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The human rights of older Australians in the bush: Chris Sidoti

Rights Rights and Freedoms

The human rights of older
Australians in the bush

Speech by Chris Sidoti, Human
Rights Commissioner at Harnessing the wisdom - Harvesting the gains
- Rural Ageing Seminar, Bungaree Station, 1 November 1999

I am very pleased
to be here tonight at the Rural Ageing Seminar dinner. Thank you, to Dame
Roma and the Rural Ageing Seminar Reference Group, for inviting me to
attend an event that (for once) takes place where it counts - in rural
South Australia.

'Harnessing the wisdom
and harvesting the gains'. - What an appropriate and moving title for
a seminar!

It not only speaks
to the farming roots of rural Australia, but also points out so clearly
the active role which older persons have played and continue to play.
When Kofi Annan, the United Nations Secretary-General, launched this year
as the International Year of Older Persons, he said

A society
for all ages is multigenerational. It is not fragmented, with youths,
adults and older persons going their separate ways. Rather it is age-inclusive,
with different generations recognizing - and acting upon - their commonality
of interest

I hope that the seminar
will provide an opportunity for reflection on the great contributions
made to rural Australia by the older people, rather than concentrating
solely on the many difficult and sometimes overwhelming challenges which
face the ageing rural population.

Having said that,
I would be misrepresenting the people of rural Australia if I did not
focus on some of the problems facing the bush, and older people in the
bush in particular. Indeed all Australians need to recognise the challenges
facing rural Australia if we are to hold our heads up as a truly inclusive
and fair society, one which respects the contribution of all generations.

As part of our Bush
Talks
program over the last 18 months, rural Australians have been
telling us loud and clear about their human rights concerns. Tonight I
think it is appropriate to mention some of these concerns, focusing especially
on issues relevant to ageing that were raised in the talks. I will also
describe a few initiatives which the Commission is undertaking to address
the human rights problems facing older Australians.

Bush Talks

Over the past 18
months I have travelled to around 50 communities in all States and Territories
from large regional cities like Cairns and Bunbury to small towns like
Bourke and Peterborough, to remote communities like Boulia, Papunya and
Yuendumu. My travels in regional, rural and remote Australia have been
part of the Human Rights Commission's Bush Talks program. We set
out at the beginning of 1998 to learn about the human rights concerns
of people outside the capital cities.

I am sure that none
of you will be surprised to hear that many communities in country Australia
we spoke to are under siege: they have declining populations, declining
incomes, declining services and a declining quality of life.

In the words of a
woman from a small town in NSW

As we head
for the year 2000 my greatest concern is for the viability of small rural
towns which are slowly being obliterated by loss of services, institutions
and medical care ... We all need to fight this insidious process or there
will be only ghost towns where busy and fruitful communities once flourished.

Dying country towns
become places of loneliness for older people. Once families of many generations
lived in these towns, supporting and caring for each other. Grandparents
helped with babies and young children and in turn were looked after in
their later years by their children and grandchildren. But whole generations
of families have left. Older people, who have retired, don't need to leave
to find work and don't want to leave town where they've lived most, perhaps
all, of their lives. So they stay to struggle on, with little or no family
support, as their needs and years increase. There is a great and increasing
gap between need and service in almost every area of life.

Health care

Country Australians
are profoundly concerned about the availability of health care within
their communities. This concern was one of two issues raised with us in
every centre we have visited. The other was education.

There is no doubt
that these concerns about health care are well founded. The general health
of country Australians is poor in comparison to urban Australians. Country
Australians have a lower life expectancy, higher rates of avoidable injury,
higher suicide rates and higher rates of illnesses such as heart disease
and cancer.

Despite the greater
need, the availability of health services is considerably less in rural
areas than in urban. For example, 30% of the population lives in the bush
- but only 16% of Australia's doctors.1 The number of medical
specialists is substantially lower, especially in small rural centres
and remote areas, compared to metropolitan centres.2

A lack of health
services impacts greatly on the health of older rural Australians. This
is especially so where the aged and those with chronic diseases are over-represented,
for example in many country towns. The health needs of these people may
be difficult to meet because they often are unable to travel great distances
to seek the care that they need. They may also be poorer than many other
sections of the population and unable to fund themselves for private health
care or to move to a town with greater services.

