Senate debates

Wednesday, 12 September 2007

Matters of Public Importance

Belvedere Park Nursing Home

Photo of Alan FergusonAlan Ferguson (President) Share this | | Hansard source

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

The fact that the Government has failed, over 7 years, to protect the health, safety and wellbeing of frail, elderly residents of Belvedere Park Nursing Home.

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—

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.

3:41 pm

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

It is with a very strong sense of disappointment and anger that I propose this matter of public importance. I have a strong sense of disappointment because, once again, public trust in our residential aged-care system has been tested and it has tested badly. I have a sense of anger, and it arises from the fact that this situation could and should never have occurred. The report of the assessment undertaken from 6 to 15 August 2007 is the most appalling and distressing description of what is clearly not care for the residents of Belvedere Park Nursing Home in Victoria. It is the most distressing report I have read in my almost three years of being the shadow minister for ageing.

Whilst not wanting to dwell on some of the findings from the assessment committee, I do think it is important that people understand how bad this facility has been to the 25 residents who live there. Residents and relatives stated to the assessors that the stench in the visitors toilet was so overpowering it made them vomit. Staff had attempted to camouflage the oppressive odour with the use of aromatherapy oils. The living room is filthy, the carpet is frayed, reeking of urine, and furniture is ripped and stained. There is built-up grime on the walls and floors, and an offensive odour permeates the home. A resident was consistently urinating in a handbasin in the community areas. There is delay to call bell response. Some residents call out loudly to attract the attention of staff. However, these calls were observed by the assessment team to go unanswered. A resident requiring palliative care was not receiving pain management. Seven of the 25 residents had lost significant amounts of weight over the last few months. The evening meal commenced at 4.30 pm, meaning that if residents did not have supper they had nothing to eat until 8 am the next day—some 15 hours later.

The assessment team found that a hot water tap delivered only cold water after nine o’clock in the morning. Both of the lifting machines that are used for showering were rusty; one was completely rusty. This line completely appals me: activity resources for residents included childish puzzles, such as Thomas the Tank Engine; activity centres for babies; card games for children; and soft toys. Taped music for children was played for the residents. The recording invited the ‘children’ to sing along with the song. This was the most distressing report that I had ever read, and then I got to this finding:

One resident was observed in a semi-recumbent position with the over bed table over his head. The resident was attempting to eat the meal and was observed eating with his/her hands.

The person was in bed with a table sitting across their lap. They had slumped to the point that their head was under the over table and they were so hungry that they were attempting to take the food off the plate so that they could eat. This happened this year in an aged-care facility in Victoria. As I said, this could have been avoided.

The company that owns this particular facility has a track record of poor performance in the provision of aged care in Australia, and this government knows that. This man, Graeme Menere, lost the ability to be a key personnel member at an approved provider back in 2000. The facility that he was a part-owner of, Kenilworth, was closed because the then Minister for Aged Care, Mrs Bronwyn Bishop, called it the worst aged-care facility in Australia. You would think this government would have had a bit of an eye to a facility that had been sanctioned, I think, four times between 1998 and 2000 but continued to provide so-called care at Belvedere, clearly without the appropriate monitoring that our older people deserve.

Mr Graeme Menere operated two nursing homes in Victoria: Belvedere Park and Kenilworth Private. Mr Menere operated the facilities under different corporate structures. As we heard in question time today, Mr Menere received a suspended jail sentence in May 1998 for stalking a nursing home employee. Rightly, the government said that this was not a person who should be running an aged-care facility in Australia. Rightly, he lost his status as an approved provider. Rightly, he could no longer be a key personnel member under the act. But we know, from the reports in the media and from commentary that we have heard, that Mr Graeme Menere continued to provide those services by managing Belvedere.

One journalist said to me that he rang up to speak to Mr Graeme Menere and was told, ‘Ring back at lunchtime; he’ll be back then.’ This is a person who is not meant to be near the aged-care facility, but he is continuing to manage the day-to-day operations of this place. Back in 1998 the federal opposition brought Mr Menere’s conviction to the attention of the minister at the time. It was through our actions that we have kept this government watching and making sure that its own Aged Care Act is being complied with.

In 1998, 1999 and 2000, Belvedere Park Nursing Home was found not to be meeting aged-care standards. In January 1999, residents were found at serious risk in relation to 17 separate aspects of their care. From June 1999, Kenilworth Private Nursing Home was found not to be meeting standards. Five sanctions were applied during 2000 and then funding was cut in 2001. The provider appealed the sanctions to the AAT and won. That has just happened again. Hasn’t the government learnt anything about how to ensure compliance with AAT principles when they are ensuring that their act is being complied with?

