Interview - Dr Mukesh Haikerwal, AMA Vice President, Radio 3AK , Mornings - Lack of aged care facilities

CLEARY: Well, dear me, can we believe The Herald Sun this morning when it says that desperate Victorian families fed up with caring for elderly relatives are leaving them in hospitals in a trend dubbed granny dumping?

State Health Minister Bronwyn Pike says the problem is contributing to 500 elderly people in hospitals waiting for nursing home places. People dumping the elderly, their parents I suppose, in hospitals because they can't look after them. Is this the case? Dr Mukesh Haikerwal, from the AMA, is going to tell us whether that's true or not.

How are you, Doctor?

HAIKERWAL: Hi. Good morning, Phil. How are you going?

CLEARY: Good, thanks.

HAIKERWAL: That's good. Yeah, look, the concerns, of course, are that the available facilities for older people are getting more difficult to come by. We have a policy, which is very reasonable, for people to stay at home as long as they can with all the supports that they can get. And those supports are there, but they're limited, and so we're finding that more and more people are staying at home with less and less available support.

And people are relying on their family to come in and there's a limit to which families can actually come in and help and make things work. And at the end of the line they have to try and organise for them to go into some kind of residential care and the waiting list for that is quite extraordinary in some parts of town.

CLEARY: Well, why is that the case? I mean, health is regarded as one of the-- the number one ticket issue for people, so why are we in this parlous state?

HAIKERWAL: Well, I mean, there are a variety of problems. But, as far as the care of the elderly is concerned, we've had a problem, that the number of available aged care beds has not really kept pace with the demand.

You know we have a health-- sorry, a Minister for Ageing federally, who's actually very good and on the ball, but the problem is that his hands are kind of tied on how much he can allow to happen. And that's a problem, because, you know, it's not a particularly vote winner at this stage, but it's going to be a major problem in the future. And the last thing--

CLEARY: Well, does it afflict the rich in the same way as it afflicts the poor?

HAIKERWAL: Look, it afflicts everyone, because the number of beds just aren't there full stop, and, you know, the amount of contribution that's required varies depending on people's pockets. So no matter who you are, if you're looking for a federally supported aged care bed, there is a huge demand and a shortfall in supply.

CLEARY: Well, does the AMA, of which you are the Federal Vice-President, have a policy or a strategy which advises governments of impending problems of this kind?

HAIKERWAL: Look, certainly, we're very engaged with government at all levels, state and federal, and also at a ministerial level, state and federal. And our engagement is around making sure that there is access, first of all, to medical care for older folk when they're still at home, and if they do actually get into residential aged care facilities that there is access to care there as well.

And also we've made-- at the last Federal Election there was-- one of the few health issues that got raised was the issue of the lack of aged care beds, which is around 5,000 short in Victoria alone because-- well, based on the Government's own benchmarks.

CLEARY: Have we-- have we-- yes. Have we reached a point where people are less likely to look after their own parents?

HAIKERWAL: It's not so much whether they're less likely to look after them; they try and they try hard and they try long and hard and put in many hours doing that. It's just that it becomes impossible to maintain somebody who's older, with multiple medical problems, possibly dementia, at home safely on a 24-hour basis. And--

CLEARY: Did we have more people, though, looking after people at home in the past?

HAIKERWAL: We have an awful lot of people looking after their relatives at home and that continues to be the case. What we're finding is--

CLEARY: Well, has it changed at all?

HAIKERWAL: It's probably increased because there is a much greater trend for people to be cared for in their own homes in the community.

CLEARY: Is that right, is it?

HAIKERWAL: Yeah, absolutely. And, you know, what we're finding is, because people are staying around longer and living a better life, that they are staying at home longer. Their own spouses may well be doing a lot of that care, but it just becomes too arduous to do after a certain level of the disability sets in.

And, you know, there are help-- there is help available from councils and via the home community services and so on, but at the end of the day they do eventually need to move on to a retirement facility, you know an aged care facility. And that's often seen as being a defeat, ...

CLEARY: Yeah.

HAIKERWAL: ... and I think it's not a defeat, it's actually quite a reasonable thing. Because there comes a time when people need more help and more care and they should demand it and they should expect it.

CLEARY: Yes indeed, Doctor. Just one second, we're going to take a call. We've got Margaret from Prahran.

How are you, Margaret?

