NSW Budget: Some welcome initiatives but inadequate investment to prevent community crisis points

Hand cradling paper figures

Jan Barham MLC, Greens NSW spokesperson on Housing, Homelessness, and Family and Community Services has warned that the latest NSW Budget continues to fall short in preventing key pressures on communities across the state.

“The NSW Government has again failed to adequately invest in addressing the key challenges in our society, including pervasive housing stress and alarming rates of risk to children and young people, to promote wellbeing and improve the long-term social and economic outlook,” Ms Barham said.

“Ahead of the Budget the Government announced $560 million in new funding for community services over four years, including $170 million on efforts to reduce the number of children entering care.

“While this appears to be a long-overdue step toward investing in prevention and family preservation, the budget papers show that overall funding for targeted earlier intervention isn’t increasing. The sad reality remains that the major budget increase in supporting vulnerable children comes from the 1,100 more children and young people than expected entering out of home care.

“Until there is a genuine boost to genuine early intervention services, including universal supports and targeted interventions for families with risk factors for abuse and neglect, we won’t see the cycle broken. The Government can invest now to prevent the crisis or face continued growth in demand for crisis interventions.

“Fewer households were supported in social housing in 15/16 than forecast, revised down from 142,000 to 140,700 households. Even fewer households are expected to be supported in social housing in 2016/17, despite the waiting list for social housing being higher than it has ever been sitting at 60,000 households.”

“The budget for maintenance and repair of Aboriginal Housing dwellings has been cut, down from $28.4 million in 2015/16 to $15 million in 16/17. Considering the huge improvements made to people’s lives and health from repairing rundown homes, this is disappointing and could cost the health budget in the long run.”

“These cuts come as stamp duty revenues of $8.88 billion have smashed forecasts, highlighting how the NSW Government continues to rely on speculative investment in property to balance its budgets, which only makes housing more unaffordable”, said Ms Barham.

For further comment, please contact Jan Barham directly on 0447 853 891

Opinion Article – Community expects high quality aged care

Traffic warning sign - frail or older people

This article was originally written and published on World Elder Abuse Awareness Day, 15 June 2016

Aged care policy has changed a lot in the past 20 years. But what about care quality? Many in the industry would argue that it has improved, but what about people living in nursing homes? Would they agree?

Back in 1997, the Howard Government removed a requirement for nursing home operators to account for the funding they received and specifically show how much was spent on staffing. While the system wasn’t perfect, it implemented some accountability into a model where private operators receive public money to provide care to a vulnerable and generally voiceless group of people.

Since then, we have seen a substantial decline in registered nurses working in nursing homes and a substantial increase in lower skilled and lower paid personal care workers. Latest data show that registered nurse numbers are actually lower than what they were in 2003, despite there being 40,000 more high-needs residents in the aged care system. If care need has risen since 2003, why are there fewer registered nurses?

The nursing home industry has admitted that it stands to profit when it reduces the number of registered nurses, whose high-level skills and professional judgement come at a price. RNs have slowly been replaced by lesser-skilled Enrolled Nurses and Assistants in Nursing. The upshot is that we have nursing homes full of high-needs older people but fewer skilled people on the floor to look after them.

There are many homes that do a fantastic job caring for people. There are also homes that don’t. The problem with the current system of regulation is that it’s hard to tell the difference – 95% of homes are fully accredited with no mark against their name.

As repeated examples have shown, accreditation doesn’t equal good care. In 2010, a woman died in an accredited NSW nursing home because she fell from her bed and strangled herself on a bed pole. There were 45 residents in the home at the time but only one care worker rostered on to do the entire nightshift, with another worker on cleaning duties. The woman wasn’t discovered in time to be saved. The Coroner investigating the case found that one care worker to 45 residents was insufficient, even if it satisfied legislative requirements.

This is not an isolated case. Monash University and the Victorian Institute of Forensic Medicine released a report in 2015 that found over 100 Victorian nursing home residents die prematurely each year from preventable causes.

Most of the residents studied died from falls, but choking, being given the wrong medication and assault from other residents comprised the remaining deaths.

The report barely got noticed. What would be the public’s reaction if these figures applied to childcare centres?

Just because someone is old doesn’t mean their life doesn’t matter.

According to the latest Aged Care Financing Authority report, the average nursing home is making a profit of just over $9,000 per resident per annum. The top 25% of homes are making twice that. The 2014 Living Longer Living Better reforms are broadly expected to have injected billions into the industry as it opened up accommodation pricing allowing providers to charge more for the nursing home rooms.

Government, and the public, need to recognise that nursing home residents are more than just numbers on a profit ledger.

It is World Elder Abuse Awareness Day today, and I believe we need to reform regulation of aged care to protect our vulnerable older citizens. An obvious place to start is implementing minimum staffing requirements. A NSW Parliamentary Inquiry I chaired last year found that facilities looking after residents with high needs should have at least one registered nurse on duty at all times. Unfortunately, the NSW Government looks to be removing the last piece of regulation in the country that implements such a requirement.

Older people recently identified health as their number one concern when deciding who to vote for in this upcoming election. Yet, neither Labor nor Liberal has committed to reforming aged care regulation to improve care quality.

The community expects high quality care, particularly for older, vulnerable people. Aged care policy needs reform so that we can actually achieve what the community expects and show that we as a community value older people’s lives.