As I said, the nursing home was widely reported by Mrs Bishop to be the worst nursing home in Australia. In 2001 Kenilworth went into receivership and was closed.

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

By this government.

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

By that government—yes, exactly. That is my point, Senator Humphries. You knew back then that this operator needed to be monitored closely. I need to confirm this with Senator Ellison, but from answers given in question time today it seems quite clear to me that from 2003 through to 2007 there has been one unannounced spot check. That is what I learnt at question time today. If that is incorrect, I really do ask you to correct it, but if there has only been one unannounced spot check from 2003 to 2007 the government need to tell us what they have been doing to ensure the wellbeing of the residents of Belvedere Park.

On 15 August 2007, following that very lengthy audit, Belvedere Park was found not to be meeting 42 out of 44 outcome areas. I have never seen a report that was that bad—hence my anger. This government has known that this facility should have been monitored far more closely. As you know, Mr Deputy President, the government is responsible for the standards of care in Australia’s aged-care facilities. I have called on Minister Pyne to explain how the conditions of this facility could be so bad despite the fact that the government has known since at least 2000 that Mr Graeme Menere had an appalling record for aged-care provision. These problems have not occurred just overnight. A showering seat does not become rusty in a short period of time. These things take time and require appropriate monitoring to ensure that the residents’ welfare is paramount.

How many spot checks has Belvedere had since it was sanctioned three times in 2000? What measures did the government take to ensure that Mr Graeme Menere, a disqualified individual, was not involved in the day-to-day running of Belvedere? Has Mr Menere been involved in the day-to-day running of the home? How many complaints has the government received about the home? When were they and what did the government do about them? When did Saitta, the company which owns Belvedere, receive its approved provider status? That is very important. And will Minister Pyne rule out Mr Graeme Menere operating nursing homes in the future? I asked those questions almost a month ago. Minister Pyne has declined to answer them.

Confidence in Australia’s aged-care system has been severely threatened. We have to be absolutely sure that all aged-care facilities are providing the quality of care that Australians expect of our 3,000-odd aged-care facilities. The concern is very much felt by many aged-care facilities which are doing the very best that they can to provide quality care. Quality aged-care providers hate it when something like this is exposed because, in the community’s mind, trust in our aged-care system generally is questioned. Everybody is concerned that the level of care which is being provided in all of the other aged-care facilities is up to scratch. So it is in the interests not only of those older people who live in aged-care facilities; it is also in the interests of the community at large and the aged-care sector that we have an efficient, effective and quality management and monitoring system. It is in all our interests that poor aged-care providers are weeded out. That is what we have to ensure so that confidence in aged care can be restored.

Unfortunately, this is not the only example we have had where an individual who is an approved provider has been operating aged care outside of the act. In 1999 Kerry and Malcolm Bishop, Queensland aged-care providers, were convicted of defrauding the Commonwealth of $139,000 in aged-care subsidies and were jailed. Today they are operating nursing homes in two states of this country and receiving almost $16 million every year in subsidies. When those two individuals were jailed, they simply transferred the ownership of the companies, the approved provider status and the key personnel status to their children. But it is alleged that Mrs Bishop, in particular, is still operating aged-care facilities in Australia. This government has to be drawn to account with respect to these two cases—not just the case in Brisbane, which is of concern, but on behalf of the 25 people who have been living in what can only be described as horror in that aged-care facility in Victoria. This government has a responsibility to ensure that all of the almost 170,000 people who live in aged care—and their families—are confident that they are receiving the sort of care we all expect they should receive.

3:56 pm

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

I am pleased to contribute to this debate on a matter of public importance. It needs to be put on the record, unambiguously, that the Australian government does not in any way support or condone or seek to downplay the significance of the kind of neglect and maladministration which Senator McLucas referred to in her speech. Clearly, what has occurred at Belvedere Park Nursing Home is unacceptable and an example of practices which should form no part in the aged-care industry. Although we can agree on that much, Senator McLucas has attempted in this debate to employ, by implication, the argument that, first of all, there is a more widespread problem than there is at places like Belvedere Park and previously at Kenilworth—another facility operated by the same operators; both of them have now been closed down by the federal government—in the broader aged-care industry in Australia. That is a matter which Senator McLucas, with great respect, has not established, and she can only attempt to do so by using an extremely broadbrush approach to tar many other, reputable operators with the actions and omissions of Belvedere Park.

