Craig Thomson (Dobell, Australian Labor Party) Share this | Hansard source

It is my pleasure to speak to the Aged Care Amendment (2008 Measures No. 2) Bill 2008, which is before the Main Committee. Before I start I want to say that the member for Herbert’s contribution was a very thoughtful contribution and he raised many very valid points. The difficulty, in terms of the hypothesis that was put forward by the member for Herbert, was that his criticisms of our current aged-care system lie squarely at the feet of the previous government. They oversaw the aged-care industry for over 12 years. The previous government made the changes that put in place the system that we have today.

The issues that the member for Herbert raised are indeed important ones; for example, the shortage of beds. A shortage of beds within 12 months of coming to government is clearly a responsibility of the previous government in failing to address the particular issue of shortages. One of the criticisms of the previous government, made by many commentators and many of the participants in the industry, was that there were so-called phantom beds. An allocation of beds went out to various providers, but it was often many years, if at all, until those allocations of beds became real beds that people could occupy. So the whole planning system, in terms of beds, by its very nature had a lag time, which the previous government did not look at addressing in any sense whatsoever.

The issue that the member for Herbert then went on to raise in relation to staff and pay is an issue that I was intimately involved in, having represented aged-care workers for 18 or 19 years. It was an issue that the previous government refused to look at; they did not look at it at all in terms of what they wanted to do with aged care. The member for Herbert, though, is right: what we need to do in aged care is look at other workforce models. Currently, 80 per cent of staff who are direct care staff are not registered nurses; they are either assistants in nursing, personal care assistants or enrolled nurses. So the vast majority already are not registered nurses. We need to look at the way in which those models work in a more efficient way to make sure that we can attract and retain properly skilled staff in the aged-care industry.

It is interesting to note that, despite a number of recommendations to the previous government, there are still no minimum qualifications for people working in aged care. While the vast majority of providers self-regulate and ensure that their aged-care workers are at least at the certificate III level, this is not mandatory at all. In fact, it is quite possible in an aged-care facility to have someone walk off the street one day and be caring for our elderly the next day. These are important issues that we need to address. With this piece of legislation, the Rudd government is starting to address some of the issues that have hindered and plagued aged care in this country for the last dozen or so years.

The member for Herbert raised the issue of aged-care facilities raising capital to renew their buildings and their structures. This issue is very much alive at the moment. I am certainly not advocating for an extension of bonds in the aged-care industry, but we do have the very anomalous situation of aged-care residents in low care being able to be charged a bond while those in high care are not able to be charged a bond. In their transition through aged care, people move from one level of care to the other and face completely different circumstances. This skews the way in which aged-care providers run their businesses and the type of residents they seek to attract. This is an issue that the previous government did not face, but it is a challenge that is before the Rudd government. We must make sure we adequately fund aged-care facilities for capital growth and capital infrastructure. There is an anomaly at the moment, and it is a challenge that is before this government given that the previous government chose to ignore that particular issue.

Another issue the member for Herbert raised was in relation to red tape. I wholeheartedly agree with the member for Herbert about the amount of red tape that exists in aged care, but I repeat that this is the system that the previous government put in place. This is the system of regulation that they decided was the best system to look after aged-care facilities and ensure quality care. Frankly, this has created a whole series of red tape that ties up staff without ensuring that quality aged care is being delivered in all of our aged-care facilities. To the great credit of the Minister for Ageing, in the first 12 months of government she has immediately increased the number of spot checks—because, frankly, she could not rely on the paperwork and the red tape to ensure that quality care was being delivered. What she needed to do—and did do—very decisively and very early on in taking over this portfolio was to make sure there was a massive increase in the number of spot checks and spot visits to aged-care facilities and that there would be people on the ground to see that quality care was being delivered. Having said that, red tape is a real issue and it is one that this government will need to look at and address properly. We need to ensure that we are not unnecessarily tying up resources and that we are putting in place a system that measures the quality of care rather than measuring how someone fills out the paperwork.

In Australia we need to have adequate and effective regulatory safeguards to ensure that our older citizens are afforded high-quality care. Unfortunately the current legislation is inadequate, and that is why we need to change it through, in the first instance, the Aged Care Amendment (2008 Measures No. 2) Bill 2008. The purpose of the bill is to amend the Aged Care Act 1997 and the Aged Care (Bond Security) Act 2006. These amendments will address some of the current legislative inadequacies. They will also maintain effective regulatory safeguards. In particular, the proposed amendments will link ‘approved provider status’ to the allocation of aged-care places—those directly linked to Commonwealth funding; modernise the legislation so that it better aligns with contemporary business practice and applies to all approved providers regardless of their corporate structure; streamline assessments of frail older Australians to ensure more timely and consistent quality assessments; ensure that any accommodation bonds or similar payments made by frail older Australians for entry to aged-care services are fully protected under the accommodation bond guarantee scheme; and make some minor operational changes to improve the administration of the legislation so that it operates more efficiently and effectively.

We have some tremendous aged-care facilities in this country. I am privileged to have in the seat of Dobell, on the Central Coast, some of Australia’s best aged-care facilities. I recently had the pleasure of attending the opening of a brand-new, state-of-the-art aged-care facility in the suburb of Kanwal, in my electorate. I was very pleased to have the Minister for Ageing attend the opening with me. We were able to see firsthand what a cutting-edge aged-care facility should look like. In this particular facility, each room has a huge computer screen that takes away the necessity for a lot of the paperwork that the member for Herbert was talking about. When an aged-care worker comes to look after a resident, they immediately go to the screen and fill out the forms there. There is no need to fill out laborious paperwork. There is an immediate response; it goes back to a central server. If key indicators are not filled out, there is notification to the director of nursing in the facility and she makes sure that remedial action is taken immediately in relation to the care of the particular resident. That sort of state-of-the-art aged-care facility is the sort of aged-care facility that we are going to see throughout Australia. It is one that I was very pleased to visit, to see the way in which aged care has developed and changed. I am very happy that we have such a facility in my electorate.

