Senate debates

Thursday, 10 September 2009

Aged Care

3:53 pm

Photo of Mathias CormannMathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Hansard source

Thirty-six per cent of all the bed licences that were handed back to the government since the election of the Rudd government were handed back in my home state of Western Australia. The Labor senators from Western Australia are not doing anything about it. The few House of Representatives Labor members from Western Australia are not doing anything about it. It is time that they stood up for Western Australia and for the needs of senior Western Australians when it comes to aged care. It is time that they stood up to the Prime Minister.

We have had a whole series of reports. You, Mr Acting Deputy President, would be well aware of the report that was put out by the Senate Standing Committee on Finance and Public Administration on 29 April in relation to residential and community aged care in Australia. That inquiry received 125 submissions. The committee made 31 recommendations. This was five months ago; nearly half a year ago. The minister has still not responded to any of the recommendations. There has been report after report. We had the Trends in aged care services: some implications report from the Productivity Commission in September 2008. We had the Annual review of regulatory burdens on business: social and economic infrastructure services from the Productivity Commission, in which it was stated:

Meeting regulatory requirements can come at the expense of providing better care as staff are directed to paperwork—a perverse outcome in a regulatory system that is designed to improve the quality of care.

Rather than assisting senior Australians, the minister’s approach is clearly compromising their care.

These are just a few of the reports. We have also got the residential aged-care surveys, like the Grant Thornton review, and there is a whole series of other reviews: the Bentleys MRI/James Underwood and Associates 2007 survey and a whole series of surveys, which all say the same thing. Here we have a statement provided to the Senate inquiry into residential and community aged care by Grant Thornton Australia, James Underwood and Associates and Stewart Brown Business Solutions, together, which said:

Our research confirms that modern, single-room High Care services make very poor or negative returns on average. These returns are far below the returns achieved in older, shared-room High Care services.

In our opinion, modern, single-room High Care services—other than those with extra services approvals—are not viable under current funding and regulatory arrangements.

The time for reviews is over. The time for more reports is over. It is time for action. It is time that the government pulled their head out of the sand and took some action when it comes to the needs in the aged-care industry.

I mentioned budget cuts before. We are talking about a situation that is developing where increasing demand—beds handed back and fewer beds taken up than the government thinks are needed—and here we have the Rudd government actually cutting funding to aged care in the 2009-10 budget. I will go through some of the examples. The indexation of the conditional adjustment payment subsidy has been cut. The CAPs remain at 8.75 per cent until 2011-12. There is discontinuation of the assistive technology in community care program—$25.8 million lost over four years. Hearing Services will introduce a minimum hearing loss threshold of more than 23 decibels to determine eligibility for hearing devices—losing $33.9 million over four years.

This is just extraordinary. Aged-care services are a direct responsibility of the Commonwealth. We have got all of these spending sprees and cash splashes—this spendathon—for the Julia Gillard memorial halls and the signs in front of state and territory government schools. There is mismanagement and waste—a $1.7 billion overspend, $7 to $8 million for signs—and a core responsibility of the government is not being looked after. It is being neglected and people are going to get hurt. If we do not take some action, very soon we are going to have some serious issues.

The industry puts all of its surveys and data out there for peer review. They say to me: ‘This is why we think the aged care industry is really facing a serious funding crisis. This is why we think that under the current funding and regulatory framework we are going to have a problem in aged care moving forward unless there are some changes to the funding and regulatory framework.’ Do you know what the government—the aged-care divisions in the Department of Health and Ageing—do? They spend most of their time explaining, defending and ducking and weaving as to why what everybody else is saying is wrong. They come out and say, ‘They are wrong because of this.’ They say something different and there is inconsistency there. The industry has to continue to organise themselves and say: ‘Hang on and let’s get together and swap notes and see what we have all said. And, yes, we will all say in a joint statement that we all agree with the same thing.’ What does the government do? The government is collecting all of this data and doing all of this internal research and, when we ask questions at estimates or during Senate inquiries, they say: ‘No, our research does not say that. In our assessment of the data across Australia we come up with very different conclusions.’ So we say: ‘Show us your data. Tell us what you think so that we can again swap notes, there can be a peer review and we can scrutinise what you are basing your conclusions on.’ The industry experts say that the return on investment is about 1.1 per cent on high-care places in aged care. The department says, ‘Oh, no, it is a 10 per cent return on investment.’ But how do you get to that conclusion? So the Senate passed an order of the Senate a little while ago that ordered the government to release all of the audited general purpose accounts from aged-care providers since the 2004-05 financial year. Essentially, information has to be submitted by aged-care providers as a condition of receiving conditional adjustment payments every year. There is national de-identified comparative data from those accounts, and it was expected that it would be made available every financial year to assist in performance benchmarking and in industry planning and investment decisions. But only the 2004-05 data was made available to the aged-care industry—the Bentleys MRI report. Subsequent reports are being kept secret.

I put a question on notice asking if details can be provided for individual facility EBITDA and performance for single-bed and multi-bed facilities. The very helpful answer from this transparent—not!—government was that the de-identified unit record data is available on the department’s internet site at www.health.gov.au. Every single aged-care provider across Australia, my staff and everybody who has an interest in this have been searching that website for the last couple of weeks and nobody can find it. So I thought that, if the government says it is available on the website in an answer to a question on notice, let’s have a Senate order for the production of those documents. What happened then? We got a letter from the minister which states, ‘The files contain various documents that are now being examined with a view to providing an appropriate response to the Senate’—et cetera, et cetera—‘and we are going to take 30 days to have a look at it.’ If it is on the website somewhere, why don’t you just table it? Why don’t you make sure that we can all work on the same basis?

As I am running out of time I will sum up. We are facing a serious crisis in the aged-care industry and it is time for some action. It is time that the Rudd government pulled its head out of the sand and faced up to the crisis. That is the first thing they have to do. It is time that the Prime Minister remembered that in Health and Ageing he promised that the buck would stop with him.

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