CALLER: Oh, Phil, this is a very passionate subject of mine; I've had lots of visits to nursing homes and hospitals and my mother died six years ago.

CLEARY: Mm.

CALLER: And I observed that-- it was a private hospital, she was fully privately insured, ...

CLEARY: Sure.

CALLER: ...and I got the impression that the nurses weren't interested in geriatrics.

CLEARY: Really?

CALLER: And yet she was covered by private health insurance.

CLEARY: Mm. Mm.

CALLER: And I said, "Look, she's got the highest private insurance, why isn't she in that private room over there?". And they said, "Oh"-- and she was in a little hole of a room, a shared room one minute and not shared the other, and they said, "Oh, they're booked".

CLEARY: Mm.

CALLER: And then-- and then--

CLEARY: How did that affect you, Margaret?

CALLER: Pardon?

CLEARY: How were you affected by that?

CALLER: Because, I think, basically it was a lack of communication: what we understand that our parents deserve ...

CLEARY: Yes.

CALLER: ... and what they are taught ...

CLEARY: Mm.

CALLER: ... to put up with, the laws and regulations. And we weren't given an alternative. And when my mother did go to a nursing home, I observed they're only moved about twice a day. And I thought, 'Now, why can't that happen at home?'. And then they take their bells from them.

CLEARY: Mm.

CALLER: They're not allowed-- you know, it's just ridiculous. What they say is care ...

CLEARY: Yes.

CALLER: ... and what I mean by care are about six different things.

CLEARY: Sure. Margaret, just hang on, I'll take Dr Mukesh Haikerwal, AMA Federal Vice-President.

Doctor, how do you respond to Margaret?

HAIKERWAL: Well, there are a couple of issues, or three issues really, that Margaret raised. One was the issue of a private hospital stay for older people. And it's certainly an issue that we've been-- we've raised in the public quite high-- and highlighted, because there was a time when it was more difficult to get into a private hospital if you were older or had multiple problems. We believe that problem is less of an issue.

However the private health funds still only pay a limited amount, no matter how high your private insurance is, on a given episode. So if somebody's in hospital more than a couple of weeks, they end up not getting the same level of cover. And, unfortunately, people who are older or people who are in hospital longer, a private hospital or wherever, tend to get ignored. And that's a real problem and we need to make sure there is awareness.

CLEARY: But Margaret's point about geriatrics is an interesting one. Have we-- have-- do we have a society that's less concerned about the aged?

HAIKERWAL: I don't feel society's less concerned about it, I just think that the governmental direction isn't really into putting money into that area.

CLEARY: Well, how can that be ...

HAIKERWAL: cope with her, 'til eventually she was moved to a hospital, a public hospital. And I tell you what: the care that the girls at the public hospital are giving my Mum is fantastic. But the Government is not interested. It is high-level quality care and quantity. And a lot of the places that he said that are sixty-bed residences; tell me how two staff, daily, can look after sixty residents with high-level care.

CLEARY: Mm.

CALLER: It is impossible. It is impossible. If the hospitals have the girls, the nurses, on eight-hour shifts and you see five or six there only with, say, fifteen or twenty people, then tell me how two people can look after sixty residents.

CLEARY: Tell me, Doctor, what's the answer?

HAIKERWAL: Yeah. Well, this is a major issue. I mean, to actually get staff to work in aged care facilities is a problem.

CLEARY: Mm.

HAIKERWAL: They get paid 20 or 30% less than in hospitals. The responsibility--

CLEARY: Well, that's outrageous, isn't it?

HAIKERWAL: Yes, absolutely.

CLEARY: I mean, what is wrong with the society that we have those sorts of ...

HAIKERWAL: Yep.

CLEARY: ... pay rates?

HAIKERWAL: We don't value our older people and we don't value care for older people.

CLEARY: Well, that's what I was asking you earlier.

HAIKERWAL: And I believe that that's a paradigm we have to change. And we're certainly trying to work with all of the organisations responsible for the care of the elderly and their carers to raise this as being a major calamity here. Yeah, we've got to make sure that the older folk are respected, are cared for, are valued, and their carers need that attention too.

CLEARY: Okay. Dr Mukesh Haikerwal, AMA Federal Vice-President, I'd loved to have talked to you with-- about Medicare with you, Doctor, ...

HAIKERWAL: Any time.

Ends