Senate debates

Wednesday, 1 March 2006

Matters of Public Importance

Aged Care

Photo of Michael ForshawMichael Forshaw (NSW, Australian Labor Party) Share this | | Hansard source

The President has received a letter from Senator McLucas proposing that a definite matter of public importance be submitted to the Senate for discussion, namely:

The need for the Government to:

(a)
treat the allegations of sexual abuse in residential aged care facilities as a matter of national priority, and
(b)
restore public confidence in residential aged care in Australia by investigating these allegations and reporting openly on the findings.

I call upon those senators who approve of the proposed discussion to rise in their places.

More than the number of senators required by the standing orders having risen in their places—

The Acting Deputy President:

I understand that informal arrangements have been made to allocate specific times to each of the speakers in today’s debate. With the concurrence of the Senate, I shall ask the clerks to set the clock accordingly.

4:08 pm

Photo of Jan McLucasJan McLucas (Queensland, Australian Labor Party, Shadow Minister for Aged Care, Disabilities and Carers) Share this | | Hansard source

The issues that have been raised over the last eight or nine days are certainly matters of public importance. The stories we have heard—and unfortunately they keep coming on—have rocked this nation. Not since 2000, when we heard the stories of the kerosene baths, has aged care been brought into question in the way that these allegations of sexual and elder abuse have done so. First of all you will recall that allegations were made that four women, all suffering from dementia, were allegedly sexually assaulted at the George Vowell centre in Melbourne in a six-month period between June and November of last year. What I think appals most people about this is that those events happened over such a long period of time. The family of one of the alleged victims—who was given the name ‘Anna’—was informed in December of 2005 by the police of three alleged rapes over what could have been a six-month period. The alleged assailant had also assaulted three other women.

The concerning issue in this particular case is that apparently—and this has not been confirmed by the Minister for Ageing although we have asked him—one of the assaults was witnessed by a staff member and that staff member did not report what had been seen. That is the issue that I think concerns most people. What happens in a facility that allows a situation to occur where the normal human behaviour that anyone would have after witnessing such an event was not followed? Why is it that the person who witnessed this event was so threatened or so cajoled—whatever it was—into not reporting what any person should know was a police matter right at that very minute? We do know that the alleged assailant has been sacked. We cannot confirm—because the minister will not confirm it—that the person who allegedly saw the event but did not report it has been sacked. But the other concerning part of this story is that another staff member who apparently witnessed the event was also sacked. That person did report it, apparently, on the day that she witnessed it but this woman has also been sacked. The minister needs to confirm whether or not that is, in fact, the case.

Then we heard of the events at Immanuel Gardens where an aged care worker was sacked after allegations of abuse in October 2005. He had allegedly inappropriately touched several residents of the facility and had used vulgar language. I can say that the home did respond promptly to these allegations—the staff member was immediately stood down and then dismissed, and the home is assisting police with their investigations. The facility did the right thing and immediately contacted the families of all of the female residents involved and provided the Department of Health and Ageing with a full briefing. But that was in October 2005. We only find out this information when people bring it to the public eye, and that is not appropriate.

Then this week we have heard further allegations. We know that a woman has raised issues that affected her mother in a facility called Millward in Victoria. Her mother made claims of sexual abuse two years ago at this Millward aged care facility. However, rather than contacting the police or her family, the director of nursing forced the person who was alleging she had been assaulted to confront her attacker. I have never heard of a more appalling situation and a more inappropriate way of dealing with the reporting of sexual abuse. Anyone who has done any work in sexual abuse knows that you do not force someone, especially an elderly woman with a brain injury, to sit in front of her alleged attacker and confront the issue. Naturally, the alleged perpetrator denied it. I do not know how many senators actually saw the report on Lateline, but to watch an elderly woman say, ‘I am not a liar’ I think has affected us all.

We have also heard now—and this is the fourth incident—that allegations of rape of a 73-year-old woman, also with dementia, were made to the staff of an unnamed aged care facility in March of 2005, and nine months later the police were alerted. Late last year another female resident of the same unnamed facility also made sexual assault claims and they were investigated by the police, but the first allegation was only investigated when there was a second set of allegations. These are appalling allegations. It is very concerning to the community. The reason I have proposed this matter of public importance today is to say that yes, we do need to recognise that these allegations of sexual abuse in residential aged care facilities do need to be treated as a matter of national priority. But I am also urging the Minister for Ageing, Senator Santoro, to restore the public confidence in residential aged care in Australia by first of all investigating the claims and reporting openly on the findings.

Confidence in aged care has to be restored. We cannot sit around and wait for three weeks for an urgent meeting. It started out being an urgent summit but has turned over the last eight days into a meeting that is going to happen three weeks after the first allegations were made. It is not a special summit of people who have been collected together because of their particular expertise in this matter; it is the ministerial advisory committee on aged care. That is a reasonable committee, but none of the members of that committee have specific responsibility for advocating on behalf of residents in residential aged care. All of the people who are members of that committee are very talented and do have a lot of experience to add to this issue, but none of them are specifically advocates of residents in aged care. None of them have had a lot of experience in the issue of elder abuse, although many of them have had a lot of experience in aged care itself.