She also suggested that this government has failed by not being aware of the issues going on at Belvedere Park and has failed to act on them. Today in this debate I want to comprehensively indicate that that is simply not the case. Since the connection between Belvedere Park and Kenilworth became evident to the Department of Health and Ageing because of an overlap in persons involved in both organisations, comprehensive steps have been taken by the federal government to ensure that an extremely close eye is being kept on Belvedere Park. I want to outline some of those steps.

It is worth acknowledging, first of all, that the government needs to operate in the context of the administration of the law with respect to aged-care facilities. The laws have been greatly strengthened in the last few years by virtue of reforms undertaken by this government to ensure that higher standards are in place in Australian aged-care facilities—standards which could not have been applied before because there were no such laws underpinning those standards. But, despite that, the government has faced the battle of enforcing standards when there are rights built into laws, appropriately, for persons affected by government decisions to appeal to courts.

I want to come back to the issue that, by implication, Senator McLucas is raising—that the government and its agencies, particularly the Aged Care Standards and Accreditation Agency, must somehow accept responsibility for attempting to enforce standards in respect of these areas and being knocked back by the Administrative Appeals Tribunal on a number of occasions.

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

Senator McLucas interjecting

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

No, on a number of occasions, Senator McLucas, and I will come back to that in a moment. With great respect, you are not well-informed about the background of this matter.

Senator McLucas has asked whether there were any unannounced checks of the Belvedere Park facility between 2003 and 2007. I want to give an answer to that question. There has been a long history of the department monitoring this particular facility. Between 1998 and 2002, there have been five separate occasions when the Department of Health and Ageing has imposed sanctions on Belvedere Park. During that period there were frequent unannounced visits. In fact, on 12 June 2002, there was an unannounced visit; on 7 October 2002, a further unannounced visit; on 15 November 2002, an unannounced visit; and on 12 December 2002, an unannounced visit. Again, in 2003 on 6 June, on 18 June, on 31 July, on 10 September and on 11 November there were unannounced visits. The operators of this facility could not have been under any mistake that they were being very closely watched by this department and its accreditation agency.

In 2004 there were some changes in personnel and an apparent attempt by the home concerned to try to lift its game. However, the agency continued to ensure that there were spot checks on this particular facility. An unannounced visit occurred on 19 January 2005, another on 21 January 2005 and one on 10 February 2005 as well. On 16 and 17 November 2005 there was an accreditation site audit over a two-day period—a comprehensive examination of how well this particular facility was attempting to lift its game. On 28 April 2006 there was a site visit in response to a complaint, where some of the things that Senator McLucas has referred to were raised, and it resulted in a number of actions being taken by the agency to press the particular provider to lift its game. There was a further support contact visit to the home in November 2006, and there was a further visit on 3 July 2007. There is no question and it is simply untrue to suggest that the government has failed to act in respect of this particular home. Comprehensive, repeated actions have been taken to monitor the activities of that home. This indicates great pressure put on these providers to lift their game.

Senator McLucas raises the additional question of the way in which Mr Graeme Menere was involved with this facility, and the suggestion is that Mr Menere’s involvement as an active participant in the administration of this home has been ignored in some way by the department. Again, this is not true. Of course, under the system of health care standards that we inherited, there was no capacity for the department or the accreditation agency to prevent a provider from being accredited if a person with an indictable offence to their name was involved in the administration of that facility. We fixed that in legislation in 2000, effective as of January 2001. The trouble is that, unfortunately, Mr Graeme Menere’s involvement has not been a formal involvement on the record in that home. He has not been a director of that home; he has not been on the board of management of that home.

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

Senator McLucas interjecting

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

Yes, he was involved, Senator McLucas. But the problem that you face in bringing this case against the government is that mere suspicion of those things is not sufficiently strong evidence to convince bodies like the AAT, the Administrative Appeals Tribunal, that we should disqualify this particular provider from operating that home in circumstances where we cannot prove the involvement of Mr Menere in its activities.

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

Because you were not monitoring it!

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

We were monitoring it. Senator McLucas, please! Nine spot checks in 2002 and 2003; another three in 2005; further site visits in 2006 and 2007. To say that we were not monitoring the facility is the grossest exaggeration, I think, you can possibly come up with.

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

There were no spot checks from February 2005 until this year.

