Monday, 18 June 2007
Aged Care Amendment (Residential Care) Bill 2007
I rise to speak on the Aged Care Amendment (Residential Care) Bill 2007. The bill will amend the Aged Care Act 1997 to introduce a new arrangement for allocating subsidies in residential aged care. The aged-care funding instrument is designed to reduce the amount of documentation generated in aged-care facilities which is used to justify the funding classification for each resident.
Aged care is an important issue that needs to be addressed, of course. A reduction in paperwork for aged-care staff is welcome, as it will allow for the resources in aged-care facilities to be concentrated on looking after residents. At many of the aged-care facilities that I have visited over the years as a candidate and as the member for Hindmarsh, one of the things that has come across from the providers of aged care is that too much time is spent on paperwork and not enough time on care of the aged. So this bill is welcome in that it will ensure that providers can spend more resources and time on looking after the people in those aged-care premises and will relieve providers of the mountains of paperwork—the No. 1 issue for aged-care facilities in my electorate.
It is also essential that aged-care providers have the information about the levels of funding that each classification level will attract so they can assess the impact of the new instrument on their operations. Currently, there is a variation between classification scales, making it difficult for providers to evaluate income streams.
The electorate of Hindmarsh is demographically the ‘oldest’ electorate, with over 20 per cent of the population aged over 65. As these residents approach their twilight years, some will seek accommodation in aged-care facilities or community care through an aged-care package. It is important that the aged-care system is simplified for the residents of Hindmarsh—and in fact the aged all around Australia—and their carers. The aged-care system is continually plagued by underfunding, which has led to a shortage of aged-care packages and aged-care beds in recent years, leaving many elderly Australians on waiting lists for care.
We know that the best solution for people when they reach those twilight years is to remain in their own homes, with adequate care, if they are able to. But here we are talking about the older Australians who have no option—those who, because of their health and many other issues that affect their day-to-day living, have no choice but to go into an aged-care facility. So we are not talking about people staying in their own homes, something the government constantly raise when we raise the subject of aged-care beds; this is about people who need adequate care because their health has deteriorated, no amount of home or community care would be enough to assist them and they actually need a nursing-home bed. That is who we are talking about in this instance.
The government has not satisfactorily addressed these shortages within the aged-care industry. Aged care should be affordable. Rod Young, CEO of the Aged Care Association Australia, this year pointed out that the government’s current aged-care package was flawed, as it removed funding which could have made aged care more affordable. He stated in a media release earlier this year, in February:
In the light of these flaws, aged care providers are struggling to understand how the Government can claim that the package will achieve its main objective of solving the capital requirements of high care nursing homes.
He also declared:
Quality, choice and affordability will not be delivered to older Australians, as promised by the Government, unless the new arrangements are accurately costed and fully funded.
Even after over a decade in power, this government cannot seem to provide sufficient funds to address the problems in aged-care affordability. The objects of the Aged Care Act 1997 talk about accountability of the providers of the care for the funding and for the outcomes for recipients. This government has constantly shied away from fixing the corruption and poor management of many aged-care facilities. There is a longstanding problem of an underskilled and understaffed workforce in aged-care homes. We know that the workforce in aged-care homes is one of the most rapidly ageing workforces. That brings with it many issues such as the type of work that is done in aged-care homes by this ageing workforce. Obviously, in physical terms, workers themselves would be struggling to cope with the work and the aged-care profession has one of the highest incidences of injury of all workforces.
Recently five people died of gastroenteritis from salmonella poisoning in an aged-care facility in Broughton Hall, Victoria. After hearing of the tragic deaths of these people, the minister proceeded to play the blame game, as we often see in this place, whether it be dental care, aged care or water. They continue to blame anyone else but themselves. It should have been a wake-up call that minimum staff numbers were needed and higher training standards put in place, but the minister instead blamed both the state government and the staff. The minister acknowledged:
... the staff didn’t have the necessary skills to be able to gauge whether incontinence in a resident, for example, was a result of a laxative being applied or gastroenteritis.
However, the minister did not take responsibility for the government’s underfunding for qualified and trained staff. When homes need to meet shortfalls in funding to provide basic care for residents, staff—the most expensive outgoing within the industry—are the first to be made redundant. We have seen this time and time again. Broughton Place received federal government accreditation for three years in mid-2006, even though there were findings of inadequate cleaning standards. You would have hoped that the government would have learnt from the scandal in 2000 where some 57 residents of an aged-care home in Melbourne were given kerosene baths, inappropriately used to treat an outbreak of scabies. Instead, they ignore the undertraining and just pass the blame when ‘embarrassing’ events such as these occur. One of the objects of the Aged Care Act is:
... to promote a high quality of care and accommodation ...
This government cannot even get enough beds to meet the requirements of our ageing citizens, let alone to fix the standards. I have many examples of constituents in the electorate of Hindmarsh who have parents, their loved ones, mothers and fathers, who are in perhaps a public hospital waiting for an aged-care bed so that they can be looked after in their twilight years. They may find a bed at the other end of the world. In other words, they are in Hindmarsh but they may find a bed in Gawler, for example, in the member for Wakefield’s seat, approximately 30 to 40 kilometres away. This is no good for those people who want to stay within their community and have people visit them. Perhaps their only next of kin is their son or daughter. Obviously, this is not good enough.
The government will claim that they have lots of aged packages for home and community care and that is fantastic, but we are talking about people who need to go into a nursing home because no matter how much care they receive at home it will not be enough because their health issues far outweigh that care. According to the government the operational ratio of residential aged-care beds in each aged-care planning region in Australia should be—this is the formula that the government uses—88 beds for every 1,000 people aged 70 years and over. The June 2006 stocktake of residential aged-care beds in Australia showed the undersupply of 287 beds in areas covering the federal electorate of Hindmarsh. This comprises parts of metropolitan south Adelaide, which was 184 beds short of the operational ratio, and the metropolitan west, which was down by 131 beds. What the target ratio is and whether or not this ratio has been reached is only statistical jargon to many residents in Hindmarsh. It is, however, the reality that they may not be able to find satisfactory accommodation and care that impacts on their daily lives.
It is shocking to know that the worst affected by these shortages are the most vulnerable in our society. Regrettably for all Australians the government has not met its own benchmark for aged-care beds. For all the minister’s promises, the demand for beds within Hindmarsh has not been met and the number of beds has actually fallen by 28 since December 2005—10 per cent in less than one year. In 11 long years, the Howard government has managed to turn a national surplus of 800 aged-care beds in 1996—on that formula that I mentioned earlier of 88 beds per 1,000 people aged 70 and over—into a 4,613 shortfall by June 2006. We are going backwards under this government. This is just not good enough especially in a society that is ageing very quickly. When we go back to 1996, we see a surplus in the number of aged-care beds provided under the current formula of 88 beds per 1,000 people aged 70 and over. Today, with the same formula, we are going backwards at a time when the population is ageing at a fast rate. That is not good enough.
The minister will argue that the government has increased the numbers of community packages. That is a good thing. We want more people to stay at home. No-one is arguing about having people stay at home. I hope, if I get to that age, that I can stay at home. Labor supports and welcomes the provision of community care.