It is my view that that response from the minister—and that has been the only response from the minister, except to say, ‘We’ll have departmental investigations’—is not enough to restore public confidence in residential aged care. People will not be comforted by the fact that we will have a meeting to talk about the events that have unfolded. The management of crises in confidence requires three actions. Firstly, it requires immediate action. Secondly, it requires openness and transparency. Thirdly, it requires a confirmation of confidence in the systems that are in place now to ensure quality and safety of care of residents in residential aged care.

None of those three conditions have been met. There has not been immediate action. We are going to have a meeting three weeks from the first allegation. There is no openness and transparency. We have directed a series of questions to the minister this week, and he has said that he is disturbed, worried and troubled by it. Minister, we all are. Every Australian is, but you are the Minister for Ageing in Australia and you have a responsibility to ensure that the systems are in place and that you can be open and clear in response to what has happened. We as a community need to understand what has happened and how the minister is going to deal with it. We also need confirmation of confidence in the systems that are in place. On two occasions we have asked the minister to confirm that he is confident that the aged care accreditation system, the complaints resolution scheme and his department are up to the job of delivering what he is expecting, and he has declined to annunciate that confidence. I am afraid that the minister is failing on all three counts.

Let us go to the complaints resolution scheme. The complaints resolution scheme is a system established so that people who have concerns about what is happening in aged care have a method of dealing with it. When the Senate Community Affairs References Committee looked at the question of aged care in late 2004 and 2005, the issue of the bureaucratic nature of the complaints system was raised by many people. People were uncomfortable with the process. They found it difficult to navigate. They became disheartened and disillusioned about their ability to get a proper resolution out of the system. Our committee made a very good recommendation: that the complaints resolution scheme should be reviewed with a view to making it more user-friendly, to paraphrase the recommendation.

The other evidence we received during that inquiry was about the reason people do not go to the complaints resolution scheme—that is, not only the fear of retribution but also actual retribution. The Commissioner for Complaints raised this issue himself in his annual report of 2002-03. He said:

Many discussions with relatives and friends of care recipients reveal an obvious and pervasive attitude—one where there is an expressed anxiety not to make a fuss, not to complain, not to inquire too often and not to be noticed for fear that it would reflect badly on their relative and lead to some kind of retribution.

We know that there were 6,000 complaints received last year. How many would there be if there was a system in place that ensured that people who want to complain did not fear, or did not experience, retribution? That is an issue that has to be dealt with. Our committee recommended that the Commissioner for Complaints conduct an investigation into the nature and extent of retribution and intimidation of residents in aged care facilities and their families, including the need for a national strategy to address this issue. As we all know, this report came down in June last year, and we are still waiting for a response. There were 51 recommendations in this report. It was a unanimous report. That means that coalition senators supported the recommendations that the committee made. We are still waiting for a response.

The issues that we covered in that report, if they had been addressed at the time, would have allowed the minister to restore the confidence in aged care that our system is desperately crying out for. What we have is a system where every single aged care provider’s service has been brought into question. A number of people who provide aged care have rung me and said: ‘This is a problem. We have to restore the confidence in the system.’ The number of phone calls that they are receiving from family members concerned about their relatives has increased. That is predictable. The minister needs to intervene now to make sure that confidence in the system can be restored.

Let us get the CRS, the complaints resolution scheme, working. Let us make sure that people feel that, if they have a complaint, they can take it to the resolution scheme and get some action from that system without fear of retribution. The other system that is in place that the minister has not felt it in himself to say that he thinks is working very well is the accreditation system. During our inquiry, there were many complaints, both from the providers and from resident advocates, about the nature of the accreditation system and the fact that it needs an overhaul. There are recommendations in the Senate inquiry report to that effect.

Over the last 12 months or so that I have been the shadow minister for ageing, it has become evident to me that the use of sanctions by the agency and the department has changed. The period from when the inspections are done to when the sanctions are applied seems to be much longer. We found that with Immanuel Gardens, one of the facilities that were referred to last week where allegations of abuse have occurred. There were inspections of Immanuel Gardens in July, August and December of last year. Those reports identified that Immanuel Gardens had had ongoing noncompliance for the previous three years. It is very clear from the reports that there is something fundamentally wrong with this facility, and we just got a sanction on 9 February. (Time expired)

4:23 pm

Photo of Kay PattersonKay Patterson (Victoria, Liberal Party) Share this | | Hansard source

I rise to speak on Senator McLucas’s matter of public importance. I always find it amazing when the Labor Party raises the issue of aged care, because it reminds me of Labor’s appalling record in aged care. Senator McLucas mentioned that we needed to restore confidence in the system. In 1996, when we came into government, there was no confidence in the aged care system. In fact, only two years before that, the Labor Party had commissioned a report into aged care by Professor Gregory. That was a damning report. He indicated that 13 per cent of nursing homes did not meet the relevant fire authority standards, that 11 per cent did not meet the relevant health authority standards, that 70 per cent did not meet the relevant outcome standards and that 51 per cent of nursing home residents were living in rooms of three or more beds.

