House debates

Monday, 18 June 2007

Aged Care Amendment (Residential Care) Bill 2007

Second Reading

7:55 pm

Photo of Laurie FergusonLaurie Ferguson (Reid, Australian Labor Party, Shadow Minister for Multicultural Affairs, Urban Development and Consumer Affairs) Share this | Hansard source

On 6 June I met with a number of organisations in Melbourne who have involvement in aged care: the Australian Greek Welfare Society, COASIT—the Italian Assistance Association—and the Australian-Polish Community Services. In the case of the Greek and Polish organisations, I have had meetings with them over the years, and it was not my first visit to COASIT. I mention in passing that one thing I was very impressed with was the amount of money the Italian government devotes each year to the retention of Italian languages in Victorian secondary schools. The Italian government actually funds 40 teachers to come to Australia each year to assist in the Victorian secondary education system. I also mention that I have had previous meetings with the Ethnic Communities Council of Victoria, the ECCV. This visit, some correspondence from those organisations and earlier activity by the ECCV will inform my comments on the Aged Care Amendment (Residential Care) Bill 2007.

This bill seeks to amend the Aged Care Act 1997, introducing a new arrangement for allocating subsidies in residential aged care: the Aged Care Funding Instrument. The bill also alters current arrangements in which classifications expire after 12 months and removes the requirement for providers to submit reappraisals, but it gives providers the option to reappraise residents after 12 months. Another area of amendment allows a provider to accept a resident’s current classification when a resident moves from one home to another rather than being required to submit a new appraisal. I would think that is an eminently sensible suggestion. In essence, the bill is designed to reduce the amount of documentation generated in aged-care facilities which is required to justify the funding classification for each resident. The opposition welcomes the stated objectives of reducing paperwork for aged-care staff and, hence, liberating people’s time for essential tasks in actually caring for residents.

With the above in mind, I now move on to the issue of providing aged-care services to people from culturally and linguistically diverse—CALD—backgrounds. This issue has been raised with me by numerous community organisations, including the Ethnic Communities Council of Victoria—ECCV—which, it must be said, of all the state organisations of the Federation of Ethnic Communities Councils, has been the most active around these issues. According to the ECCV, senior people from CALD backgrounds are rapidly ageing. It is projected that CALD seniors will represent 38 per cent of Melbourne’s senior population by 2011, based on the departments of Treasury and Finance figures in 2004. In particular, the population of CALD people aged 80-plus in Victoria is projected to grow at the exponential rate of 171 per cent between 1996 and 2011. That is based on material from the Australian Institute of Health and Welfare.

As summarised by the previous speaker—and, no doubt, it will be repeated by many other speakers in this debate—it is well known that Australia’s population is progressively ageing, as is the case in many Western nations. Approximately 13 per cent, or 2.5 million people, are currently aged over 65. By 2051 the proportion of the population aged over 65 will represent one-quarter of the nation’s population, barring major immigration intake changes. While the population as a whole is ageing, the migrant-background population is ageing even more rapidly. By 2011, just four years from now, it is predicted that nearly 23 per cent of Australians aged over 65 will be from a culturally and linguistically diverse background. The Federation of Ethnic Communities Councils argues that demographic changes within CALD communities are reflective of Australia’s migration patterns.

Refugees from eastern Europe and the Baltic states described as displaced persons began to arrive in Australia after World War II, while the 1950s and 1960s intakes were characterised particularly by nationals from Germany, Greece, Italy and the Netherlands. These participants in Australia’s postwar migration program are now representative of the growing group of older CALD persons. As at 2001, the top five oldest birthplace groups were from Italy, Greece, Germany, the Netherlands and Poland. While Italy and Greece represent the most demographically significant birthplace groups in overall numbers and will continue to dominate for the next 20 years, by 2026 people of Vietnamese and Chinese background are projected to rise to third and fourth position respectively in the top four cultural groups of the older CALD population. Naturally, the number of aged people in this group is only going to increase. With this will come more difficulties and greater urgency, and there is a need to act now.

The following national statistics provide a snapshot. As of 2001, there were 94,500 people aged over 65 who spoke Italian at home; 43,000 Greek speakers; 29,000 speakers of the total of Chinese languages; and 24,000 German speakers. If we look at some of those language groups, we notice that some of the smaller groups have a large number of their population in the over 65 age category. Amongst Ukrainian speakers, the figure was 43½ per cent. Of those who speak Netherlandic and related languages, such as Frisian, it was about 39 per cent. Of Hungarian speakers it was 32 per cent, and of German speakers it was 31 per cent.

