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Component Under the CAM/SAM Funding Arrangement, the Situation PRIVATE NURSING HOMES 290 COUNCIL Wednesday, 8 April 1992 component under the CAM/SAM funding would achieve the best economies of scale that are arrangement, the situation will worsen. needed to survive. It is important that the Minister convey not only the It is an important issue. We welcome the Minister's text of this debate to the Federal government, but commitment to support the motion. She almost that she adopts a high public profile in trying to embraced it in its entirety, and it seemed to us that force the Federal government to confront the issue. It she did, but she then backed off a little when we simply is not good enough for Minister Staples to were suggesting that there ought to be a capacity for say that this is only about putting more money in the those who are able to make a contribution to their pockets of private operators. We have clearly own care to do so. established that that is not the issue. In fact, there is no profit in the running of private nursing home The Minister did not embrace that measure beds at the moment. They are running at a enthusiastically but did not suggest why she was not substantial loss and, inevitably, that must have an embracing it. It is standard practice now in hostel impact on the standard of care because it defies accommodation. It does not create difficulties; it economics and good business management that one enables that sector to operate more effectively and simply cannot continue to operate at a loss, and the achieve equity. figures substantiate that fact when one considers the number of private nursing homes in receivership or I do not believe frail, aged people who may be quite being scrutinised by independent accountants. wealthy should be charged only seven-i?ighths of the pension and attract a public subsidy for the balance It is quite possible that one or two homes find of that cost of the care. It does not occur if they themselves in difficulty because of poor require hostel care and it should not occur, and this management - that is the nature of business - but country cannot afford to have it occur for those frail that does not explain why 25 per cent are in financial aged people requiring nursing home care. difficulty when there is a guaranteed income. I am pleased to receive the Minister's assurance that That is the crux. The problem goes across the the present government is considering the matter. It spectrum. Large, medium and small nursing homes has been embraced by the Federal coalition and will are going under and, as Mrs Tehan suggests, it is be implemented after the next Federal election, if, in happening both in the country and in the city. fact, the present Federal government does not embrace it in the meantime. It is only one way of It is important to recognise that CAM/SAM funding providing some relief, but it is important. was developed on the notion of a minimum of 30 beds and a maximum of 60 beds. I might say that My final point concerns the role the State can play. that is a contradiction in terms, as one of the social The Minister herself referred to this point in the policies is to try to develop a home-like standards and monitoring role that the State environment. Those involved in the area know that government has embraced. With the it can be done if one is starting with a greenfield site Commonwealth embracing responsibility for of a 6O-bed nursing home which, as I understand it monitoring care, there is no role for the State from the practitioners, is an optimum. That size government in that area. provides the advantage of economies of scale but avoids the problems of institutionalisation and the It is leading to a duplication, and while the Minister additional costs that accrue for institutionalisation in talked about adopting a cooperative approach, the large institutions. experience on the ground among those trying to make it work is that it is not a cooperative approach. It can be done if one is starting from a greenfields It is, in fact, creating conflict because different site, but one of the real difficulties that the private standards are being embraced by the State and sector has been experiencing, and one of the Commonwealth governments. In fact, a number of difficulties that certainly will confront the public proprietors have said to me that in trying to build a sector, is that we are not starting with greenfield new nursing home it is impOSSible to meet the sites. Many of the centres are operating in old and standards that both governments lay down. The inappropriate buildings that do not lend themselves financial mess the government has created in this to restructuring to allow for a sufficient number of State leads us to embrace the view that the State beds that would meet the relevant standards, which ought to withdraw. would allow for good management and which CRIMES (BLOOD SAMPLES) (CLARIFICATION) BILL Wednesday, 8 April 1992 COUNCIL 291 We are not so embarrassed by such resources that addressed urgently. When one takes into account we can afford the duplication. It makes for poor Victoria's peculiar situation with numbers and the management and makes it difficult for the industry impact of CAM/SAM it will be disastrous if no to prosper. The State can play a role in providing support is provided for the private nursing home minimal relief by eliminating that level of system in Victoria. duplication and leaving the setting and monitoring of standards entirely to the Commonwealth. Although I acknowledge the Minister has accepted the motion I urge her to be pro-active in her meeting I finish as I commenced: it is an important issue and with the Federal Minister next week. The National one that will be of ongoing concern for a number of Association of Nursing Homes and Private years unless the Commonwealth government moves Hospitals has expressed its concern but Minister quickly. I commend Mrs Tehan for introducing the Staples in his comments last year did not hold out motion, and I certainly commend the motion to the much hope. House. Even though the government has looked at the Hon. M. T. TEHAN (Central Highlands) - In motion positively and favourably I urge the reply, as Mr Knowles finished his remarks on the Minister, rather than taking a transcript of the basis that this is an important motion, I am pleased position agreed to by the House today, to spell out that it has the support of the entire House. chapter and verse to Minister Staples the catastrophic situation. This situation can be averted The results of the motion will not be addressed or if the Minister takes a pro-active role when she implemented immediately, but unless action is taken reports the sentiments of the House to those who immediately and urgently we will have a major can do something about the situation. problem. I appreciate the comments the Minister made about I was delighted with the contribution of Mrs Varty, public sector nursing homes, an issue we have who clearly explained, in particular, that Victoria is debated previously. In the Minister's contribution to primarily affected by the problem, and, although I the debate she elucidated some of the facts and am delighted that the Minster has seen fit to support figures associated with the cost burden Victoria is the motion, I point out that she must be pro-active carrying because of the large number of public because of the situation in which Victoria finds itself. hospital beds. She gave figures on the subsidies for Victorian State nursing homes being $48.50 higher As Mrs Varty pointed out, while across Australia the than any other State and that is another reason I CAM/SAM formula has been seen to be beneficial believe she will be able to speak with commibnent for 66 per cent of nursing homes, those nursing and, dare I say, with passion at the appropriate time. homes in Victoria, primarily because they are smaller, are adversely affected by the formula. Her I commend the motion. I am pleased that it will be figures show that 85 per cent have been worse off carried with the support of the whole of the House. under the CAM/SAM arrangements post-1987. Many problems have been addressed today and I look forward to the implementation of the motion. It is imperative that the urgency of the motion for Victoria is brought to the attention of the Motion agreed to. Commonwealth Minister, and I am delighted that the Minister has supported the role of private CRIMES (BLOOD SAMPLES) nursing homes in Victoria and recognised the (CLARIFICATION) BILL problems we have pointed out and is obviously concerned at what the consequences could be. She Second reading did raise the question of whether it was precisely 8000 hospital nursing home beds in the private Debate resumed from 20 November 1991; motion sector that would go under, and I had used that of Hon. B. A. CHAMBERLAIN (Western). figure. There are more than 8500 nursing home beds in the private nursing home sector. Although I am Hon. M. A. LYSTER (Minister for Health) - The delighted with the Minister's support, we cannot government has examined the proposals that afford to jeopardise those beds. As Mr Knowles Mr Chamberlain put to the House and it will not accurately pointed out currently 25 per cent of those support the Bill for the following reason: the beds are in jeopardy and that problem must be government introduced procedures for CRIMES (BLOOD SAMPLES) (CLARIFICATION) BILL 292 COUNCIL Wednesday, 8 April 1992 court-ordered blood samples in 1989, as meet the concerns of civil libertarian groups and he Mr Chamberlain will recall because he was a vital shortened the sunset clause to ensure that those contributor to that debate.
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