I defy anyone on the other side who stands up and says they are absolutely certain that allegations similar to those that have been made of abhorrent behaviour towards older people did not occur when they were in government. All of us would say that it is totally unacceptable to see older people, probably the most vulnerable people in our community other than very young children, subjected to sexual abuse or inappropriate handling or touching. Nobody on the other side can stand up with a clear conscience and say that they are absolutely certain that that sort of thing did not happen. What we all ought to do is work towards ensuring that the likelihood of that happening is reduced.

When we came into office we found aged care in absolute disarray. I have to give credit where credit is due to the then minister Bronwyn Bishop, who in the early part of our time here closed 200 nursing homes that failed to reach standards. I hate to think what was going on in some of those nursing homes. I have visited them, mostly those in Victoria, as a Victorian senator, and they were disgraceful. I have said here a number of times that I would not have put my dog in some of those nursing homes.

I think I am right in saying that no nursing homes were closed in Labor’s period of 13 years because of failing to meet standards. Mrs Bishop closed 200 of them. It was a difficult task to relocate those people and make sure that they were appropriately accommodated. Over the time we have been in government we have focused on accreditation and quality, equity, sustainability and accessibility. Another thing that came to light when we came into government was that, as reported by the Auditor-General, we had 10,000 too few nursing home beds. Labor had a paltry 4½ thousand community aged care places. In terms of Labor’s record in aged care, whether it is in standards, accessibility, quality or sustainability, they do not have a leg to stand on.

Senator McLucas mentioned a number of processes of quality and accreditation. There was no national quality assurance program when we came into government. We established the Aged Care Standards and Accreditation Agency to monitor homes to ensure they complied with the standards and to take action against the homes that did not comply. Accreditation provided the first ever audit of the quality of care in aged care homes. Senator McLucas, when she mentioned the accreditation process, did not give credit where credit was due and that is to the coalition government for introducing the monitoring and accreditation processes.

The agency can reduce a home’s accreditation period while the relevant department can require the home to implement an improvement plan and to impose sanctions. The Aged Care Standards and Accreditation Agency visits aged care homes around Australia and if necessary changes the accreditation period. In addition, hundreds of spot checks are carried out annually, something that was not done under Labor. It is interesting that Senator McLucas has left the chamber. It is usually courteous to at least stay for the next speaker. But Senator McLucas is so uninterested in this topic that she has left the chamber.

Photo of Penny WongPenny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | | Hansard source

Where’s the minister? The minister doesn’t have the guts to come down.

Photo of Michael ForshawMichael Forshaw (NSW, Australian Labor Party) Share this | | Hansard source

Order, senators!

Photo of Kay PattersonKay Patterson (Victoria, Liberal Party) Share this | | Hansard source

She does not want to hear Labor’s record in aged care. They want to put their fingers in their ears and their heads in the sand like ostriches because they have no policy in aged care and they had no policy in aged care when they were pretending to run aged care.

Photo of Penny WongPenny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | | Hansard source

Where’s Senator Santoro? Get the minister down here and then you’ll have something to say.

Photo of Kay PattersonKay Patterson (Victoria, Liberal Party) Share this | | Hansard source

Senator Wong will have a chance in due course, I presume.

Photo of Penny WongPenny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | | Hansard source

I am not speaking, actually.

Photo of Kay PattersonKay Patterson (Victoria, Liberal Party) Share this | | Hansard source

She is not speaking on it—that is how interested she is in it.

Photo of Penny WongPenny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | | Hansard source

Senator Wong interjecting

The Acting Deputy President:

Order! There is far too much discussion, interjection and comment across the chamber. I ask, firstly, that interjections cease. Senator McLucas was heard in silence all through her speech. I think the same courtesy should be shown to other senators. Also, Senator Patterson, direct your remarks through the chair.

Photo of Kay PattersonKay Patterson (Victoria, Liberal Party) Share this | | Hansard source

I am directing—

The Acting Deputy President:

Senator Patterson, do not challenge what I said. You were having a conversation across the chamber. You know that is disorderly. Please resume your remarks.

Photo of Kay PattersonKay Patterson (Victoria, Liberal Party) Share this | | Hansard source

By 2004, 94 per cent of aged care facilities had reached the maximum accreditation period of three years, a process that Labor—and Senator McLucas does not want to hear about it; she is not here—failed to do anything about. We have introduced certification standards to ensure the physical environment is appropriate, and the industry has responded to the requirement that by 2008 every aged care resident lives in a home that is appropriate and suitable to their needs.

As well as introducing a quality assurance program and a process of certification to ensure aged care homes reach specific building standards, the coalition also introduced a complaints resolution scheme. Again, Senator McLucas referred to the complaints resolution scheme but did not give credit where credit was due by saying that this was introduced by the Howard government, not by Labor. Labor did nothing; they sat on their hands.

A Freecall number is available so that if any resident or family member or staff member has a concern or complaint it can be raised, anonymously if they wish. We introduced the position of Commissioner for Complaints. Senator McLucas quoted the Commissioner for Complaints but failed to mention that it was the Howard government that introduced that position. The role of the commissioner is to mediate and negotiate outcomes in response to complaints.

