Gary Humphries (ACT, Liberal Party) Share this | Link to this | Hansard source

I was saying earlier in the course of this second reading debate on the Aged Care Amendment (Residential Care) Bill 2006 that I wanted to commend the minister for having steered his way through a very difficult issue. The Senate Standing Committee on Community Affairs is a busy committee and the members of the committee always relish the opportunity to get stuck into significant issues, but on this particular occasion the committee was grateful that the heavy lifting of the complex issues which had been canvassed with the community in relation to this legislation had already been done by the Minister for Ageing by the time the committee came to consider the legislation. As a result, the consensus of those who appeared before the committee was that the legislation was effective and worth while and should be proceeded with as soon as possible.

As I mentioned before, a key element of this legislation is the harmonising of gifting arrangements and income tests to ensure that the arrangements as applied to eligibility for pensions should line up as much as possible with the arrangements governing eligibility for subsidised places in aged-care facilities in Australia. It is, of course, extremely important that older Australians, who often face the prospect of moving into residential care at a stressful point in their lives, should have an opportunity for arrangements to be as simple as possible without intruding into fairness or public accountability. This legislation achieves that. It aligns those two tests so that if a person is eligible for a pension, they will in most circumstances be eligible for a subsidised place in aged-care facilities as well.

The other arrangements that the legislation enacts have been covered by other senators in this debate; there is no need for me to repeat those. They provide, broadly speaking, for more flexibility in the way in which people are dealt with when it comes to seeking that subsidy and ensures that there is a harmonisation of arrangements between those different spheres of operation.

It is important to note that, having reached the point where this legislation can pass through the parliament reasonably swiftly and with support, once again we have a position where the government has a clear policy on aged care. This is a policy now backed up by a number of years of demonstrating its good faith and its commitment to this area by making simpler and fairer arrangements with respect to eligibility for benefits provided by the federal government and also with a significant commitment of funding to back up that commitment.

The Australian Labor Party has not been able to come up with a clear aged-care policy in this area, despite having made promises, as it has made promises from time to time in the past, since the last election. I note that only recently the Australian Labor Party released an ageing policy discussion paper. I suppose that is one small step towards some clear idea of what the Australian Labor Party actually believes in in the area of ageing. But that is not a policy, and I look forward, as I am sure others in this place do, to clearly understanding what the alternative is that is offered by the Australian Labor Party. It has had 10 years of leisure in opposition to be able to put together a policy. There has been more than enough opportunity in that period to formulate a policy.

The discussion paper, in the meantime, does contain a number of factual errors, omissions and a lack of understanding of current aged-care policy and programs. The discussion paper claims, for example, that the leadership of the federal government in the area of aged care is lacking, despite the track record that I spoke of a moment ago. For example, in the past 10 years the federal government has more than doubled the amount that it spends on service delivery for older Australians. This government knows that the population has been ageing and it knows that there is an increase in our aged population as a proportion of the total Australian population, but it certainly has not come anywhere near doubling it. It is surprising on the face of it for there to be such a large extra commitment. But, in fact, it reflects this government’s view that much more needs to be done to make older Australians comfortable and properly cared for in old age.

The paper claims to have come up with a range of policy options in the area of healthy ageing, community care and residential care. However, I think it is true to say that, in all those areas, concrete policy proposals are actually very thin and overlook the fact that, in all of those areas, there are already significant government policies and government initiatives not just on the table but actually operational. The Howard government is committed to the National Strategy for an Ageing Australia, and the amendments in this bill before the Senate at the moment are designed to simplify the interaction of the aged-care and pension arrangements for greater transparency and to facilitate wise financial planning for older Australians. They will apply from 1 January 2007.

These comments are of course very timely, as this week has been designated as Carers Week around Australia. It is quite appropriate that we should take the opportunity of passing a piece of legislation such as this to note the significant contribution made to the wellbeing of Australians by the 2.6 million people who choose each year to be carers for other Australians. One in eight Australians are carers at the present time. Very often—in fact, almost always—those people are carers for reasons beyond their control. That is, a member of their family or a close friend is, for whatever reason, incapacitated or in need of particular assistance and those Australians, out of an honourable sense of duty, choose to become carers for those people. The community owes them an enormous debt of gratitude.