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

No, there were further checks. You said there were none between 2003 and 2007 before; now you can see that there were some in 2005. There were further checks during that time on the basis of a continuing operation to monitor the activities of this home subsequent to that, and the fact is that it has continued throughout this period. There have been both spot checks and announced visits. It has been comprehensive over several days. The fact is that it has placed enormous pressure on this agency.

However, I want to make one other point. You are obviously claiming that we are too slow to act; that we have not done enough to get this particular provider off the scene. I note that, on 28 August in the North West Advocate, a paper in Melbourne, the state Labor MP, George Seitz, condemned the federal government for the haste with which it closed the home and suggested that it did not follow due process. So, what is it: are we going too fast or going too slow? Are we doing too much or doing too little, Senator McLucas? This government has been proceeding in accordance with the framework of the law; it has acted appropriately and promptly; and the fact that this home has been closed is a testament to the standards that we have put in place to ensure that aged care standards in this country are maintained to a high level. (Time expired)

4:06 pm

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

It is disappointing that we are again having a debate about a nursing home which has had to be closed down for appalling treatment of the elderly. Listening to the list of visits, checks and monitoring that the government has been engaged in since 1998 makes me wonder just what the government found when it went to this place and whether the situation which finally caused it to act decisively was not apparent at those other visits. If it was apparent at that time, one wonders why the situation was allowed to go on. It seems to me that if the AAT knocked back perfectly reasonable efforts on the part of the government to sanction the operators then there has to be something wrong with the law. It is clearly too indulgent of those nursing homes which are doing the wrong thing. They are a tiny minority, as we know, but every time something like this comes up it shatters confidence in the sector as a whole. It is one thing to come in here and suggest that there has been enormous pressure put on this agency, as Senator Humphries just said, and another to demonstrate that the government has not been simply indulgent with the aged-care provider in this case.

We want better. We expect those standards to be upheld. I acknowledge that this government brought in those standards and they were missing with the previous government. There is no question about that. I had quite a bit to do with Senator Bishop at the time that she brought them in. I congratulated her then, and I do now, but it seems to me that the government have dropped the ball a bit on this issue and they are not as vigilant on aged care as they might have been back when Senator Bishop began this reform process.

I think we need to look more broadly at aged care, however. There are ongoing concerns about the quality of care available to residents in many nursing homes and hostels, and the government needs to be more vigilant, as I said, to make sure that residents receive the quality of care they are entitled to expect. A number of people of my generation are now unfortunately having to place their parents in aged-care facilities and they are deeply troubled by this process. Some find an aged-care facility which is very good and they are pleased and enormously relieved, but others are deeply anxious about the process because they do not have confidence. It is incumbent on the government, having subsidised the industry substantially, and rightly, to provide the best quality care and ensure that we do not have shysters, such as we have heard about today, taking advantage of older people and obviously taking that money and not using it in those facilities.

There is a history of failing assessments over years, and we need to get to the bottom of it, but it is also the case that the complaints monitoring and accreditation system could be much more transparent and much more independent of government than it is. We need more resources to monitor our aged-care facilities so that they are not simply glossing over the problems so that they are not seen to be to blame.

There are major problems looming for future governments when it comes to aged care. With the number of people 80 years and over set to increase from the level of 680,000 in 2002 to 2.6 million by 2045, there is going to be a massive increase in demand for aged-care services and aged-care workers. The number of people with dementia will increase more than threefold over the next 50 years unless there are effective methods of prevention and treatment found. Some 65 per cent of residents in aged-care homes are estimated to have some degree of dementia, and dementia will progressively become the biggest disability driver of demand for aged care. We may have solved the problem of accreditation and standards to some extent, but there are bigger issues looming. It is disappointing that the government has not turned its reformist zeal—if I could put it that way—to some of the problems that are already with us but are looming as greater problems into the future.

We need a system that is transparent, takes into account capital, staffing and operating costs and can respond to those future needs. We also need to ensure the money is there to provide dementia-specific care for people with challenging behaviours, including funding for training for all nurses and care staff, and we need additional supplements to provide care for residents— (Time expired)

4:11 pm

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

It is sad that we are back here discussing this issue, but in some ways it gives us a chance to work through the particular issues that must come out of yet another aged-care home being publicly exposed as not meeting the standards that have been imposed and that we have also grown to expect. On the Department of Health and Ageing website—and I do look at the department website; sometimes I think they do not think I do—are probably the most damning couple of sentences I have seen on a department assessment. I think it sums up where we are. On the background to the Belvedere Park experience it says:

Belvedere Park has the most significant number of non-compliance outcomes in the history of accreditation, with 42 out of 44 expected outcomes under the Accreditation Standards.