So our record is in sharp contrast to Labor’s neglect. We have a range of measures in place to reduce the likelihood of abuse and poor standards of caring. As I say, I challenge the assertion by people on the other side that they had a system that would have even identified that there were problems, because they had no accreditation, they had no monitoring, they had no complaints commissioner and they had no hotline for people to make complaints.

The assumption in the statement by the opposition spokesperson, Senator McLucas, is that the government is not treating the allegations of sexual abuse as a national priority, and that is an outrageous suggestion. I will just list what the Minister for Ageing has done. As soon as the allegations came to light, he was swift and decisive. He met personally with the grand-daughters of the alleged victim at the centre of the George Vowell case to hear their concerns about the treatment of their grandmother’s case. The department is undertaking an inquiry into the way those complaints were handled, and the minister gave the grandchildren an undertaking that he would improve the system.

The minister has made contact with the family of the alleged victim of the Millward nursing home. As has been pointed out, he has called a meeting of his aged care advisory committee, to take place on 14 March. That committee represents key national stakeholders in the industry, and he will be asking its members to consider proposals in the area of mandatory reporting, police checks, improvements to the complaints resolution scheme and the accreditation system, and protection for whistleblowers. He has written to his state and territory ministerial colleagues asking them to a meeting to discuss a collaborative approach to improving the system. That is also an indication that this is seen as a national priority.

You would think from what Senator McLucas said that the minister had done nothing. He has been in the ministry for a matter of a week or two, and he has achieved all this, taking action as soon as he saw that there was an issue.

The minister has established within the department a high-level task force to receive and respond to input from the public about all of these issues, and that feedback will be provided to the advisory committee. This set of actions suggests that he is treating this issue as a national priority. As I said, he has taken all these actions quickly and decisively, with a view to restoring the confidence of the public in what is a world-class aged care system.

I think the most important thing we should say here is that these isolated cases—and, if the allegations are confirmed, this totally unacceptable behaviour—are a very small part of the aged care sector and should not besmirch the armies of staff working diligently in aged care facilities—and they do, many of them above and beyond the call of duty, over and above what they are paid to do—and the army of directors of nursing who run what are very difficult places to run. They are not easy to run, with people with dementia and people who are very frail. I would hate to see a few bad apples spoil the whole situation.

We have a very strong and proud record on aged care. As I said, Labor did not close one aged care facility in 13 years. We closed 200. We set up processes to identify the sorts of things that have now been alleged. I know that the minister is determined to get to the bottom of them as quickly as he possibly can.

Photo of Penny WongPenny Wong (SA, Australian Labor Party, Shadow Minister for Corporate Governance and Responsibility) Share this | | Hansard source

Mr Acting Deputy President, I raise a point of order which, in deference to my colleague Senator Patterson, I deferred till the end of her speech. In the course of Senator Patterson’s speech, she suggested that I and perhaps other senators who were participating in this debate were not interested. As the chamber knows, arrangements are made as to party debate on this issue, and senators are allocated time. But what we note is that Senator Santoro, the minister, is not here.

Photo of Michael ForshawMichael Forshaw (NSW, Australian Labor Party) Share this | | Hansard source

Senator Wong! Senator Wong, there is no point of order.

4:34 pm

Photo of Gavin MarshallGavin Marshall (Victoria, Australian Labor Party) Share this | | Hansard source

I can certainly assure the chamber that everybody on the Labor side is very aware of the importance of this issue and is very concerned about it, as I assume most people in this chamber would be. We are appalled by the revelations of abuse, as I am sure all senators are. I do not think it is appropriate, really, for Senator Patterson to suggest, about those who are unable to contribute to this debate directly because of time constraints, that that in any way means that they are not appalled by the abuse.

Before I get onto the substance of what I want to contribute to this particular matter before the Senate today, I did want to just note a common theme. It is not one that is exclusive to Senator Patterson, but it is a common theme for the government that, whenever they get into a crisis situation or difficulties, they always hark back to what other governments before them might or might not have done, more than 10 years ago. I find it interesting that they are unable to accept that they are in fact the government. They have been the government for 10 years, and the test of this government is what they do, not what previous governments might have done or might not have done. It is about what they do now and how they respond to a situation. I must say it is hard for those on this side of the chamber to accept that this government is taking this issue as seriously as they should and treating it as the priority that it should be.

It is interesting that Senator Patterson went through a list of things that the Minister for Ageing is now putting in place. Every one of those things Senator Patterson mentioned is identified in the Senate committee report into aged care that was tabled in June last year. Every single one of them actually goes to a recommendation in the report. I was listening very carefully to what Senator Patterson said, and I was able to tick off all of those recommendations. It is a bit rich, I think, to come in here and accuse previous governments of not doing enough, try to avoid any of the responsibility of having been in government for the last 10 years and then say, ‘Now that it has been brought to our attention,’ as if it is the first time it has been brought to their attention, ‘we will do these things.’