The slogan for Carers Week this year is ‘Anyone, anytime’, which connotes the idea not only that the need to be a carer can spring up in anyone’s case but also that the capacity to deliver that kind of care is something which many Australians readily undertake and readily acknowledge. In that context, finding ways of easing the burden is very important. Respite for all carers is extremely important. That has certainly been the subject of a number of initiatives of this government, as have other ways to offset what is a tremendous financial commitment made in kind by those carers to the Australian community. It has been estimated that some $31 billion is the economic value of the care which those carers provide, and we need to acknowledge that in the course of a debate like the one we are having today.

I also want to note that the Australian Greens have foreshadowed a number of amendments to this legislation. The points made by Senator Nettle in the debate earlier today are reasonable points to take on board. I think she certainly has some points that need to be carefully considered by government. The points about the needs of older Australians from non-English-speaking backgrounds are well understood by members all over this chamber. We have all had experiences of older Australians of that kind having difficulty adjusting to residential care where their own cultural background is not properly catered for. We also need to ensure that the workforce issues which go with that are properly and fully addressed. Again, the government has demonstrated a commitment to deal with those issues.

Senator Nettle also raised, and her proposed amendments directly deal with, the issue of same-sex couples seeking access to nursing homes in Australia and to aged-care facilities. Again, some reasonable points have been raised in the course of that contribution by Senator Nettle, but I make the comment that the changes which Senator Nettle has put forward in the course of this debate clearly entail very significant changes to the position as understood and applied by providers of these services in the community. I think it would be unfortunate if the Senate were, at the end of a reasonably long process, to arrive at these amendments and in the course of this debate to impose additional conditions on aged-care providers about which no consultation has at this point occurred—or at least none that I am aware of. These amendments would certainly entail a change of arrangement and possibly a cost to those providers, and I think it is unfortunate that we should contemplate such arrangements, such changes, in place without having done the appropriate consultation around them. This has been a process in which, as I have said, there has been genuine consensus about what needs to be done. It would be unfortunate if we introduced into this an element of changing the arrangements which was not a matter of consensus between the industry, government and others involved in this debate.

I want to close by again congratulating the government on this legislation. It is a very positive step forward which will be welcomed by older Australians and their families as decisions are made about either moving into aged accommodation or moving between different forms of aged accommodation in Australia. Easing the burden in those circumstances is a very important duty that falls on all of us, and I think the government has discharged that duty very well with the decisions it makes today.

I know that, when the minister first took on the mantle of Minister for Ageing, it was put to him very early on in his tenure that a whole range of problems needed to be solved. People were beating on his door almost before he had squeezed into his chair, demanding that certain long-term—

Kay Patterson (Victoria, Liberal Party) Share this | Link to this | Hansard source

‘Squeezed’?

Gary Humphries (ACT, Liberal Party) Share this | Link to this | Hansard source

Perhaps ‘squeezed into his chair’ is a reflection I need to withdraw! I mean that, before he settled comfortably on his ministerial place, he was being asked to provide answers to issues and questions that long preceded his bottom appearing in that place. It is to his credit that he did not allow that clamour for instant action to overcome his better judgement. Instead he calmly and soberly assessed the situation and produced legislation of this kind. Let us hope that there is much more of that kind of considered approach to these complex issues in the offing. I commend this legislation to the Senate.

Santo Santoro (Queensland, Liberal Party, Minister for Ageing) Share this | Link to this | Hansard source

in reply—I table a supplementary explanatory memorandum. I have appreciated listening to the contributions of all senators in relation to the Aged Care Amendment (Residential Care) Bill 2006. This legislation will make amendments to the Aged Care Act 1997. In the 2006-07 federal budget the coalition government announced that it would bring the treatment of assets for aged-care purposes into line with its treatment for pension purposes in relation to limits on the gifting of assets and the concessional treatment of complying income streams. The legislation gives effect to these changes and will enable Centrelink and the Department of Veterans’ Affairs to streamline their systems so that they no longer have to assess gifted assets differently when they undertake aged-care assets assessments on behalf of the Department of Health and Ageing. This will prevent a pensioner who has been assessed as eligible for residential aged care from gifting away most of their assets before entering care and thereby avoiding paying an accommodation payment and becoming eligible for the government’s concessional resident supplement.

