risk factors and overall maintenance of good health.

Successful telehealth monitoring saves money in a range of ways, some of which are not immediately obvious. We need to consider reduced ambulance journeys, reduced travel to doctors and specialists, reduced numbers of acute incidents arising out of chronic illness, and reduced hospital visits and admissions. The list goes on, and over time the billions add up.

Most of the studies on telehealth have come from overseas, notably the United States. However, studies conducted in Australia by not-for-profit aged- and community-care provider Feros drew incredible results. Some 80 per cent of clients in a trial reported that telecare had improved their quality of life during the program, and 69 per cent of clients reported being less concerned about the daily severity of their condition.

But let's talk numbers. Daily telehealth supervision every day costs just over $7. Let's compare that figure to the staggering $967 that is spent on an average acute hospital bed stay, beds which are of course limited in number and desperately needed.

When Access Economics was commissioned by the Department of Broadband, Communications and the Digital Economy to provide a cost-benefit analysis of introducing a telehealth intervention into aged care, the results were staggering. Based on a target population of just over 17,000 older Australians, it was estimated that the intervention could save over $17 million in net present value terms, with a further $6.8 million in health system savings. If the benefits from reduced pain and suffering are included, the total gross benefit is a further $9.5 million. Just imagine if this were deployed right across the country, if every household were connected to world-class broadband.

But here is the other component of this solution: to take advantage of telehealth, we need world-class, medical-grade broadband. We need fibre-to-the-premises broadband. Unfortunately, when it comes to discussing the NBN, the coalition have sought to trivialise the benefits associated with superior broadband and pretend that it is something that will benefit a small fraction of the Australian population.

In fact, earlier this year I appeared on a panel television show, The Nation, alongside Senator Eric Abetz and Senator Peter Whish-Wilson. I was slightly horrified to hear what the Liberal senator from Tasmania, my home state, had to say on delivering fibre-to-the-premises broadband to every household and business. He said:

It's like saying that every home needs the Rolls Royce parked in the driveway.

This is actually how the Liberal Party and the Liberal government think.

But of course we have heard even worse. It was in fact our now Prime Minister who said earlier this year:

The National Broadband Network is a luxury that Australia cannot now afford. The one thing you don't do is redo your bathroom when your roof has just been blown off.

But it gets even worse. When asked in relation to fibre-to-the-premises NBN in December 2010, our Prime Minister said:

… do we really want to invest $50 billion worth of hard-earned taxpayers' money in what is essentially a video entertainment system?

A video entertainment system! A luxury that is likened to renovating your bathroom! That is how the coalition views the NBN, as a glorified video entertainment system.

What if I were to inform those opposite that fibre-to-the-premises NBN is almost certainly worth building for the healthcare benefits alone, especially for those older Australians who need day-to-day assistance to live their lives to the fullest extent possible? In fact the former head of the National E-Health Transition Authority estimated that 30 to 40 per cent of total NBN usage across all areas will be for health applications. These are applications that will of course be particularly valuable for the old and infirm. Fibre-to-the-premises NBN is a massive infrastructure achievement that will enable older Australians to access medical-grade reliance connections. We have to do this. We really do not have a choice. Even if we were to ignore the numbers, the cost benefits, the trials, the indisputable evidence that this is a superior solution, there is something else I would like to remind everyone of. Embracing telehealth technologies through fibre-to-the-premises broadband makes an enormous difference to the lives of older Australians. I have to say that in my new role as shadow parliamentary secretary for aged care, I have been able to visit several residential facilities and speak to older Australians and I plan to continue to do a lot more of this and to speak about this important issue into the future. (Time expired)