All of these things in aged care have been the subject of a very substantial Senate inquiry, which produced a unanimous report. Government senators and opposition senators together carefully worded a report that reflected what all senators found during our inquiries into aged care. We were very careful in writing that report not to use words like ‘aged care is in a crisis situation’. We did not want to panic people who are in aged care, or their families.

I do agree with Senator Patterson that there are, on the whole, a lot of very good people in the aged care sector and there are a lot of very good nursing homes—our criticisms do not go across the board. But there is a fundamental flaw in the procedures. Senator Patterson wanted to remind us that this government put in place measures for accrediting nursing homes and for a complaints resolution process. But Senator Patterson failed to recognise that none of those things that were put in place actually identified this abuse. This abuse was identified because one of the staff members eventually made a complaint and Victoria Police handled it. The accreditation process did not identify it and the complaints resolution process did not identify it. It just happens to be that those areas are addressed by two very important recommendations in the Senate report which was tabled last June.

Last October I got up in this place and asked why the government had not responded to that very important unanimous report. It had 51 recommendations that went to things that this government has responsibility for and which, if followed, would have improved the quality of care, the process for complaints, the process for mediation and the process for accreditation—all essential things.

We have heard the minister talk about reviewing reviews, yet there is a Senate report that he only had to pick up and read. You would have thought that the Department of Health and Ageing would have given the Senate report some consideration and looked at the 51 recommendations, and that the department would have been in a position to say whether they were workable recommendations and whether they would go some way to fixing the problems. Other senators saying, ‘The minister has been in the job only a short period of time; give him a go,’ really belittles the process of departmental responsibility and the minister being responsible for the department. Surely the department was not just sitting back and saying, ‘We didn’t know there were any problems with aged care.’ Of course they did, because over the last eight years there have been 34 reviews. Most of them have gone to the nursing process in aged care, but for the minister to suggest that the first action that he is going to take as the new minister, when this abuse has been identified, is to review the reviews is a fairly poor ministerial response to a crisis situation in managing these issues.

In 2002 the Senate Community Affairs References Committee tabled a report into nursing, and in that report the committee noted the acute shortage of nurses in the aged care sector. The committee pointed to evidence which indicated that delivery of quality care was under threat from the retreat of qualified nurses, both registered and enrolled nurses, from the aged care sector. The committee made a range of recommendations directed at improving recruitment and retention of nurses in the aged care sector, including changes to workplace practices and improving the image and training of nurses in the aged care sector.

Unfortunately, when we conducted our inquiry into the aged care sector specifically, in the first half of last year, it suggested that there had been very little improvement at all since 2002. Concerns were raised about shortages of not only aged care nurses but also general practitioners and other people with expertise in older persons’ health—geriatricians, psychogeriatricians and allied health professionals. All of that is detailed and substantiated in the report. There were huge staffing problems identified, and there has been no real turnaround and very little evidence of improvement in the situation since those reports were done.

What does the minister do, apart from reviewing the reviews? He talks about setting up a summit: getting all the players in the industry together to talk about what can be done to fix this problem. The summit very quickly became just a continuation of a normal committee meeting which is an existing process to do that. What happens if we go back and look at the Senate committee report? That is one of the recommendations: to get all the people involved in the process together to look at the accreditation process and the complaints and try to develop a process that will satisfy the industry and ensure an improvement in the quality of care in the aged care sector. It is all there; it has been there.

Senator Patterson challenged us to say that this could not have happened under a previous government. I will not suggest that. It probably could have happened, and in fact it may have. I do not actually know. But don’t we expect some continuous improvement? Isn’t that what policy development is supposed to be about—some efforts by the minister and the department to continually improve things? Things do not remain static; things are meant to improve, and we have an absolute expectation that they should. Part of the Senate committee process is to assist the government in that sort of policy development.

A key recommendation of the Senate committee report goes a long way to addressing some of the complaints we are now hearing very publicly. The committee has heard them all before, surely the department has heard them all before, and I suggest previous ministers have heard them all before. The complaints resolution scheme is addressed in recommendation 16 of the committee report. It recommends:

That the Commonwealth review the operations of the Aged Care Complaints Resolution Scheme to ensure that the Scheme:

  • is accessible and responsive to complainants;
  • provides for a relaxation of the strict eligibility criteria for accepting complaints;
  • registers all complaints as a complaint, with the complaints being categorised by their degree of severity, such as moderate level of complaint, complaints where mediation is required or where more significant levels of intervention are required; and
  • provides that the mediation process is responsive and open and that sufficient support for complainants is provided in this process.

The committee heard evidence, and not just single— (Time expired)

4:44 pm

Photo of Gary HumphriesGary Humphries (ACT, Liberal Party) Share this | | Hansard source

I am very happy to contribute to this debate, although I must confess that as I have heard Senator McLucas and Senator Marshall in this debate I have had some difficulty in coming to grips with exactly what it is that the Australian Labor Party is trying to put forward here and what exactly it is that they are alleging about the system of aged care in Australia that needs to be fixed or for which the government stands condemned. They have raised the four incidents of alleged serious abuse of residents of aged care facilities in Australia. As I think has been made clear very eloquently on this side of the Senate by the Minister for Ageing and others, we regard that with grave concern and as a matter of great seriousness that can be and will be fully and properly investigated.