I note in passing my disquiet at the decision of the Department of Immigration and Citizenship to discontinue funding for the Ukrainian Welfare Association in my electorate at a time when this particular community—whilst its numbers are being reduced and we are on to the third and fourth generation in some cases—is facing particular needs, especially in the aged sector.

In the lead-up to the 2006 Victorian elections, the Ethic Communities Council of Victoria prepared an insightful report into the key issues affecting ageing CALD communities in Victoria, titled A proposal for a multicultural aged care strategy. Some of its analyses involved:

Clearly communities with large ethno-specific populations should be entitled to deliver services, particularly communities such as the Italian, Greek and Polish—

who—

have large numbers of seniors with low-level English proficiency.

That was the reality of their employment in the manufacturing sector in this country when English was not required for unskilled jobs and there was not much availability of classes at work or the time to pursue them out of hours. Another matter raised by the ECCV was:

Ethno-specific agencies and migrant resource centres are close to their communities and intimately understand and are able to respond to their communities’ needs. A Multicultural Aged Care Strategy should commit to supporting ethno-specific agencies and where relevant migrant resource centres as key partners in delivering aged care services, particularly when there is critical mass in those communities.

These issues are particularly acute for some eastern European communities. For example, the Polish community has been early to reach its peak demand for aged-care services. As a result, the Australian-Polish Community Services Inc. have recently written to me about a number of issues: the need to expand the existing Community Visitors Scheme; the lack of culturally appropriate activities for CALD residents in aged-care facilities; and the almost complete lack of use of interpreters by residential care providers—in this case, the Poles themselves raised their personal circumstances. This is particularly problematic when residents are trying to express complex medical conditions and are having them explained to them.

Another issue raised was that existing promotional materials need to better reflect the needs of communities, such as the Polish community, where failing memory amongst many has meant that they are no longer able to communicate in English. I give a personal instance of a person known to me, Larry Kowzlowski. He is formerly of Granville. He is a person who did not totally immerse himself in the Polish community. He is a follower of the Western Suburbs Tigers rugby league team and a person who frequented clubs in the area. He is married to a woman of Tongan extraction. He was involved in the Catholic Church and in broader Australia. He was a victim of the Nazis and received some compensation for that years later. This person did not live inside the Polish diaspora. He lived in the broader context of Australian society, yet he is part of the example that the Polish community has given to me in that he has totally lost his English ability and can now only speak in Polish and is in a nursing home. He is a local example of that problem.

Similarly, it is claimed that Carers Australia are not aware of the needs of ethnic carers and they are not referred to at all in their policy responses. Some of the key recommendations in the ECCV’s multicultural aged-care strategy include combining various multicultural aged-care programs with limited funding into a comprehensive multicultural aged-care strategy; allowing more client choice in selecting HACC providers; strengthening the capacity of ethno-specific agencies to provide services for larger ethnic communities; ensuring state public sector aged-care facilities provide culturally sensitive services wherever appropriate; funding ethnic senior citizens clubs—and one aspect of my recent Melbourne visit that was particularly impressive was the number of clubs in the Greek community that operate in that city and the support given by the Greek Welfare Association and its staff and volunteers to them; and, finally, ensuring that elder abuse in ethnic communities is addressed.

In respect of HACC, the ECCV has spoken of greater consideration being given to client choice in HACC services. In many areas of government service provision today, such as residential aged care, clients may choose their preferred provider. However, many HACC services seem to have been exempted from the reality of this general trend. That is particularly the case in Victoria, where there is, by national standards, a very high participation by local government in the delivery of HACC. Local government, nursing services and community health centres are the main providers of HACC services. While the Culturally Equitable Gateways Strategy and cultural action planning have strengthened local government’s commitment to multicultural services, more precise research is needed on issues such as the level of multicultural and bilingual staff in local government services and the efficacy of translated materials for HACC services.

In summary, I have taken some time to speak about the specifics of a burgeoning problem in respect of the ageing of our postwar migration intake. It is all right to assume that families are close in these communities. Traditionally, they have not been as prone to recourse to aged-care facilities. But whether it is from the point of view of them living independently or the reality of modern Australia, the second and third generations of these communities are as subject to social change as the rest of society, and it cannot be assumed, as it was in the past, that these issues will be taken care of in the family context. We have to face up to the failures in the system that are there at the moment because the community was perhaps not attuned to the expanding numbers, to the changes that are occurring inside these demographics themselves. These organisations, particularly in Victoria but also in other states, have been proactive in trying to get some attention focused towards these issues.

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