Northern Territory Second Reading Speeches

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PRIVATE HOSPITALS AND NURSING HOMES AMENDMENT BILL 2002

(This an uncorrected proof of the daily report. It is made available under the condition that it is recognised as such.)

Madam Speaker, I move that the bill be now read a second time.

The purpose of this bill is to amend the Private Hospitals and Nursing Homes Act primarily to bring a broader range of residential aged care facilities under the licensing scheme provided by the act. The bill also amends the name of the act, provides for more appropriate nursing care requirements, introduces a clear statement of the objectives of the act, allows for a body corporate incorporated under Commonwealth law to hold a license to operate a private hospital or nursing home, and removes the requirement for a short term replacement Matron to be approved by the Chief Health Officer.

The Private Hospitals and Nursing Homes Act was passed in 1981. It provides protection for the patients and residents at private hospitals and nursing homes by way of a licensing scheme and regular inspections. The proposed amendments are consistent with the recommendations of a national competition policy review of the act conducted on behalf of the Department of Health and Community Services. That review found that although there is a strong net benefit for the retention of a licensing scheme, several of the anti-competitive features of the act did not meet the stage two public interest test set down in the 1995 competition policy agreements.

There are currently seven licensed nursing homes operating in the Northern Territory housing approximately 266 residents. There are a further three facilities currently operating which can offer a mixture of high and low level care with a total of approximately 100 residents. These residential style facilities currently do not required a license under the act to operate.

There are three reasons to bring these facilities under the act. Firstly, with the introduction of the Commonwealth Aged Care Reforms in the Aged Care Act the philosophy of aging in place as been adopted by the Territory. In essence, this allows for residents of a low care facilities, formerly referred to as hostels, to remain in that facility even if their needs require high level or nursing home care. This has resulted in some former hostels caring for high care residents and former nursing homes catering for residents with low care needs. Secondly, because although the two broad classes of residential care facilities are in effect competing in the same market, one is competitively disadvantaged by the licensing requirements of the act. Thirdly and most importantly, because all senior Territorians who for whatever reason are no longer able to live independently deserve the fullest possible protection.

Accordingly, the most significant amendment in this bill is the substitution of the term ‘nursing home’ with the term ‘residential aged care facility.’ This new term will be defined as a facility which provides residential care within the meaning of the Commonwealth Aged Care Act. In effect, any such facility which is funded by the Commonwealth under the Aged Care Act will also be licensed by the Territory. This amendment will also ensure consistency with Commonwealth and industry terminology.

While this may seem to amount to duplication and regulation and unnecessary red tape, it should be remembered that Commonwealth regulation in this area focusses on funding matters. Under the Commonwealth legislation, it is possible for a residential aged care facility to go uninspected for up to three years. That this dual regulatory regime is in the best interests of the residents is recognised by the management of the residential aged care facilities affected by this bill who support its introduction. New inspection and licensing processes have been developed to ensure a complementary approach with the Commonwealth regulations.

Section 20(d) of the existing act places an onus on the manager of a private hospital or nursing home to ensure that a registered nurse is on duty at all times. This requirement may prove unduly onerous to facilities which provide a lower level of care to residents and ultimately lead to their closure. The amendments will allow for more appropriate levels of nursing care to be prescribed. This will operate on a tiered system, with the level of required nursing care increasing proportionately to the needs of residents.

The bill modifies the requirement to replace a matron of a private hospital or residential aged care facility with a person who has been approved by the Chief Health Officer. This requirement is overly bureaucratic and can result in delays in temporarily filling such a position with no demonstrable benefits. The bill provides instead that the replacement matron must be suitably qualified and that the name of the replacement must be provided to the Chief Health Officer within seven days.

The bill also introduces a requirement that a body corporate licensee be incorporated under the Commonwealth Corporations Act 2001 to replace the current provision requiring incorporation under Northern Territory law. This amendment reflects the recent referral by all states and territories of their corporations powers to the Commonwealth.

Finally, the bill introduces to the act a clear statement of its objectives: to protect the health and well-being of patients in private hospitals and residents of residential aged care facilities, and to provide community confidence by ensuring that those enterprises are operated only by suitably qualified persons or bodies.

The development of this bill has taken place in consultation with the Commonwealth, and regular updates have been provided to other jurisdictions through national aged care officials’ meetings. I understand that there is considerable interest in the model which this bill introduces and that it is being seen as a best-practice option by the Commonwealth and other jurisdictions, particularly given the unfortunate events which have been reported in aged care facilities elsewhere.

Madam Speaker, I commend the bill to honourable members.

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