Rowan Ramsey (Grey, Liberal Party) Share this | Hansard source

It is an honour to speak on the Aged Care Amendment (Red Tape Reduction in Places Management) Bill on behalf of the government and on behalf of the people of Grey. It is pleasing to be part of a government that has taken some very solid action in this area to remove unnecessary red tape not just in aged care but right across the board. Aged care is an area that has layer upon layer of regulation. Not for one minute would I suggested that we throw out the regulatory rule book altogether, but it is a right and proper thing for governments to revisit the rule book and see what it is that has to be there and what it is that does not, and find those areas in the middle where we can make improvements to the system to make the life of those who own and operate our aged care facilities and those who work within them develop these facilities into better places for residents.

This bill addresses the issue where aged care places have been allocated but for one reason or another they have not been built. We know we are going to need more and more aged care facilities in our communities—the Intergenerational Report tells us exactly that. We have an ageing population. There are other things the government can do in this area, and we continue to grow the area of aged care support that is home care packages. Home care packages are wonderful things because, firstly, they save the taxpayer money, and that is a good thing. Secondly, and more importantly, they allow people to grow old in their homes. Who would ever prefer to leave their home even if they were going to the best aged care facility in the world if home is a good and adequate place to be? After all, home has that one special quality—it is our home and we are surrounded by the memories of our full lifetime.

I am well aware, even in my own electorate, of places being allocated to various companies to build aged care facilities and they have not got off the ground. In one case I can think of, eventually those places were handed back. Then, when others wanted to access those places—in the same city, as it turns out—it was not so easy. This reform allows for proposed providers to transfer their licences to other aged care providers who may want to operate facilities in the area. Instead of having to go through the rigmarole of advising government, following ream after ream of paper on what has to be done, there is now a fairly simple notification process.

Departmental data indicates that the median time it takes for providers to build new facilities is four years, and 80 per cent are operational within six years. This bill amends the legislation so that approved providers have to build within four years with the possibility of two 12-month extensions. That gets to that six-year point when about 80 per cent of these facilities are currently built. Further extensions will be granted in exceptional circumstances. On 30 June 2014 there were more than 7,000 aged care places still provisionally allocated six or more years after allocation—they still had not been built. These were 7,000 aged care places that the government of the day had planned to have available. Approved providers to whom places have been provisionally allocated have been accustomed to just rolling over the extensions: 'We'll keep our hands on those, they'll be worth something one day.' This will bring that behaviour to an end—it will be easier for us to control that situation.

The contents of this bill allow me to speak on a few other issues concerning the aged care industry, and the member for McMillan, who spoke before me, touched on some of them. At one stage, I was chair of a management committee for a local aged-care facility. I will come to that in a moment. In all the time that I have been involved in politics I, like the member for McMillan, have been absolutely amazed at people who have dedicated their life to caring for the aged in their community. I think of myself as a caring man but I marvel at what these people do and I doubt that I would have it in me to do the same job.

The one thing that you can guarantee when you go into an aged-care facility is that the nurses and workers will tell you about the paperwork. I cannot believe what they have to do. The member for McMillan touched on accreditation. When I was the chair of this particular facility, we would eye the three-yearly time frame as we came to accreditation with great trepidation because we knew how much work would be required by the staff to meet these accreditation guidelines. The facilities are getting older and it is harder to meet those accreditation guidelines. Sometimes I even became convinced, in both the area of aged care and in the hospital sector, that the accreditors were people of fetish. One accreditor would say that the facility was in perfect working order and the next accreditor would pick on anything they could find just to prove they had been doing their job. And if the first accreditor was not the person who rolled up the next time, the person who did come would not be particularly concerned about the improvements that may have been made in that area. It is a fairly imprecise science and it is not a time that nursing homes and aged-care facilities look forward to.

I am reminded of a story that a good friend of mine who was running a fair sized nursing home at the time told me. This facility was some distance from Adelaide—about a six-hour drive and about a 1½-hour flight. In a two-week period, she had four different inspectors come into the kitchen of the aged-care facility. I think one of them checked the gas to see that it was safe. Another one looked at the food health standards within the kitchen. I am not too sure now what the other two were for. But in each and every case the aged-care facility was responsible for transporting the licensing inspectors there. And being 600 kilometres from Adelaide you can image how this would add to that particular facility's cost.

Like I said, we are not going to throw out the regulatory rule book but we should at least look at all these things and see how it affects the operations of these facilities. My electorate is made up of vast open spaces and the towns are a long way in between. Many of our facilities are below critical mass. They are just not big enough to make money on a regular basis. In fact, they are probably pretty good at just trying to break even. If you have a 30-bed facility, or even a 20-bed facility, it is very, very hard to make ends meet. Interestingly enough, in my electorate I have a number of major private providers that are concentrated in the bigger centres. Port Pirie, for instance, has a major private provider and Port Lincoln has a major private provider. But in the smaller communities we have facilities that quite often started life as aged-care hostels. And because of the changing demographic and the changing demand for aged-care facilities, they have become de facto nursing homes with much higher levels of care. They are not necessarily designed to deliver nursing home standards but, because that is what you have got, the staff make it work and very well.

I spoke earlier about the fact that I used to chair one of these organisations. That came about by happenstance because at the time I was chairman of my local hospital board and in the same town we had a separately operating hostel facility. We got our heads together and thought that the smart thing to do there would be to amalgamate the two boards and amalgamate the responsibilities because there were a lot of good synergies—the hospital kitchen, for instance, could supply the meals to the aged-care facility. We were not the only community that moved in this way; it was quite common across South Australia once the ball got rolling. In the end, these facilities became controlled and operated by our hospital and aged care boards.

Some 12 years ago the state government, in its infinite wisdom, decided to basically take over the hospitals. They got rid of all the local hospital boards and now those facilities are operated from 'Adelaide Central'. But, of course, they picked up the aged-care facilities at the same time because they were common property for the hospitals. State governments do not have a direct interest in aged care as a rule, so the state government has ended up with a lot of facilities that it does not really want. They operate on Commonwealth subsidies but that is all they get. And they have no appetite, in my opinion, for reinvestment in this area.

When these particular facilities reach their use-by date in 30 or 40 years, what is going to be the driver to deliver aged care in these smaller communities in the future? The South Australian government has no direct responsibility. It does not seem to have a lot of interest in the area. I think it is embarrassed by the fact that it owns aged-care facilities. The current model would suggest that we should be looking for a larger private provider to move in because these markets are just not big enough to sustain a hostel of, say, 60 beds. It is reaching crisis point in some place. On a number of occasions, I have raised it with ministers here. As long as those facilities remain in the ownership of the state government it is difficult to see how we are going to get a breakthrough.

They are a number of issues that gave me an opportunity to speak this afternoon. The legislation itself is good common-sense reform. It delivers on the government's agenda on red tape reduction. It is going to make life easier for administrators on the ground. It will make it easier for people to invest in the aged-care industry because they will be able to obtain the bed licences when and where they need them—on a secondary market, if you like—without too much red tape surrounding it. I commend the legislation. Thanks for the opportunity to speak on it.

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