Rachel Siewert (WA, Australian Greens) Share this | Hansard source

Thank you. I must admit that I am disappointed that we are going back to the opposition and the government—whichever side of the chamber you happen to be sitting on at the time of the election cycle—fighting over this extremely important issue and blaming each other. We have to get beyond the blame game on this issue of aged care. And, yes, I do blame both of you.

But the substantive elements of this motion are (b) and (c), the first bits of the motion, outlining some of the key information. Section (b) says that the Senate:

... is very concerned that the failure of the Rudd Government to act and address the significant challenges ahead in aged care means that elderly Australians will not be able to get access to affordable, high-quality aged care places in the future; and

(c) calls on the Government to take decisive action forthwith to address the significant challenges facing aged care.

I will acknowledge that there has been some movement by the Rudd government—though some of it I do not think is in the right direction. There has been a focus by this current government, very strongly and unfortunately I think, to hide behind quality assurance and policing. The Greens are not standing here for one minute saying that quality assurance and policing are not important. But it is playing the blame game, taking pot shots at providers rather than looking at the bigger picture: where is aged care going into the future?

But there are some very significant issues now. We know that we have an ageing population in Australia. We also know that that ageing population’s demographic will be very different from that of the past. We have baby boomers starting to move into an ageing population. They will start to need aged care facilities in the not-too-distant future and, for a start, they are expecting a very different approach to aged care from the one we have had in the past. Their sheer numbers, of course, mean that we are going to need significantly more beds, but beds of a very different makeup than we have had in the past.

In my home state of Western Australia, in the last ACAR, half of the licences for beds were not taken up. In other words, the places that were identified by government as needed to accommodate our ageing population were not taken up. The other thing that you would know, if you lived in Western Australia and had an interest in aged care, is that providers are not building the beds that they already have licences for. It is not only in Western Australia that this occurs. I understand there are similar problems in other states.

Not only are providers not taking up the licences that are on offer; in fact, they are not able to build the beds that they have licences for. Not only are they not building them but, when they tell the department and offer the licences back, they are told, ‘No, no. Keep trying. Don’t hand them back yet.’ When you talk to the providers, they say very clearly, ‘We cannot afford to build these. We are not getting enough support. We are not financially viable enough to support these.’

Other providers—big providers—both in the west and in the east of Australia, say to me, ‘We’re going to have facilities closing down unless we get more help.’ Not only is there not enough funding to build beds; there is not enough funding to keep people in care either. Providers have expressed significant concern about the current assessment models and the way that payments are made for both high care and low care. They also express—and this is all contained in our Senate committee report—extreme concern about the balance between low care and high care. They have also raised concerns about community care and funding of community care as well.

So, not only are we not building enough beds for the future—that is not being adequately funded—but we are also not providing enough funding for current care, either high or low care. We are also not providing enough resources for community care packages. That is a significant issue.

In some places we are heading for crisis more quickly than in others, but we are definitely heading towards a crisis for aged care. We are going to end up with a train wreck in aged care unless some dramatic action is taken, unless we get a government which is prepared to develop a vision for the future of aged care in this country. At the moment, we are lacking that vision. It seems to be: hear no, see no and speak no evil about aged care. The government is simply not looking at the facts about aged care.

I also believe that the government is not getting appropriate advice from the department. The department seems to be defending their own patch, not acknowledging there are problems and denying there is a crisis. They have no answer to the fact that beds are not being taken up in Western Australia. They have no answer to that. They have no adequate answer to the question: what happens when beds are handed back? They have no adequate approach for this. They have no adequate approach when people are trying to convert their bed licences to aged-care provision. They have no adequate answer for any of those issues.

All you need to do is to go and talk to both for-profit and not-for-profit providers. You could say, ‘Well, for-profit providers are just worried about making a profit.’ I am sorry, but 65 per cent of our aged care in Australia is provided by not-for-profit providers and they are struggling as well. So you cannot just write this argument off by saying, ‘This is just providers squealing about not being able to make enough money.’ That is simply not the case. It is particularly not the case for not-for-profit providers because they do not have a profit motive. I am not maligning the for-profit providers, by the way. I do not want people running away thinking that. But, if the argument is that providers are simply self-motivated, it is simply not right.

When you talk to care providers, it is clear that they are there to try to provide quality care for the people who use their facilities. I will add that I went through an excellent care facility in Bunbury in my home state not long ago. They provided excellent care. They were very modern and had a very modern facility. I was very impressed. They have been just in the black up until very recently. Now they are going backwards.