In taking this strong action—

that they were taking at that time, which was the closure recommendation—

the department recognised the significant level of non-compliance and the immediate and severe risk to residents.

The department determined that the non-compliance is widespread, deeply-rooted and intractable, demonstrating a fundamental breakdown in systems and care delivery.

That would have to be a fairly clear assessment of a total failure of what was happening at that home.

It is interesting that, while we are talking about the system of accreditation, the spot check process and exactly how the department are aware of what is going on in the facilities for which they are responsible—which we have been asking for many years—the department have claimed in the assessment that they have exposed these issues by their standard process. I question whether you can claim to have exposed a system which is ‘widespread, deeply-rooted and intractable’ in August 2007 when you look back at the number of visits and discussions that have taken place in the previous two years, which we have heard Senator Humphries expose recently. Senator McLucas has pointed out that these are not new issues with the ownership of this home and Belvedere itself. There have been alarm bells ringing. In fact, the same facility in 2002 had significant failures and suffered as a result of those, under the then system. They were found not to have met the requirements of effective aged care and were punished under the system.

In the period from 2004 until now, there has obviously been some changing and some ongoing discussion. Senator Humphries proudly claimed it to be ongoing monitoring. I ask: how can you be confident in ongoing monitoring which has led to this debacle? I do not like to use emotive language, because that does not help the issue, but I am sure people saw the media coverage of those stressed elderly residents and their families, lost and frightened at the exposure that they were suffering—in the opening of the wounds and having the home where they live, where they were expecting care, exposed as not only not providing care and support but actually being dangerous to their health. When I saw the television coverage of those poor, frightened people being taken away from their home, I asked: is this system working?

We are not claiming that this process is widespread across the country, but if in July 2007 we had asked a question about what was happening in Belvedere we would not have heard the answers about the problems there. It was not until August 2007 that the failure, which was widespread, deeply rooted and intractable, demonstrating a fundamental breakdown in systems and care, was discovered. This is the issue. We have accreditation systems. We have spot-check systems. I cannot begin to remember, Senator Polley, the number of Senate estimates questions we have gone through trying to establish exactly how it works, when it happens, what stimulates the visits. We want to know what happens next.

The fact is that for over seven years this aged-care facility has continued to operate—people have lived there, families have visited—and we have now had an assessment which is the most damning in accreditation history. What has happened after the visits that have occurred up until now? How on earth can the issues, which have been identified in the audit report which is now on the departmental website, continue to exist? They did not happen in a two-, three- or four-month period. These problems are so established and so intractable that they have been going wrong for a long time. How then can you have faith in a system when, as Senator Humphries has pointed out, a facility such as this has had visits over that time? What kind of proof, what kind of evidence, what kind of legal commitment has there been between the people who have been giving information about what has been going on behind the closed doors of Belvedere over last few years?

Senator Humphries pointed out that in 2004, after they were previously punished for not meeting standards, there was some kind of change in personnel and things seemed to get better. That was a small window. I do not know the residents who are living there but one of the things we do know is that residents who seek support in aged-care facilities often live there for a long time. So I wonder whether any of the residents who have had to find a new home now because of the outrageous conditions in which they were living were there when the previous process occurred. How much disruption has been going on for those people and their families?

We also know—and you, Mr Acting Deputy President Barnett, have been at inquiries where this has been discussed—that there is not widespread availability of aged-care facilities in many parts of Australia. In Melbourne itself it is not that easy to find a facility where you are comfortable and where you can visit your family easily. It is a difficult and confronting situation. We do not want to run a scare campaign but we want to understand how we can ensure that the system that is in place—and we can read pages of what happens in the system and how it works and all those things—is working properly. In the case of Belvedere, it has not worked. I wonder how anyone could have any faith that it was going to work in the future.

In terms of statements about the government being responsible, it seems to me that if the government can claim success and claim responsibility for the things that are going well, it should acknowledge reality when things do not go well. As we consistently read in the media, when anything is positive and good the government is very quick to get out there with the media opportunity and claim a marvellous success. When things in the same system do not go as well, I think that it is only appropriate that the same government with the same responsibilities acknowledges that it has not gone well. Everyone can talk for minutes on this issue about all the things that are supposed to happen. For the people who were residents at Belvedere Park those things did not happen—and what is going to happen next?

