Ian Gilfillan: Australian Democrats in the SA Parliament

	Extract from Hansard Legislative Council 5 April 2001

Ian Gilfillan Australian Democrats Member of the Legislative Council		Parliament Index 2001 Autumn Sitting Index Browse by Subject Search all Democrats material About the SA Parliament Hansard on line

The Hon. IAN GILFILLAN: I seek leave to make a brief explanation before asking the Minister for the Ageing a question regarding fall prevention home assessments.

The Hon. IAN GILFILLAN: Falls are the leading cause of injury-related death and morbidity in older people. In 1997, there were 985 deaths in people over 65 years and 32 000 injuries resulting from falls, and that consequently takes up a very high percentage-42 per cent-of all bed days occupied by persons over 65 years.

Fall prevention is one of four immediate priorities specified in the draft national injury prevention action plan. There are many aspects to an effective strategy for the prevention of fall-related injury in older people. Aspects of an holistic approach to reducing fall-related trauma in older people would incorporate ensuring a safe home environment (for example, grab rails, non-slip floors, good lighting), maintaining individual's muscle strength and bone density, encouraging appropriate medication management, and promoting regular eye checks.

Funding by the Department of Human Services to the Make it Safe program has provided a one-off home fall prevention assessment for people over 55 years of age at a cost of $125 per assessment. That was the total cost of all aspects of the service delivery, that is, program administration and management, home safety assessment, client reports, program promotion and a $30 subsidy. This service has provided 1 200 home visits per annum, benefiting over 2 000 clients at a total program cost of $150 000.

The removal of funding by the Department of Human Services to Injury Prevention SA's Make it Safe program was effective as of 1 January 2001. Advice by the minister and by the Director for Statewide Services (Brendan Kearney) said that fall assessment services to clients over 55 years of age will be provided by domiciliary care.

In January this year, metropolitan domiciliary care agencies advised that they were not aware that domiciliary care was to provide fall assessments for people over 55 years of age, nor did they have any formal agreements with the Department of Human Services. On 15 March, domiciliary care Gawler requested details of the Department of Human Services advice that it was responsible for fall prevention home assessments because the service was not aware of it. On 19 March, domiciliary care Western and Southern Region advised that an arrangement was still being discussed and that no service contract had been agreed.

Injury Prevention SA has a central administration, it is highly regarded among the health and aged care sector and it has demonstrated performance. It services the metropolitan and surrounding metropolitan areas, and it has shown that it can provide service and training to regional areas of the state, with very short wait times. If this service is to be transferred to domiciliary care, and since this transfer was done at the end of last year, my questions to the minister are:

1. How many in-home fall prevention assessments have been carried out by domiciliary care since December 2000?

2. How many in-home fall prevention assessments have been carried out by domiciliary care for people over 55 years of age with no long-term health problems since December 2000?

3. What is the waiting time for in- home fall prevention assessment for people over 55 years of age with no long-term health problems in:

(e) In particular, non-metropolitan areas, that is, rural and regional domiciliary care areas?

4. What is the target number of households to be assessed for fall prevention in the year 2001-02?

5. How has the information that domiciliary care services will now be providing preventive in-home fall assessment been communicated to the domiciliary care services themselves, because they appear to be totally ignorant of it, and to the people most affected by this change, that is, healthy people over 55?

The Hon. R.D. LAWSON (Minister for the Ageing: The honourable member asked a series of questions about the number of assessments and particulars of waiting times and so on, matters of an administrative nature which I simply do not carry in my head; nor do I have any information available in the chamber to enable me to give an immediate response. I will obtain that information and bring back specific responses in relation to those matters as soon as possible. The honourable member described the services provided by Injury Prevention SA under the former Make it Safe Program, and I think it ought be said that the view about the effectiveness of the program being conducted by Injury Prevention SA and questions about whether those funds were most effectively devoted through that organisation are open to very serious question.

The honourable member used the expression `demonstrated performance' in relation to Injury Prevention SA. I would not want my silence in response to that to be taken as assent to the proposition, because, as I understand it, there were very serious concerns about the effectiveness of the program that was being undertaken. I am very familiar with the services provided by the various domiciliary care services around the metropolitan area and through hospitals and health services in country regions, and I have every confidence that domiciliary care workers and staff will be able to provide the assessment service adequately, appropriately and efficiently. They are in touch with local communities and I am sure that the transfer of investment from Injury Prevention SA to the Domiciliary Care Service will be a very wise investment indeed. However, as I say, I will bring back more detailed responses in due course.