When you look at the sort of care and support these people give, it is outrageous that we are letting these services slip back further and further into the red. The people that I went with around the facility knew each patient by name, knew what their issues were and knew what they liked to do during the day. In other words, they knew the patients personally and had a really strong connection. If we could provide that same sort of quality care for everybody that needs it and wants it in Australia, I would be proud of our aged-care services.

Unfortunately, at the moment we are not able to provide that. Unless we get a handle on aged care and start providing a vision for aged care in this country, we are not going to be able to provide that quality care in the future.

There are some very significant issues that we need to be dealing with. Mentioning Bunbury brings me to the issue of regional care. Regional aged care in this country is in an even worse state than is aged care in metropolitan areas around Australia. Many aged-care facilities in regional centres are absolutely struggling. They are in an even worse position than those in our metropolitan areas. The government has, I will acknowledge, recognised that there is difficulty in providing aged-care facilities in regional areas and they have moved to deal with that through provision of more interest-free loans et cetera. However, they are not being taken up at the rate they need to be taken up at either, so we are seeing an increasing problem in regional areas.

There are also problems when you look at pay disparities and the ability of providers to attract and keep staff. The staff I have met in aged-care facilities go well above and beyond the call of duty. But, as an example from my home state of Western Australia, during the Senate inquiry evidence was given by the Miscellaneous Workers Union that aged-care workers in Perth are paid less than people who work in our zoo. To me, that was pretty shocking. The union raised that as a very stark example of the fact that we are not giving providers sufficient resources to enable them to pay workers and carers in these centres what they are due. People have also expressed concern that they are unable to provide the sort of training which they think is required for those who work in aged-care facilities.

Another issue that was brought up with the Senate committee is the mechanism that determines funding for high care versus low care. The new ACFI model that was brought in was supposed to much more flexible but, from what I have heard from talking to people and from evidence the committee received, it is actually not as flexible as it should be. Again, the evidence you get from the department about what is viable and non viable is different from what the aged-care providers say, and I must admit I get very concerned when I hear the department say, ‘Surveys have been undertaken; it’s nonsense to say that providers are not viable.’ I would think that the providers would know whether they are viable or not and how much it costs to provide a bed and how much it costs to provide care.

Do you know we have not done an assessment of what it takes to provide a bed in an aged-care facility? We have not done that for a long time. Why haven’t we done that? Why aren’t the department and the government able to give the community an understanding of the unit cost of providing a bed in an aged-care facility? That is the sort of information that we need so that we can provide and commit adequate funding to aged care in this country.

The most immediate crisis here is the funding that is provided right now for both high care and low care. A point that was also made to us during the Senate committee inquiry was that the funding available to low care is simply not viable for providing beds. There used to be more of a balance between high care and low care but, because there is not a lot funding now for those in low care, that balance no longer exists.

As I was saying, there is an immediate crisis in funding for people currently in the system and for people coming into the system. The bigger-picture issue is the lack of funding for the provision of beds into the future—not just the distant future but in the next couple of years. There is also the issue of what we want our aged-care sector to look like in the future. That envisioning is not being done, and it is absolutely time that we sat down and did that. In fact, we need to have a community dialogue about what we want our aged-care services to look like into the future; and how we want to age in place, because there has been a big shift to ageing in place. The point was made to us that some people are ageing in place not by choice but because they have to because they cannot get access to an aged-care facility. It is expensive and you cannot find a place anyway, so they are ageing in place. While a lot of people want to do that and some people might want to start doing that, they are not moving into residential care at a time when they should be because there are no places or because they do not have the resources. So we do need to look at how we facilitate ageing in place into the future and what sort of funding should be made available for that, because we need to make sure the funding matches need, and then we need to look at what sort of funding we should be providing for residential care into the future.

Another point that people raised with us is that people are going to have different expectations of aged care in the future. For example, there is a greater desire now for single bedrooms with an ensuite, but there are a lot of facilities that are not able to provide that. So more resources need to be made available to upgrade facilities and we need to build more facilities that accommodate that. And that gets back to this argument about what is viable and what is not. Honestly, it blows your mind, sitting in Senate committee inquiries and estimates hearings—and I see senators nodding—listening to the department arguing about viability, about what is viable and what is not viable, and ‘this survey says it’s viable’ and ‘this survey says it’s not viable’—