This means that it
is more critical that they have access to GPs who bulk bill. Yet in some
towns we visited not one GP would bulk bill, in some instances
not even for health care card holders.

One man from Mudgee,
NSW told us how all the medical centres in town had refused to bulk bill
and how his wife had been turned away for a regular prescription for heart
medicine because she could not pay for the consultation, even though she
offered to pay on next pension day. And the pattern is inconsistent. Travelling
across north west NSW, for example, I found that all doctors in Bourke,
Brewarrina and Walgett bulk bill but not a single doctor among the 12
in nearby Moree, by far the largest town in the region. Though inconsistent
from town to town, the pattern is replicated throughout country Australia,
in all states and territories.

Residential aged
care

Besides access to
regular health services, many frail older people need to receive specialist
attention in residential care. According to the Australian Institute of
Health and Welfare, large rural centres and metropolitan centres have
supplies of nursing home beds which exceed 400 per 100,000 persons aged
70 and over. However this supply drops sharply in rural and remote areas,
by a third to less than half the rate of nursing home beds in capital
cities.3

Yet older people
in rural and remote areas can have the greatest need for residential care
because they have no family in the town any more to support them at home
and because home care services are stretched to the limit where they exist.

Bush Talks
heard from several rural and remote communities without adequate aged
care facilities. For example, in Tennant Creek we were told that the aged
care home only had 20 beds where there is a need for almost double that
number. Elderly people are being sent to Alice Springs because the nursing
home is unable to care for them. This is unsatisfactory as it forces people
to move outside their family and community support structures.4

In one town in north
western NSW Bush Talks was told, 'you have to leave town to
die'
.

Elderly people whose
home care situations break down for some reason may find that the only
place to go is the local hospital. This can put pressure on a rural hospital
and staff who may not be trained to provide aged care. One submission
to Bush Talks from Bateman's Bay outlined how this affects treatment
of elderly people in care:

Some rural
hospitals, which do not have extended care facilities, view themselves
as acute institutions only, providing "acute" care to Medical and Surgical
and Maternity cases and do not tolerate well the care of the disabled
and frail aged who often need to be in their care for extended periods
of time while they await the availability of full-time care in an appropriate
Nursing Home. I have been told that 'These people waiting for Nursing
Home are "bedblockers" and we have to get them out'.

It is distressing
to hear of frail older people being viewed only as burdens within the
health system.

Some communities
also raised with us the lack of culturally appropriate facilities for
older Indigenous people. For example, in Alice Springs we were told that

every single
strategy and every single approach taken to aged care issues is developed
by Europeans, and is virtually useless in this particular region.5

Other areas of need

A decline in health
care and residential care services is compounded by the lack of other
essential services in some rural and remote areas.

In particular the
lack of transport in small rural centres means that it can be difficult
for elderly people to maintain an independent lifestyle or to remain in
their home town at all. In Victoria we were told that

Public transport
is almost non-existent in country areas. The government does have some
transport schemes in place but if you have an elderly person or a person
with a disability who needs to come in for a doctor's appointment, they
may have 70km to come and no transport to get here.6

Banking is another
service which, as you are all aware, has declined in many rural areas
over the last few years.

In Bush Talks
we heard that 45 shires across Western Australia have no direct access
to a bank branch. The combined population of those shires is over 89,000
people.7 The closure of a bank has a marked affect on a local
community. When a bank closes it costs the local community an estimated
$350 per person per month as people transfer their shopping to their banking
town. From 1993 to 1998, 481 non-metropolitan bank branches shut, with
the loss of about 10,000 jobs.8 And the closures are continuing,
with at least one of the four major banks about the start a new program
of closures.

You can imagine the
effect on a frail older person when a local bank closes. If transport
is virtually non-existent and the person is unable to drive, access to
essential banking services is not merely inconvenient - it is impossible.

And it is not only
getting to the bank, but also finding a person to serve you when you do
get there! With the increased use of Automatic Teller Machines, people
in country areas are forced at times to rely on a machine without a teller
being available to answer questions or even explain how to withdraw money
from your own account.

