Tuesday 4th October 2016
The quality of life of chronically disabled people with life-threatening illnesses will quickly decline once state-run disability services are privatised.
Privatisation will profoundly affect current and future clients of Summer Hill Accommodation and Respite Centre in Sydney, the People’s Inquiry into Privatisation has heard.
The centre is run by the state-owned Ageing, Disability and Home Care service (ADHC), which the government is breaking up and putting out to tender.
Developmental disability nurse Gary Dunne told the inquiry Summer Hill clients all have difficult-to-manage conditions, including epilepsy and major respiratory problems, and require tracheostomies, gastrostomies, in-dwelling catheters and ventilation.
Clients come from around the state and only the most urgent cases which meet these criteria of “complex health” are accepted.
“Our clients are the most fragile and frail and need 24-hour care by experienced registered nurses. They cannot be placed elsewhere because other services cannot take them,” said Gary, secretary of the union’s ADHC Metro South branch.
The state government says its ADHC disability services will no longer be needed because clients will be able to access funds to purchase services under the National Disability Insurance Scheme (NDIS).
Government ignores parents’ pleas
The government has rejected pleas by Summer Hill centre parents and friends to maintain the centre as a safety net for the most seriously disabled.
“Everything is up for sale – there will be no exceptions,” Gary said.
“The sell-off will create a totally different financial structure around how we operate.
“Under NDIS each client will have an annual grant and Summer Hill will charge clients an annual fee. My unit’s entire operation will have to be paid for from the fees paid by our 10 clients.
“Those fees will have to cover not only clients’ accommodation and nursing but also other services on site, from the linen service and oxygen and medical supplies to cleaners, outdoor staff, clerical staff, nursing education and building and equipment maintenance.
“Currently some of these services and costs are met by the department and shared widely. Our clinical nurse educator, occupational therapist and physio are all based on site but cover a region from the inner city to Liverpool.
“Our physiotherapist, for example, spends a couple of hours each morning doing chest physio with our most frail residents before heading out to see cases elsewhere in the region.
“Once we are privatised and broken up there is no way that fee income is going to be able to pay for a physio to be on site every morning.
“We will have to use someone from a private physio service and they have proven to be unreliable.”
Even more pressure on public hospitals
Gary said a privatised service would have to cut costs to meet a reduced budget and this would include replacing registered nurses with assistant nurses or residential support workers.
“An RN can easily replace a trachie tube or gastrostomy tube, but if the skill mix is changed to save money, the plan will say ‘Call an Ambulance’ thereby putting more demand on the hospital system.
“Complex epilepsy management and quality palliative care will also become problematic and the quality of life of our clients will quickly decline.”
He said staff were concerned not only for current clients but also the “unplaceable” young people on the Summer Hill waiting list.
“They are currently in a nursing home, or non-medical environment, or home with ageing parents and need a level of care that their NDIS package cannot meet or no other current services can meet.
“As a ‘short term’ solution a nursing home will take the young person and their NDIS package and tick all the boxes – and there they will stay forever.
“My members and I aren’t coming at this from a political perspective. Our agreed position is based on what currently works and currently provides quality care and support for our clients, and what the consequences of applying a different funding model to those services will inevitably be.
“We believe the state has a basic responsibility to provide a safety net for the community – for those who, for whatever reason, cannot get the service they need from existing non-government sources.
“A society is judged by how it cares for its most vulnerable, and we believe NSW is failing in its primary responsibility by totally walking away from front-line disability services.”
Gary Dunne gave the privatisation inquiry examples of how the Summer Hill centre had changed the lives of two young people.
“We admitted a teenage lad from a non-medical group home who was not expected to live and was receiving palliative care.
“We applied better epilepsy management, a better feeding regime, physio, and taught him to cough rather than frequent suctioning. As a result, he is now able to go out to an activity centre every day.
“A woman in her twenties is another admission from a nursing home. She had not been outside the nursing home in over a year – it was no life at all. She is now thriving and going out almost every day.
She now dresses in fluoro rather than the old lady’s garb she used to wear”.