The Howard Government has done much to change the $3.9 billion nursing home industry in Australia. This week saw the end of a 14-month accreditation period for federally funded nursing homes. The theory was that unless nursing homes met standards they would not get federal funding and presumably would be driven out. The result would be higher standards of care. The Government also did more to ensure that the cost of aged care is not borne solely by the taxpayer if the aged person had assets and income that could be used to help contribute to their own care. Before 1996 it seemed that the cost of nursing homes for the aged was getting out of hand with the aging population. Further, the standard of homes was not being effectively monitored. Something had to be done.
At the end of the 14-month accreditation period all but one of the 2950 nursing homes had been given accreditation and therefore funding. It sounds too good to be true. Surely, there were more bad homes in that number?
Labor has argued that in fact there are a score of nursing homes with what it says are “”appalling” standards of care. These are the ones that have been given an extension of six months to meet the new standards. But the trouble with rigid enforcement of the accreditation process is that some old people would be severely disadvantaged. Early last year when the Minister for Aged Care, Bronwyn Bishop, closed a nursing home after allegations of treatment in kerosene baths and other poor treatment, the patients at the home suffered badly, requiring disruptive relocation. It seems she has learnt her lesson. The extension of time is not ideal given that the homes are presumably running below standard now, but it is better than abrupt withdrawal of funding and closure of the homes, putting old people and nursing-home workers on the street. The decision has rightly been supported by the Council on the Ageing. True, the homes have already had 14 months’ notice to get up to standard, but some more time is warranted when the overall picture is looked at. In the past three years, while the Government was putting pressure on the homes to meet standards and pressure on older people to help pay for care, 190 homes either closed or relocated. It indicates a weeding out of homes which will never made the grade. The 20 given an extension have taken action since their reports which indicates they are on track to meet the standard. Moreover, about $800 million has been spent by Australian nursing homes to improve facilities.
The upshot of the whole program must be improved care. More money is coming into the homes, particularly for capital works, which was not coming in under Labor. And the whole program is not a bottomless pit for taxpayers.
But there is more to be done. A more effective complaints mechanism must be put in place. It is no good relying on state-based health-complaints systems if nursing homes have to met federal standards. The trouble at present is that the Aged Care Commissioner does not have a wide enough jurisdiction. The Aged Care Act should give the commissioner more power to act of complaints, to decide if they are one-off or systemic and if the latter to put the home through further accreditation procedures with the ultimate sanction of withdrawal of funding and shutting down. And the Government must also watch whether greater private-sector influence will result in nursing homes moving away from poor towns and suburbs into the wealthier areas of the capital cities.
There have been several reports of bad treatment in the past year, including the kerosene-bath scandal. But they have to be put in perspective. They are isolated cases in a generally good system.
It is inevitable that the first accreditation process would result in the unearthing of a certain amount of poor practice. But at least there is now a system in place to keep pressure on the nursing homes to perform. Given that 135,000 elderly Australians live in these homes that is of crucial importance.
The uncovering of a certain amount of failure to meet standards is evidence that a system is in place to weed it out. Hitherto, few knew what was happening in nursing homes. After this accreditation period elderly people can be more confident their interests are being attended to.