At the June 2019 meeting of the Alliance, mention was made of a letter sent to Cameron Dick on the changes to the Retirement and Age Care Package of Brisbane City Council (BCC). This exchange of correspondence was suggested for inclusion on the SEQ Alliance website as an example of a letter (well researched and professional) and the response (as an example of an “inadequate” reply).

Dr John Mayze and Michael Wynne who are authors of the letter and they are happy for it to be put o the website for public access.

It is expected a further response will be made, in collaboration with Dr John Mayze, to the inadequate response by Christopher Aston (the response on behalf of Cameron Dick).

Ministerial correspondence on behalf of Ministers is of increasing concern when the key issues are almost dismissed without regard to the arguments and research being put forward.

Letter to Cameron Dick: retirement and aged care

The Honourable Cameron Dick
Minister for State Development Manufacturing, Infrastructure and Planning
PO Box 15009
CITY EAST QLD 4001
statedevelopment@ministerial.qld.gov.au

cc The Honourable Steven Miles Minister for Health
health@ministerialÆqldÆgovÆau

Dear Minister

Proposed Changes to the Brisbane Plan 2014: retirement and aged care

We write to you as retired medical specialists and a past professional in the planning area on the proposed changes to the Brisbane City Plan 2014 – retirement and aged care amendments package.

The Brisbane City Council recently sought public submissions on these proposed amendments and on 27 November the Council endorsed them. The proposed package has now been submitted to the Queensland Government for final review.

Along with a number of our professional colleagues, we made submissions during the public consultation period. We have concerns about how the matters raised in our submissions were addressed by the Brisbane City Council, and as such, we
contacted a Council town planner who suggested we raise our concerns with you.

The focus must be on best practice

We are concerned that the Brisbane City Council’s proposed changes to the Brisbane City Plan 2014 will not ensure our elderly are accommodated in best practice residential aged care designed with therapeutic benefits as a priority.

Extensive evidence shows that low-set, home-like, non-institutionalised environments with space to roam and gardens for therapeutic value, lead to better outcomes for the health and wellbeing of residents, especially those with dementia.

Our experience and knowledge concerning best practice for management of these patients indicates that the changes to building design included in the Aged Care Code will not deliver best practice.

A need to prioritise aged-care beds

The Council’s amendments package conflates “retirement living” with “aged care” rather than focusing on where the need lies which is the provision of residential aged care beds.

An expert panel within Queensland Health reported that the average wait in hospital for older patients who were ready for discharge but left waiting was 53 days, and the leading reason for this delay (71% of cases) was waiting for an aged care bed.

The Federal Government’s nationally agreed target is for one residential care place for every 12.8 people aged over 70 by 2020/21. The 2016 Census showed there were 475, 749 Queenslanders aged 70 and over which would equate to a target of
37,110 places. As at June 30 2017, Queensland had 36,616 operational residential care places.

Based on those figures, Queensland needs 494 new residential care places by 2020/21 particularly specialist care places for people with dementia or behaviour (disability, mobility, eating, incontinence, medication) requirements.

Further data underscore why all levels of governments must respond to the high-needs nature of people entering aged care:

* Almost 80% of people prefer to age in their own homes so the people who enter residential care (around 7%) are older with an average age of 83 years. Thesepeople require higher-needs care.

* Ninety-two (92%) of patients in these Aged Care Facilities are rated by aged-care providers as requiring High Care which results in the maximum payment from the Federal Government (taxpayers) to the organisations that run these facilities.

* Forty-two (42%) of these patients never receive a visitor in 12 months.

* Slightly less than 60% of patients have dementia and can no longer be cared for in the home environment. As a result of their dementia they are unable to communicate effectively and interact in a normal fashion with other people, so they cannot protect themselves.

Dementia is a mixture of brain disorders that affects thinking, behaviour and the ability to perform everyday tasks which results in brain function being affected enough to interfere with the person’s normal social interactions and working life.

Because a person has dementia it does not mean that they should be confined to their room and heavily medicated to keep them ‘out of sight” and “out of mind”. Many such people are still mobile and interested in what is going on around them.

These people can no longer fend and speak for themselves and as a result cannot make a submission like this to any level of government.

Because we are aware of these problems, we feel compelled to speak up for these frail and elderly patients especially as their needs are inadequately addressed in the proposed amendments as we outline below.

Shortcoming of the proposed amendments package

The Brisbane City Council’s proposed amendments package fails to enshrine best practice aged-care design in the City Plan. In its report in response to public submissions the Brisbane City Council also fails to explain why reasonable suggestions from submitters were ignored and why other positions were supported.

From our review of the proposed changes we believe that:
* There is a clear need to appropriately plan for future residential aged care -not retirement units – in Queensland.
* It is not appropriate to have the same planning code applied to both retirement living and aged care as high-needs residential aged-care must be fit for purpose
and differs markedly from retirement living.
* The design of such facilities must prioritise the health and welfare needs of the people using them over the needs of development proponents.
* The Brisbane City Council must base its decisions on evidence that can be understood and accepted by the community and must not be open to the perception that it is being politically expedient. This only serves to reduce the
trust of concerned members of the community in Government at all levels.
* There is a lack of evidence that those preparing the code have adequate healthcare expertise. To ensure that best practice is being applied it is recommended that the views of an independent third party with relevant healthcare expertise be sought prior to any State endorsement of the proposed amendments package.

With a Royal Commission due to commence next year, the aged-care sector is under intense scrutiny and any decision relating to aged-care development codes
that will profoundly impact the quality of accommodation provided to our elderly, must be approached with the same level of scrutiny.

Recommendation
I request that you do not endorse the proposed changes to the Brisbane Plan 2014 and that you meet with us, management from Brisbane City Council, and other experts from the medical profession to establish what changes need to be made to
the Brisbane City Council’s proposed amendments to the retirement living and aged care package.

Yours sincerely
Dr John Mayze, Dr Michael Wynne and Howard Briggs

Dated 11 December 2018

Minister Cameron Dick’s response (by delegation) is cursory

Despite the best intentions and the expertise being offered no meeting was agreed to and the response sound just like so many other pieces of ministerial correspondence. A follow up letter to mr Ashton is proposed but the response to date gives little to suggest the Minister is open to hearing views contrary to that of his Departmental planning officers.