While we were at William Cape Gardens, we presented community service awards to two very deserving people who are part of that facility in Kanwal. One was Cheryl Wright, who is a staff member. I want to mention Cheryl for the tremendous work she has done and the contribution she has made there for years. The other was a resident called Lindsay Rose. Lindsay plays a very important role in this aged-care facility, one that is important in terms of the way in which aged care should operate in the future. While Lindsay is a resident there, he also helps people who suffer from dementia. He has helped assemble in the aged-care facility a men’s shed, which has a whole range of tools. Lindsay helps organise the other residents to do some carpentry there to keep their minds active as well as interact in a social situation. It is important that the Minister for Ageing was able to recognise the work of Lindsay Rose and the work that this particular aged-care facility does.

There are two other aged-care facilities that I wish to mention today. One is the Legacy Hostel at Norah Head, which is a small facility but one that is superbly run. Testament to that is that a longstanding former member for the state seat of Wyong, Mr Harry Moore, is a resident there and a very happy one. Mr Deputy Speaker, you would know that politicians can sometimes be fairly demanding in making sure that they are getting the best deal they possibly can, and it is a testament to the hostel that Mr Harry Moore is very happy there. The Legacy Hostel at Norah Head is a marvellous aged-care facility. I have also visited Our Lady of Loreto Gardens, in Hamlyn Terrace, on a number of occasions. It is a new aged-care facility which is doing some great work with older Australians.

The last facility in my electorate that I wanted to mention today was Nareen Warnervale. The provider—Colin Macdonald is the name of the manager there—is doing a great job in terms of building a special-purpose garden for the dementia patients. The garden has cars in it, with radios that work, and a whole range of facilities to stimulate the minds of the dementia patients who live in this facility. This is really cutting-edge work that is being done, and the facility is looking at having a proper study done on the effects of this garden on dementia patients. It is not only making their lives more bearable in relation to the affliction that they suffer from but also delaying some of the symptoms. So they are just some of the quality aged-care facilities that we have on the Central Coast.

Aged care is an area that has many, many challenges, and this government will face many, many challenges in dealing with the ageing population and the system that we have inherited, including some of the problems that the member for Herbert outlined that have been left for this government to try and fix up—and we need to do that. One particular area that we need to look at is staffing levels and how to not only attract adequate staff to these aged-care facilities but also ensure that a provider can afford to pay for enough staff so that quality care is delivered.

Aged care in the United States is never put up as an example of a perfect system; in fact, it is usually used to describe how good another country’s aged-care system is by comparison. But it is interesting to note that, even in the United States, 32 of the states have now regulated through state legislation minimum staffing levels that need to be reached in relation to their aged-care facilities. That is because, following an extensive congressional inquiry, they worked out that the number of people who are there to look after aged-care facility residents has a direct relationship to the quality of care those residents get.

This is something that the previous Australian government chose to ignore, despite the fact that in 2004 an extensive Senate committee inquiry took place, resulting in recommendations. And those recommendations were bipartisan; there was no minority report. The recommendations that were made were unanimous, and included putting in place some way of making sure that we had a floor on the number of staff that could work in an aged-care facility. What did the previous government do, even though their own senators had made this recommendation? They did nothing—nothing at all. They did not even make a response to the Senate committee inquiry, an inquiry that made a whole range of recommendations. Those recommendations were made post the Hogan report, which cost a lot of money and made a whole series of recommendations, most of which were ignored by the previous government. There was then the Senate committee inquiry into aged care generally. It also made a series of recommendations, which were bipartisan—recommendations with unanimous support from both the major parties and, in fact, the Democrats; so minor parties were there as well—and the report did not even get a response from the then minister for ageing. They did not even respond to it; they put it on a shelf and forgot about it.

So for the member for Herbert to come in here and say that there are failings on the part of the Rudd government after 12 months for the way in which we have dealt with aged care is the height of hypocrisy. The previous government had 12 years in which they could have done something about the very problems that he was raising, and they are legitimate problems. They received recommendations during their time in government to address these particular issues, but they chose not to respond. So, when they come into this place and talk about their sympathy for the residents of aged-care facilities and what should be done, they do not come into this place with clean hands. They come into this place with a track record in relation to dealing with aged care that no-one would be proud of.

We have seen the Rudd government start to reform the aged-care process with the legislation that is before us today. Through the increase in the number of spot visits to aged-care facilities that take place we have seen that this government puts a concern for the quality of care that is being delivered to the residents right at the heart of its aged-care system. This is in stark contrast to what we had from the previous government, which chose to ignore these issues totally.

The issue of aged care is a difficult one and it is one that increasingly is going to take more resources and more government time as the population grows older and more people need to avail themselves of residential services. It is an area that we cannot walk away from and that we need to address. One thing I am very pleased about is that this government, despite the difficulties of the system we have inherited and the various problems that need to be addressed, has said squarely: ‘We are there for aged-care residents. We are there to make sure that we are going to have a viable industry. We are there to make sure that providers are able to continue to do the work they do. We are going to put the residents front and centre of an aged-care system that makes sure they are looked after properly.’ I commend the bill to the House.

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