From September 2007, the treatment of income streams purchased on or after 20 September 2007 will also be aligned. Income streams purchased prior to 20 September 2007 will continue to enjoy the 100 per cent exemption from the aged-care assets test that currently applies. Residents and prospective residents will be better placed to make decisions about their care needs as a result of these changes because they will have greater certainty about their financial situation and status prior to entry. This legislation will also remove uncertainty about the powers that aged-care assessment teams possess in approving extensions to residential respite care. The legislation will allow the secretary of the Department of Health and Ageing to, where there is a need to do so, delegate to ACAT delegates the power to increase the maximum number of days allowed by a period of 21 days.

This legislation further delivers on initiatives in the 2004-05 Investing in Australia’s Aged Care: More Places, Better Care package to streamline administration for better care. This demonstrates the coalition government’s strong commitment to ensuring a robust and viable aged-care sector into the future providing high quality and affordable care to older Australians.

As I said, I have enjoyed the contributions from all honourable senators. In particular, I thank the opposition for their indication of support for the amendments that are before the Senate here this evening. I would like to respond in some detail to all of the contributions made by honourable senators. I will commence with some responses to Senator McLucas’s proposed amendment. I am happy to elaborate further after she speaks if she chooses to do so. Senator McLucas suggested that the bill be amended so that it requires every residential aged-care facility to be subject to one unannounced support contact by the Aged Care Standards and Accreditation Agency. The agency will in 2006-07 conduct no less than 5,200 visits to aged-care homes, of which 3,000 will be spot checks. Under the changes that I announced in July 2006, the agency is required to maintain an average visiting schedule of 1.75 visits per home per year. I can assure Senator McLucas that the intent of part of her amendment will certainly be fulfilled by the accreditation agency.

Senator McLucas’s amendment also seeks to implement a rule such that residential aged-care facilities must not be given any prior notice of support contact visits. I can advise Senator McLucas that the current legislation states that the approved provider must be given written notice in advance of any support contact visit or audit. This can range from five minutes to five days. The accreditation agency will continue to exercise reasonable discretion in terms of the amount of notice that is given to providers. If it is meant to be very short-term notice, that is the notice that will be provided.

Senator McLucas, through her amendment, also wants assessment teams conducting the support contacts to have to assess the facility against all quality outcomes of the aged-care standards of the accreditation agency. Senator McLucas knows that the current system consists of a full site audit every three years, with support contact visits or spot checks in between. If Senator McLucas in her continuing consultations with the industry raises this issue, she will be informed that a full audit is extremely disruptive for an aged-care home.

A spot check is designed to focus on areas that may have been identified either in previous reviews or through other avenues. Agency support contact visits assess whether or not an audit is justified or warranted. It can be a means by which the necessity for a full review is found to be warranted, and that can then be conducted. Support contact visits do not assess all 44 standards. There are very good reasons for that, as Senator McLucas would appreciate. I am advised, Senator McLucas, that a full site audit can take up to five days with up to five staff for a large home, and can be very disruptive for the orderly and effective management of an aged-care home. In addition, I have been informed that a full site audit can cost around $10,000 on average. If we were to do this for all homes on an annual basis, that would cost the industry an additional $21 million per year. And that is quite separate from the disruption that I have just mentioned. I believe that the current system as it stands is efficient and appropriate and does not use a sledgehammer to crack a nut, as Senator Barnett said earlier during this debate.

In her remarks, Senator McLucas also stated that the committee inquiry recommended passing the bill in its entirety without amendment. With all due respect to Senator McLucas and the amendment which will be before the chamber tonight, the committee agreed to pass the bill without amendment and here we will be considering an amendment by her.

Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Aged Care, Disabilities and Carers) Share this | Link to this | Hansard source

And by you.

Santo Santoro (Queensland, Liberal Party, Minister for Ageing) Share this | Link to this | Hansard source

And by me. You are absolutely right. I take your interjection in the spirit that it is meant, and that is that things do suddenly arise, as happened for the government, where a very competent body brought a fairly technical situation to our attention and we had to respond. I want to come back to that right now.