It is worth pointing out, however, that in probably all of these instances—certainly in at least three of them—the allegations are of conduct which would have to constitute criminal conduct. Senators may have overlooked the fact that criminal conduct is a matter for state and territory police forces to investigate in the first instance. Indeed, in at least two of those cases to my knowledge, and perhaps in all four, there have been investigations by the police, or at least the police are being asked to consider whether investigations should be conducted. In at least one of those cases, a person has been charged and, I think, convicted. So the primary response to these sorts of allegations is appropriately with another level of government.

The case that the Labor Party appears to be making about the shortcomings of the government is that there are systemic issues to do with the accreditation and regulation of nursing homes and the overview of the operation of nursing homes, which, in some way, the government has not dealt with appropriately and needs to lift its game on. Senator McLucas’s motion talks about the minister needing to act to restore confidence in the aged care sector of Australia. That implies, of course, that there is a want of confidence in Australia’s aged care system.

Senator Marshall and, I think, Senator McLucas were at pains to refer to the report of the Senate Community Affairs References Committee that was delivered last June, entitled Quality and equity in aged care. I would also like to refer them to that report, because on the first page it says that ‘the standards of care in aged care facilities are generally adequate’. Senator Marshall, in fairness, did comment about the quality across most of Australia. To say that the standard of care is adequate, as the report said—I would say ‘good’ is a fairer description—across most of the system stands at odds with a statement that there is a crisis in confidence in Australia’s aged care system.

Look at some of the phrases that are being used in the media at the moment. They are about crisis, about the system failing and about there being a failure in the system to deliver quality aged care, and that is just not true. We need to put these issues into perspective, because—and this point cannot be overemphasised—we are not dealing with just any sector of the Australian community when these sorts of allegations are made. We are not dealing with the quality of sliced bread or motor cars or something of that kind; we are dealing with a sector which deals with people who are intrinsically frailer and more vulnerable than the average Australian. Each time we get up in here and talk about how the system has collapsed, about how there is a crisis in the system, about how we need to worry about the standard of fire protection in Australia’s aged care facilities and about the question of people being subject to abuse in their residential facilities, we generate a level of concern in the sector which we ought to avoid if at all possible, particularly given that in this situation the four sets of allegations that have been made cannot be described under any circumstances as an impugning of the entire aged care system. Even after a couple of weeks of very adverse publicity, we still have only four allegations of sexual abuse on the table across the whole of the Australian aged care system. We have 100,000 people in residential facilities in Australia and four allegations. In those circumstances, investigations are being conducted, or have been completed, into those allegations.

As the minister made clear—and he has pretty comprehensively responded to each of these issues—there are processes in place to deal with either the individual allegations and perpetrators or the systemic issues about the way in which the homes concerned dealt with those sorts of complaints. In each of those cases, those things have been put on the table and are being prosecuted appropriately, and yet we still have this allegation of an atmosphere of crisis. I think that that does very little to give people a balanced picture of what is going on, and it certainly does no credit to the Australian Labor Party.

This motion calls for the treatment of allegations of sexual assault to be ‘a matter of national priority’. To the extent that such cases are alleged in aged care facilities in Australia, they are, of course, treated as a matter of priority. What ‘national priority’ means is a matter of how urgent the political exigencies around such cases might be. As Senator Patterson pointed out in her contribution to this debate, let nobody imagine that these are the first cases of sexual abuse of residents of aged care facilities in Australia. They certainly are not. In my recollection, there have been such allegations made from time to time for many years. No one government can accept that they have a particular burden on their shoulders for this phenomenon in Australian aged care facilities. No one government can prevent such incidents occurring in Australian aged care facilities. But governments do have a responsibility to address the systemic issues, and there is not one skerrick of evidence that this is not happening at the moment. (Time expired)

4:52 pm

Photo of Kerry NettleKerry Nettle (NSW, Australian Greens) Share this | | Hansard source

The Greens support this motion to reprioritise the neglected aged care sector in light of these shocking allegations of sexual abuse in residential aged care facilities. We agree that these allegations must be fully investigated and that any findings should be openly reported. We are also supportive of a complete re-evaluation of the neglected aged care sector.

These latest revelations have created considerable community concern. This is totally understandable, as people have said. There is also widespread acknowledgement that the aged care sector has experienced a number of difficulties over many years. The current sexual abuse allegations are the latest in a long line of criticisms of this particular sector in the community. Back in February 2000, we had the allegations relating to kerosene baths and as a result there was the closure of the Riverside Nursing Home. A year later, in November 2001, a Victorian woman spent her entire inheritance taking out a harrowing full-page advertisement in the Melbourne Age following the death of her neglected mother after an injury she sustained in an accredited aged care institution. In a passionate call for immediate bipartisan action, the woman stated in her advertisement that ‘Australia’s politicians have for too long viewed age care as a political football, preferring to score points rather than legislate and fund to protect and properly care for all Australia’s wise elders’.