4:19 pm

Photo of Sue BoyceSue Boyce (Queensland, Liberal Party) Share this | | Hansard source

This is a very sad motion. The content of the motion is sad, as I think is the attempt by the Labor Party to suggest that the government should have 20/20 hindsight in all conditions. I find it unacceptable that the residents of Belvedere Park had to exist in the conditions that they did. The Labor Party, Senator McLucas and Senator Humphries—all of us—find it unacceptable that that happened. The minister, Christopher Pyne, has said that he finds it unacceptable that those people existed in those conditions. But that does not mean that this government is going to get it 100 per cent right 100 per cent of the time.

If you look at the number of residential aged-care facilities in Australia—and there are more than 4,000 of them—currently 14 of them have sanctions imposed on them. That number of 14 is not acceptable to me, to the minister or to anybody else, but it is a reality in our world. The Labor Party seem to be suggesting not only that the government should be using 20/20 hindsight to ensure that we never, ever have one failure in any way within aged-care residential facilities but also that we should just ignore the rule of law when we do so. It has been pointed out that, yes, the Administrative Appeals Tribunal overturned the sanctions on Belvedere Park imposed by the agency. I do not quite know what anyone living in a democracy, where the rule of law is meant to be of primacy, would suggest we should do to ensure that that cannot happen in the future, that people cannot appeal against decisions made against them. This has to be allowed to happen. I think we should be looking at and concentrating on the fact that this was picked up, that the accreditation and spot-check systems actually picked up Belvedere Park and the problems that it had.

Perhaps we should also look at what has happened in the past. Right now the care and safety of residents in aged-care facilities in Australia is the government’s highest priority. But if you look back to the records in Victoria, in particular, you can start with the 1994 Gregory report which said:

  • 13% of nursing homes did not meet the relevant Fire Authority standards.
  • 11% of nursing homes did not meet the relevant Health Authority standards.
  • 70% of nursing homes did not meet the relevant Outcome Standards.
  • 51% of nursing homes residents were living in rooms with three or more beds.

This was 1994. Let us move on to the Victorian Auditor-General’s report in August 2006, which was extremely critical of the Bracks-Brumby government’s management of the nursing home structure in the public sector. It is worth noting here that Victoria is one of two states that have very strong public sectors of aged care provision—over 6,000 beds in that sector.

Let us now turn to the current situation, where we have expenditure that has gone from $3.1 billion in 1995-96 to more than $10 billion—established, expected—for 2010-11. Senator Allison pointed out that some planning was needed in this area. There has been some planning: there has been a massive increase in the amount of spending in the aged-care area. We no longer have the situation that we had when Mrs Bishop became the minister, where over 200 homes were closed down almost immediately because they were in an appalling condition; there were not any standards for those homes to meet. This has all been established by our government in the last 11 years. Yes, there should not be one failure, ever, in an aged care facility—we are talking about vulnerable people who need every protection we can give them—but that is not going to be reality. The situation has been found, these people are now in better facilities and, as far as the law will allow, the government is currently doing its best to ensure that this cannot happen again.

Mr Menere is certainly not someone that any government in its right mind would want to let back near aged care residents. But the government must operate within the law. Van Diemen’s Land is not there anymore, unfortunately—it would have been a nice option.

Photo of Richard ColbeckRichard Colbeck (Tasmania, Liberal Party, Parliamentary Secretary to the Minister for Finance and Administration) Share this | | Hansard source

It is; it is just called something else.

Photo of Sue BoyceSue Boyce (Queensland, Liberal Party) Share this | | Hansard source

It is still under the same rule of law. Another area that has changed radically in the past 11 years is the number of aged-care community places. If you look back, you will find that there were virtually no community care places 10 years ago. We now have the situation where the government will spend $1.9 billion on aged care community places over this financial year. That is a growth of more than three times what it was 11 years ago. We have got 42,000 places, as of June 2007, that were available so that people could stay in the community. More and more people are telling us that they do not want to be in institutions any more than necessary—this relates back to the sorts of comments that Senator Ellison was making: let’s change that balance from people being in residences to people being in their own homes with our support.

We have also increased the spending through the National Respite for Carers program from $19 million in 1996-97 to $185.4 million over 2007-08—again providing a chance to support people to do exactly what they want, which is stay in their own homes.