During her contribution Senator McLucas queried the process by which we went about making the amendment to our amending bill. The amendment was drafted in response to an approach to my office by the Investment and Financial Services Association last week. IFSA—and I want to stress this—approached my office after the deadline for submissions to the Senate Standing Committee on Community Affairs had closed and the committee had met. Otherwise you can rest assured that we would have brought the matter up for the committee’s consideration. I am satisfied that my office took very swift action in responding to the representations of IFSA last week. They have acknowledged that in discussions. I am also satisfied that we did all we could to implement this amendment swiftly and transparently and conducted the appropriate consultations with the appropriate members of the committee, such as its chair, Senator Humphries, and others through a revised explanatory memorandum, which I have just tabled. As Senator McLucas quite correctly identified, it was a new piece of information that we had to respond to, and we did that as expeditiously and transparently as possible.

Regarding Senator Nettle’s amendment, I would like to note that we provided a lot more advice with our amendment than the amendment proposed by the Greens just this morning. I say that with all due respect to the intention of the Greens’ amendment. Senator Nettle’s amendment suggests that the bill be amended to reflect that a person’s access to residential aged care is not discriminated on the basis of sexual orientation and that the definition of a member of a couple includes same-sex partners. In responding to Senator Nettle’s amendment, can I say that the government is committed to removing unfair discriminatory treatment from federal laws. This includes a commitment to eliminating unfair discrimination against all interdependent relationships. Both the Prime Minister and the Attorney-General have stated publicly that they are strongly in favour of removing unfair discrimination against interdependent relationships. The government has already made a number of changes to eliminate unfair discrimination in this area. The chief amendment proposed by Senator Nettle is an additional qualification to the definition of a member of a couple. The amendment alters the definition to specifically refer to same-sex partners.

The government believes—and I think the government’s views were quite adequately expressed by Senator Humphries in his concluding remarks—that these issues should be considered through a holistic examination of all government legislation rather than in an ad hoc way and is currently looking closely at further eliminating unfair discriminatory treatment against interdependent relationships. It has made these statements previously to the Senate. I certainly have done so in relation to other legislation that the Senate has been considering. In good faith I reiterate those sentiments to Senator Nettle and the Greens, but, regrettably and because of the reasons mentioned, we will not be supporting the amendment moved by Senator Nettle on behalf of the Greens.

Much to the surprise of all senators, I probably will not take all the time remaining to me, but I would like to address some other issues that were raised by honourable senators from both sides. Senator McLucas again raised the issue of the government’s response to Professor Hogan’s long-term recommendations. I again assure Senator McLucas that the government is very seriously considering its response. She would appreciate from her discussions with parts of the sector that it is a very complex issue. It is not a simple and easy issue to provide an immediate response to. I think Senator McLucas mentioned that the government has been considering its response for 16 or 17 months.

Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Aged Care, Disabilities and Carers) Share this | Link to this | Hansard source

Fourteen.

Santo Santoro (Queensland, Liberal Party, Minister for Ageing) Share this | Link to this | Hansard source

I think that the sector and Senator McLucas will be quite happy with the government’s eventual response to Professor Hogan’s report. I am not trying to obfuscate; we are trying to get the best result. We are still consulting very extensively with the advisory committee, with individual stakeholders, with churches and right across the board. I really have been flat strap taking in all the views. There is nothing political, mischievous or sinister in our considering the views of the industry to the length that we have. I expect to be in a position at some time in the future to provide a comprehensive response to Professor Hogan’s recommendations on long-term reform.

Senator McLucas mentioned an aged-care home in Victoria that failed 30 of the 44 standards and only got four months less on accreditation. The home that she referred to was the Elizabeth House private home. Sanctions were not applied there as there was not an immediate or severe risk to the health and safety or wellbeing of the residents, as the Aged Care Act requires. Senator McLucas would appreciate that the absolute bottom line of everything that we as a government do and that I personally as a minister oversee is the welfare of the residents within our aged-care facilities. All the people in the department share that commitment and that ideal of service, and sometimes some fairly tough decisions have to be made.