In 2004 ongoing problems in the industry led to a departmental review that culminated in the report A new strategy for community care: the way forward. Then last year, as others have mentioned, there was the Senate Community Affairs References Committee report Quality and equity in aged care. Yet, despite this work, the latest allegations indicate that the policies of the government continue to fail to provide older Australians with the quality care that they deserve. Since the shocking revelations aired on Lateline last week, still more cases of abuse in Victoria and Queensland are being revealed in the media and also through reports to organisations that are focused on standing up for the rights of the elderly.

The Greens strongly support community calls for mandatory reporting of abuse of elderly people in aged care facilities and other facilities, as this is the only way to get these cases out in the open to ensure that they can be efficiently and effectively dealt with. Mandatory reporting could, we believe, easily be made a requirement for registration of aged care facilities through the Aged Care Standards and Accreditation Agency. Such reporting is standard in relation to child abuse, and we do not see why elderly Australians should be treated differently and their protection seen as less of a priority.

The Greens are also concerned that there is no national data collection on instances of abuse of the elderly. With over 160,000 Australians in nursing homes and hostels, it is very difficult to evaluate the circumstances of abuse of the elderly and how frequently this is occurring in order to have the appropriate information to ensure that these sorts of incidents do not occur again. The Greens also support calls from the community and the Health Services Union for pre-employment police checks for aged care workers. Older Australians deserve the highest standards in this regard, as many of them are particularly vulnerable. This is required to be matched with legislation that protects whistleblowers so that people can speak out and be protected.

One of the other issues which have impacted on the likelihood of these instances occurring has been the privatisation that we have seen in the aged care sector. Other sectors, such as airlines or the Wheat Board, for example, have bypassed the vagaries and the harshness of the market driven system, but then we have systems like child care and aged care being open to the vagaries and callousness of the marketplace. The Greens consider this to be a hypocritical situation. A direct result of these policies of privatisation in the aged care sector has been concerns about quality as well as issues with respect to low wages, staff shortages and a lack of appropriate professional development training for people working in the sector. Privatisation without adequate regulation and oversight will always be a recipe for disaster. These cases of abuse of the elderly in nursing homes are the latest clear example of such. As advocates for the rights of the elderly said on the Lateline program just last night, if we can get terrorism laws in overnight, we should just as easily be able to pass laws that protect older Australians. (Time expired)

4:57 pm

Photo of Nigel ScullionNigel Scullion (NT, Country Liberal Party) Share this | | Hansard source

The signature on the bottom of the letter proposing this discussion of a matter of public importance is that of someone well known to me. I genuinely have a great deal of faith in and respect for her, so I know this has not been done with mischief. But, when you read it and it talks about ‘the need for the government to treat the allegations of sexual abuse in residential aged care facilities as a matter of national priority’, clearly the assertion is that this government does not see allegations of sexual abuse in aged care as important. At best, I would have to say that that is misleading and it does not really represent truthfully or accurately the actions of the minister in any way in this matter. The letter goes on to talk about restoring public confidence in residential aged care and a crisis in confidence.

I would like to deal with the first part initially. I would like to put the record straight. The implication behind this matter of public importance is that the minister has not acted or that he did not act quickly enough. I think this minister—a minister new to this portfolio, I might say—has acted decisively with quick action in this matter. He met personally with the grand-daughters of the alleged victim at the centre of the George Vowell case. His department has undertaken inquiries not only into the content of the issue—and much of that is a police matter, of course—but also into the way that the complaints system works, and he has given the two grand-daughters a personal undertaking about exactly what he will do to improve that system. That is an immediate action.

He has also made contact with the family of the alleged victim at the Millward nursing home. This minister is obviously a personal individual. He is happy to display a personal touch at a very grave time for everybody involved—not only the victims but the families of the victims. They have a very reasonable right to assume that their grandfathers and grandmums or fathers and mothers are looked after in the very best way.

He also called a meeting of the Aged Care Advisory Committee, which will take place on 14 March. Senator McLucas indicated that this committee would not have any particular expertise in dealing with victims of sexual assault. I am not in a position to advise whether that would be the case, but I do know that they are the key national stakeholders in the industry who represent aged care and I would have thought that that advisory body would be able to deal with every single aspect of aged care in Australia. I think the criticism of those sorts of people does the senator no service.

The minister immediately wrote to his state and territory ministerial colleagues and he asked them to provide assistance in a collaborative approach to improving the system. Not only have we dealt with this personally but we have dealt with the process, and the department is undertaking an investigation of the complaints system process. The minister decided that there should be a collaborative and partnership type approach, yet we are seeing cheap political shots in this place. He wants a collaborative approach with his ministerial colleagues around Australia to ensure that this is a national priority.

He has also established within the department a high-level task force to ensure that the feedback through this Aged Care Advisory Committee gets dealt with immediately. He wants fast, decisive action—and that is certainly not the implication behind this matter of public importance. To suggest that this particular set of actions is doing anything less than treating the issue as a national priority has to be put down to cheap political point scoring. These actions by the minister have been quick and decisive and have shown good leadership, and I am very proud to be part of a government that would provide a minister of this quality.

The second part of this MPI states the need for the government:

To restore public confidence in residential aged care in Australia by investigating these allegations and reporting openly on the findings.