The other area that I think we should mention is the spot check area. This has been strengthened and developed and improved radically. It is now a requirement that every home will receive at least one unannounced visit every year—the current average is 1.75 unannounced visits every year. There will be more than 5½ thousand unannounced visits to homes over the next 12 months. This has to begin to give us some security in this area. The other point is that unannounced visits had to be legally provided for. (Time expired)

4:27 pm

Photo of Helen PolleyHelen Polley (Tasmania, Australian Labor Party) Share this | | Hansard source

I rise to speak today on aged care as a matter of public importance. In particular, I will focus on the horrors of Belvedere Park Nursing Home. Like other speakers here today, I am disappointed to think that we are once again talking about the negative side of an industry that, overall, has a good reputation.

We could not go through debate here today—not even on nursing homes—without government senators getting into the blame game. If all else fails, when they want to take the credit—as Senator Moore said—they will take the credit for all the good things that happen; they are out in the media. But, when it comes to taking responsibility, they run a mile.

Our aged-care system faces a number of long-term challenges. It is estimated that the number of Australians aged 70 or over will double over the next 20 years. A shortage of aged-care workers is also a major problem. Ultimately, the Howard government has done nothing for aged care, except make hollow promises, for the time they have been in government—a long 11½ years.

The sector has suffered for far too long. This is evident in the problems that are emerging within the sector now. Our elderly deserve the right to live in a safe and caring environment. The community needs to be assured that our mums, dads and grandparents are secure and well cared for. Labor believes that healthy and positive ageing must be an achievable goal, because older Australians deserve the best our nation can provide. The Australian Labor Party is concerned about the quality of Australia’s aged care system. Reflecting this, Labor’s election policies will be based on respecting and valuing the enormous contribution to our society by older Australians.

Over the last few months, we have heard of the shocking treatment of the residents at the Belvedere Park Nursing Home. The Herald Sun reported on 23 November that at Belvedere Park investigators found faeces smeared on equipment, undated food in the fridge and pathology specimens stored with medicines. Auditors also revealed that there was a sickening stench in the toilets and a lack of incontinence hygiene. This could have been detected earlier if the government had unannounced spot checks. We have heard from government senators about things back in 2002 to 2005 but, if those unannounced spot checks were actually working, we would not be here having this debate now.

There was serious, widespread, systematic noncompliance at this aged-care facility—and that was reported at the AAT hearings. The Age also reported that Belvedere Park failed 42 of 44 aged-care standards. Inspectors found that, amongst other things, the home had failed to properly manage residents’ medication, nutrition and hydration. Their families had complained that they were not given access to basic toiletries, such as toothpaste, toothbrushes and soap. Other reports claim that staff at the Belvedere Park aged-care home had no effective infection control system in place, medicine cabinets were left unlocked and medicine administration lists were signed off before being given to residents.

Confidence in Australia’s aged-care homes has been seriously eroded due to the Howard government’s inept monitoring of aged-care facilities. What I find most upsetting after reading the horror reports of the Belvedere nursing home is the indignity the residents were faced with. We are talking about people’s homes. The residents were literally treated like small children and given childish puzzles, including Thomas the Tank Engine, activity centres for babies, card games for children and soft toys. Furthermore, tape music for children was also played for the residents. The recording invited the children to sing along with the song. This is completely unacceptable. Our elderly are not a burden and they deserve the very best care that we can provide. In fact, we have a responsibility to ensure that they have the best possible care. Labor’s policies recognise that elderly people are vulnerable to abuse, including neglect, financial exploitation, psychological manipulation and physical and sexual abuse.

Labor is firmly focused on the long-term future of aged-care provision—not just from one election to another. Labor is acutely aware of the workforce shortages constraining Australia’s aged-care sector. Attracting and retaining aged-care workers, including nurses, is a looming crisis which must be addressed. Caring for older family members is also complex. Access to services such as community and respite care that can assist frail older people is essential. In 11½ years the Howard government turned an 800 aged-care bed surplus in 1996 into a 4,613 shortfall by June 2006—what a record! Labor is committed to providing a guaranteed, universal and integrated retirement incomes system that is secure, stable, simple and fair. Labor will develop high-quality care standards for aged-care providers so that they deliver high-quality outcomes.

As has been said by other speakers from this side of the chamber, it is regrettable that we are once again here talking about aged care and the neglect of our elder Australians. Unfortunately, when this is raised in the media, it reflects across the whole industry—though we know that the majority of those who work in the industry use world’s best practices and do the best that they can and with the respect that older Australians deserve. We should be providing the highest quality care—as I said, it is our responsibility. The Howard government, for a variety of reasons, has not accommodated this. I think this once again clearly demonstrates how the Howard government is out of touch with the community, with what is expected and with what our obligations are as elected members.