When a breach occurs which looks severe, including breaches that may involve serious assault or sexual assault, we are often asked by Senator McLucas and others on her side of the chamber, or even members of the community, ‘Why is that aged-care facility still allowed to operate?’ It is very simple. To just shut down a facility and get people out of the facility very quickly is not always a feasible option. Senator McLucas knows that through no fault of the government there was recently the closure of an aged-care facility in Victoria with all the commotion and emotional drain that that caused to residents.

Kay Patterson (Victoria, Liberal Party) Share this | Link to this | Hansard source

Senator Patterson interjecting—

Santo Santoro (Queensland, Liberal Party, Minister for Ageing) Share this | Link to this | Hansard source

Beg yours?

Steve Hutchins (NSW, Australian Labor Party) Share this | Link to this | Hansard source

Speak through the chair please, Minister.

Kay Patterson (Victoria, Liberal Party) Share this | Link to this | Hansard source

Senator Patterson interjecting—

The Acting Deputy President:

You can interject all you like, but no-one is recording it, so keep talking, Minister.

Santo Santoro (Queensland, Liberal Party, Minister for Ageing) Share this | Link to this | Hansard source

No disrespect to you, Mr Acting Deputy President. I was just asking if Senator Patterson would clarify what she was saying. The point that I am making is that severe sanctions including the closure of a nursing home can sometimes be considered but that may be against the best interests of residents and is not always an easy thing to do.

Senator Nettle spoke at length about aged care and migrants. In broad response to Senator Nettle I will say that, with all due recognition to the tremendous amount of work that former ministers like Senator Patterson did before me, there probably has never been an aged-care minister in Australia who has been able to bring about as ethnically sensitive a perspective to the administration of aged care in Australia. With a name like Santo Santoro and having been born overseas and with all that sort of thought and argument, I am very much concerned about and interested in advancing the policy agenda when it comes to looking after ageing and frail migrants.

The Australian government does provide support for all Australians in need of aged care, including those from culturally and linguistically diverse backgrounds. As of March 2006, there were 180 ethno-specific residential aged-care services, with 7,079 places. Additionally, the Australian government recognises that extra support is required to ensure good access by people from culturally and linguistically diverse backgrounds. In 2006-07, the Australian government will be funding over 40 organisations to provide further support for aged-care services. The Community Partners Program—one of the programs which provides the support—will continue in 2006-07 with funding of $2.4 million. Thirty-five new projects have been approved under the Community Partners Program for the 2006-07 financial year, and around 24 communities will benefit from this funding, including five projects for the newly funded Afghanistani, Iraqi, Albanian, Thai and Laos communities.

It may also interest members to know that in the near future I will be meeting with the Federation of Ethnic Communities Council of Australia, possibly as soon as next week. During the past two or three visits interstate, I have met with representatives of migrant communities on a number of occasions and have benefited greatly from the advice that they have been able to provide to me on behalf of the people that they represent.

Senator Webber raised some issues relating to the workforce. She quite rightly raised concerns about the growing requirements for a workforce that already provides very valuable service to the aged and the frail, in both residential settings and community settings. Of course, with respect, I think that Senator Webber was a little cynical, because we should recognise in this chamber and anywhere else that right across the Western world there is an acute shortage of doctors and nurses. I will not go through at any great length the great amount of funding and the intended increase in the number of new doctors and nurses that the federal government has provided for through that funding, but the Howard government has provided $229 million for workforce initiatives for the 2005-09 period, including upskilling opportunities—for example, 5,200 enrolled nurses being educated in medication management—1,600 new nursing places to universities that demonstrate aged-care expertise and emphasis, and 1,000 aged-care scholarships. Of course, the government has undertaken and will continue to undertake aged-care workforce surveys.

I very much appreciated Senator Barnett’s contribution because he again clearly outlined the great contribution that this government has made in terms of investment in the aged-care sector—$2.2 billion—and the great increases in places that we have spoken about in this chamber, both during question time and on other occasions. I will not go through the details of the contributions of Senator Barnett, Senator Adams and Senator Humphries. They put very much on the record in a very eloquent way the government’s contribution to the aged-care sector since 1996. (Time expired)

Question agreed to.

Bill read a second time.