Of course, the implication is that we are either (a) not investigating these allegations or (b) somehow going to hide the findings. I spoke personally to the minister about this when I realised I was supporting him on this matter. I understand that of course the process would be a publicly reportable process but obviously within the confines of the Privacy Act and the notion of privacy that should be afforded to all people in these very difficult circumstances. Clearly that is going to be the case.

I want to talk about the contribution from the other side. There is talk about a crisis in confidence, particularly from Senator McLucas. It is okay to make these rhetorical noises about the accreditation system, the certification system and the complaints system, but let me remind those in this place and the Australian public that the only reason we have an accreditation system, a certification system and a complaints system is because this government put them in place. This government is not about sitting on its laurels. This government and this minister are committed to making a good system better. From today’s contribution, the opposition is only interested in running the government down for political purposes. If you are all about avoiding a crisis in confidence, one of the things you do not do in this place is stand up and attempt to mislead people by indicating that this government has not put this up as an absolute national priority. The opposition is scaremongering by not indicating that this is about four people out of 100,000. I have to put on the record that there should be nobody in aged care who suffers like this. I am appalled that there would be a human being who would want to perpetrate any harm on the elderly. It is beyond my belief.

These things happen and it would be just scaremongering to say that this is somehow commonplace and this government is not taking this as a national initiative. The continuous criticism of the aged care sector and of the vast majority of the providers and carers that has happened in this place over the last week I think is absolutely outrageous. Those are the sorts of outrageous comments that mislead, are scaremongering and actually undermine the confidence of the wider community. They do so unnecessarily. I am pleased to see that we have a minister who is happy to act decisively and who is happy to act in exactly the right way and in the interests of those people in his care.

5:04 pm

Photo of Lyn AllisonLyn Allison (Victoria, Australian Democrats) Share this | | Hansard source

I concur with much of what Senator Scullion said on this MPI. I do not think that there is a crisis in aged care in this country—far from it—and I do think the government has done a good job on accreditation, on a complaints mechanism and so forth. But we cannot be complacent. I think there is a case to answer, given that complaints were made that appear not to have been followed up. So we do need to investigate; we do need to get to the bottom of it. And we do need to consider some form of mandatory reporting of abuse. It is also the case that I think it would not do too much harm to have a shake-up of the complaints monitoring and accreditation system. They could be more transparent and they could be more independent of government. I think we should also explore police checks for those employed in residential care. And we most certainly need to look at whistleblower legislation, not just for aged care but across the board, that makes sure that those who report abuse are not targeted in any way.

I thought I would take the opportunity today of talking more broadly. We have given a lot of attention in this place to the abuse of children, and there are 40,000 or so reports of abuse or neglect of children in this country every year—that is in the community and within our institutions. Not a lot has been said about an equally appalling issue—that of abuse of a similarly vulnerable group within our community, the frail aged. The vast majority of older people in residential care have either severe or, more often, profound disability. Even within the group of people with profound disability, those in residential care are likely to be the oldest and frailest and more often likely to be women. This puts them at very high risk of exploitation and sexual, physical and emotional abuse, not to mention medical and physical neglect. I think it is an indictment of the currently poorly maintained data sources that there is no reliable data on the prevalence of abuse or neglect in nursing homes or residential long-term care facilities or, for that matter, out in the community.

The piecemeal evidence we do have suggests the problem is serious, if not widespread, and it is a very complicated problem. Although the focus tends to be on the abuse of residents by aged care workers, this is not the only issue that we need to deal with. Violence directed at staff by residents and families is a real problem in aged care facilities, as are other incidents which are in many cases problems of institutional care per se. Estimates have suggested that 80 per cent of staff experience frequent verbal and physical aggression from residents. The most common occurrence of aggression results from residents within the high-care areas and within dementia specific units, and often lack of training in those dementia areas is part of the cause. Violence and aggression in the context of dementia is common. Estimates have suggested that around 20 per cent of aged care residents with dementia are physically aggressive to staff and other residents.

Abuse of older Australians is not limited to residential aged care. There is a growing awareness that many elder persons suffer the pain of psychological, physical and sexual abuse, neglect and exploitation at the hands of their own family members. Estimates vary as to the extent of the problem, but it is generally accepted that between three per cent and five per cent of people aged 65 and above experience some form of abuse within a domestic setting. Given the population projections for Australia, using the conservative estimate of three per cent would mean that by 2011 some 97,000 Australians would be subject to elder abuse in domestic settings, and the vast majority of those will not come to the attention of the authorities.

No-one, whatever their age, should be subjected to violent, abusive, humiliating or neglectful behaviour. We have had some success in increasing awareness of child abuse by putting efforts into education and prevention. We have encouraged people to report any signs of this abuse and made it compulsory in some fields. Now we should be exercising the same diligence to protect older and infirm people. We have a growing ageing population, which means that more and more Australians will be at risk of being abused, whether in the community, in residential care or even in a hospital setting.

Photo of Claire MooreClaire Moore (Queensland, Australian Labor Party) Share this | | Hansard source

Order! The time for this debate has expired.