The blame game is once again the fallback position for government senators here today. If all else fails, they blame a state Labor government or even go back through history—go back to 1994. We are in 2007, and this government has to take responsibility for its failings. (Time expired)

4:34 pm

Photo of Judith AdamsJudith Adams (WA, Liberal Party) Share this | | Hansard source

I would say in reply to those on the other side of the chamber that I think it is important for you to note—and this is not about the blame game—that, in 1996, there was no independent oversight of the quality of aged-care homes. Now there is an independent agency, the Aged Care Standards and Accreditation Agency, which accredits every aged-care home—and all homes will receive at least one unannounced visit every year. I too am very disappointed with what has come up from the investigation into the two aged-care homes, which my colleagues, Senator Ellison in answering a question in question time today, and those opposite have described very adequately.

I think it is important for me to be positive about where we are going and what is available at the moment. This government has certainly recognised the failings. It is very upsetting to know that these things happen in some of our aged-care homes. We have put different measures in place to ensure that these things do not happen but, if they do, that they are rectified very, very quickly—as has happened with this last incident. As at the end of June 2006, almost 3,000 residential aged-care homes had been accredited. The Australian government has acted to protect people in aged-care homes from sexual and serious physical assault. The Australian government’s response to abuse allegations totals more than $100 million over four years. With legislation passed this year, 2007, we have also strengthened protection for accommodation bonds paid by aged-care residents, which I think is a very important issue—and it also prevents abuse.

The Australian government has in place a quality framework for residential aged-care homes which includes accreditation, building certification, the Aged Care Complaints Investigation Scheme and user rights programs. Residential aged-care services are required to be accredited to receive subsidies from the Australian government. As at 30 June 2007, only 2.9 per cent—85 homes—were identified as having some noncompliance. Aged-care homes are monitored by the department and the agency.

In 2006-07, a total of 6,329 visits were undertaken by the agency, including 3,627 unannounced visits—otherwise known as spot checks. The agency makes at least one unannounced visit to each home every year. Issues of concern are acted upon promptly and monitored until compliance is achieved. Poor care is never acceptable whatever the circumstances and in these cases sanction action may be taken. We have had a number of examples of that from earlier speakers.

There are currently sanctions imposed in respect of 14 residential aged-care homes out of a total of nearly 3,000 aged-care homes around Australia. The care and safety of residents at all aged-care homes remains the highest priority for this government. Concerning increased protections, recent amendments to the Aged Care Act 1997 put in place a more robust aged-care complaints investigation process and established a new independent Aged Care Commissioner from 1 May 2007. They also require compulsory reporting of incidents of sexual and serious physical assault in residential aged care, with protections for approved providers and staff who report from 1 July 2007. It is important that those opposite understand the new Aged Care Complaints Investigation Scheme, which has the scope to investigate any possible breach of an approved provider’s responsibilities and take action where approved providers fail to meet their responsibilities.

On 1 May 2007, the Minister for Ageing appointed a new Aged Care Commissioner, Rhonda Parker, who will provide an independent review mechanism. I know Rhonda Parker personally. She is from Western Australia. She has a very long history in aged care and in her former employment was as a minister in the Court government covering the portfolio of Families and Children’s Services, Seniors and Women’s Interests. We could not have a better person to act as the commissioner. As the new Aged Care Commissioner, she has the capacity to examine complaints about decisions of the department under the investigation scheme and, as a result of a complaint or on her own initiative, the department’s processes for handling matters under the investigation principles. This is very important. This system is certainly going to improve any problems we have had in the past.

Also, on 21 December 2006, the Australian government amended the Aged Care Principles 1997 to give effect to police check arrangements that require approved providers to ensure that certain staff and volunteers in Australian government subsidised aged-care services who have unsupervised access to care recipients are screened every three years for any criminal history. This is certainly a big improvement too.

We go on to compulsory reporting and whistleblower protection. From 1 July 2007, approved providers must have systems in place to ensure staff report allegations of sexual and serious physical assault to the approved provider. Providers are required to report this information to the police and to the Department of Health and Ageing.

The Australian government is providing an additional $8.6 million over four years to increase the number of spot-check visits by the agency. Since 1 July 2006, every home has received at least one unannounced visit a year and the average number of overall visits was increased to 1.75 visits per home per year. I do believe that this government is doing the right thing for aged care. (Time expired)

Photo of Guy BarnettGuy Barnett (Tasmania, Liberal Party) Share this | | Hansard source

Order! The time for consideration of the matter of public importance has expired.