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DISSENTING REPORT BY THE AUSTRALIAN DEMOCRATS
The Aged Care Amendment Bill 1998 is designed to bring about changes to the Government's aged care reform package which was debated and accepted by the Senate last June. Some of these changes were announced by the Prime Minister on A Current Affair in November last year, while further changes were announced over the ensuing months. This bill also introduces measures which are designed to `fine-tune' provisions which were introduced by the Aged Care Act 1997.
As far as the Australian Democrats are concerned, any proposal which is designed to change the way residential aged care arrangements operate must be carefully weighed up against the impact it will have on:
- the ability of elderly Australians to access high quality residential aged care services regardless of their capacity to pay; and
- the long term financial viability of the residential aged care sector.
With respect to this, a number of the issues raised with the Committee need to be considered.
Ad hoc approach to policy
Several witnesses told the Committee that the Government's ad hoc approach to residential aged care policy over the past six months has resulted in a policy package which is inconsistent, uncoordinated and lacking in long term vision.
As Ms Davies from Uniting Community Services (the largest provider of aged care services in Australia outside of government) told the Committee:
This package of structural reforms is not a package. It has not been put together as a package. What we are asking this committee to seriously consider is whether the amendments to the act as contained in this bill provide the answer to an industry structural reform which has taken place in a fairly ad hoc and rushed way, and not with any due structural reform package in place. [1]
The Democrats share many of the concerns raised by witnesses regarding this Government's approach to the development of residential aged care policies over the past six months.
We suspect that the Prime Minister's backflip on accommodation bonds for nursing homes last November was driven, not by a desire to produce a `better' policy package, but by a desperate need to minimise the political and electoral backlash associated with its failure to successfully sell its original aged care reform package.
Many of the changes which followed the Prime Minister's announcement in November seem to have been derived in an extremely ad hoc fashion. Once again, we suspect that the major driving force behind these policies was not so much a desire to achieve a beneficial policy outcome for the residential aged care sector but a desperate need to counteract a series of negative opinion polls on the Government's original aged care package.
The Democrats believe that the Government's original package of aged care reforms was unfairly subjected to a deliberate scare campaign which was driven primarily by the Opposition and supported by the media. It is, however, regretful that the Government chose to respond to this in the kind of politically driven, ill-considered and ad hoc fashion we have witnessed over the past six months.
Uncertainty
One issue raised with the Committee which the Democrats are concerned about, is the level of concern and confusion which still surrounds both the Government's original aged care reform package and the subsequent changes which have occurred over the past six months.
Once again, we recognise that the Opposition's scare campaign played a strong role in creating the current situation. However, we believe the Government also has a case to answer to in this regard. While we accept that a range of brochures and information material is now available on the full range of reforms, it is clear that in many respects this has come too late for the many elderly Australians who are concerned and confused by the changes. It is unfortunate that the Government failed to take steps to ensure that all those with an interest in aged care reforms were fully informed from the outset.
The Democrats urge the Government to take whatever steps are necessary to ensure that elderly Australians, their families and their carers are fully informed about the way the Government's aged care reforms will affect them.
The future viability of the system
As the majority report notes, a number of submissions commented on the future viability of the aged care sector, with a number of these suggesting that the Government's reversal on accommodation bonds for nursing home patients will make it very difficult to fund capital works.
Mr Ireland from Aged Care Australia told the Committee that:
We would want to make a particular point about the capital crisis…We believe that it may be possible over two decades for the capital framework by government to provide a funding stream: it `may' be possible. However, the funding processes and mechanisms are totally inadequate in the short term, both for those that have met accreditation and for the 300 facilities that scored less than 65, and particularly also for those that get nothing, because they have not been certified. [2]
Despite Departmental assurances that concerns about viability are `not substantiated by the facts' [3] the Democrats have grave concerns about the future viability of residential aged care facilities in this country. With a shortfall in capital funding for aged care facilities estimated to be close to $1 billion and a rapidly aging population it is vital that the Government find a way to provide the aged care sector with a funding source which is sustainable and continuing.
The TriCare submission makes a valid point when it states that:
There is no doubt that the future viability of the aged care industry will continue to rest in the hands of the Federal Government upon whom it is almost totally dependent for income. [4]
The future of uncertified homes and the residents of those homes
The Democrats are not convinced that the $20 million the Government has set aside to assist nursing homes and hostels which need to restructure as a result of failing to meet certification standards will be sufficient. Clearly, for many of these facilities it will be difficult to access the required capital for restructuring while they are unable to raise funds through accommodation charges or subsidies for concessional residents.
Where facilities are eventually forced to close, the Democrats urge the Government to ensure that the rights and needs of residents living in those facilities are given top priority.
Concern over equality of access and treatment
The Democrats support the suggestion that the adequacy of concessional quotas be regularly and carefully reviewed to ensure justice and equity for all elderly Australians is being achieved.
Senator John Woodley
Australian Democrats Senator for Queensland
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Footnotes
[1] Ms Davies, Transcript of Evidence, p.3.
[2] Mr Ireland, Transcript of Evidence, p.11.
[3] Department of Health and Family Services, Submission, p.12.
[4] TriCare, Submission, p.7.