As more and more
services become automated and electronically delivered, certain sections
of the rural community may be increasingly blocked from accessing essential
services. Older people will be among those most affected.

E-commerce inquiry

The Human Rights
and Equal Opportunity Commission recently launched a national inquiry
into the accessibility of electronic commerce and information technologies
for older Australians and people with a disability.

Through broad consultation
the inquiry will identify barriers to equal access and current best practice
for using technology to reduce barriers to equal participation by these
groups.

At the launch of
the inquiry, Professor Alice Tay, President of the Commission, pointed
out that information technology has the dual potential to disadvantage
and marginalise those who "miss the technology bus" and to benefit and
enfranchise those who catch it.

This is even more
true in rural and remote areas than anywhere else in Australia. Information
technology promises to solve some of the problems of isolation and distance.
At the same time, however, it can marginalise some sections of the community,
such as older people, and seriously disadvantage them in accessing vital
information.

ATMs may reduce costs
for the banks, yet on-the-street banking rarely favours those who require
wheelchair access, those who are visually impaired, or indeed anyone who
feels particularly vulnerable to robbery.

Telephone banking
and information services are far from convenient for someone with hearing
difficulties or cognitive disabilities and can deprive the isolated of
important social contact.

E-mail and the Internet
demand a whole new set of skills, which can be extremely daunting if you
haven't grown up with them.

New technology continues
to enter every realm of our private lives, and at an increasingly rapid
rate.

For instance, last
year virtually every second Australian household had a home computer,
and one in five households had Internet access.

There are financial
incentives too: an over-the-counter bank transaction costs an average
$2.50 to $3.50, but only $1.00 to $1.50 at an ATM, and a mere 12 cents
by Internet.

Literacy in new information
technology must be extended urgently to all sections of society. The alternative
is a yawning gap between information rich and information poor, with most
older people in the poor group. The inquiry will go some way to developing
strategies to ensure equal access.

To a certain extent,
those older people who live in a rural area, and especially a remote area,
expect to have reduced access to a full range of services. There is an
element of choice in deciding where to live.

Still, it is false
to argue that people should up and leave a farm or a town where they were
born and have worked all their lives, or in the case of indigenous people
where their traditional land and people are, just to get the basic essentials
for life. Regardless of where you live, all Australians should have access
to essential facilities. We have an obligation to ensure that access to
these services is equitable across Australia.

International Year
of Older Persons

This year, the International
Year of Older Persons, is the appropriate time for governments of Australia
to recognise that all older Australians, whether in the bush or the cities,
possess the right to an adequate standard of health care and other basic
essentials for life.

Of course, not all
older people in the country are frail aged or in need of specialist health
services or aged care. Part of the problem lies in defining 'older' people.
I suspect that I am considered very 'much' older by many people in the
population, and definitely so by my children, but my needs understandably
are completely different from a frail elderly person. To say 'older Australians'
should not deny the differences of experience and health among older people.
Large numbers of self employed people on farms are working or actively
involved in their communities. Large numbers of older people are in fact
carers of older or younger people themselves. I am sure that in rural
communities, where people have been used to surviving in isolation, there
are even greater numbers of older carers.

It is important to
explode the perception that all older people are inactive, dependent and
unable to accept change. Rather, older Australians should be celebrated
for their independence, not only for the contributions they have made
but for those they continue to make to society and the economy. Just because
people may need some special consideration at times does not mean that
they should be judged as incapable simply because they are old.

The Commission receives
a number of complaints of age discrimination from older people, mainly
in relation to employment issues. These complaints reveal that many older
people can continue to work and want to work but they are discriminated
against because employers and governments fail to recognise their individual
talents and skills, and instead stereotype them as unable to learn or
as redundant. Simply because they are over 65 or 55 or, dare I say, 40
years of age.

Earlier this year,
as its contribution to the International Year of Older Persons, the Commission
published a discussion paper on age discrimination entitled Age matters?,
to invite debate on age discrimination experienced by both old and young.
Some of the issues raised include access to technology, transport, health
care and of course employment. We will be reporting on the findings to
the federal Attorney-General and Parliament reminding them of Australia's
international obligations to ensure non-discrimination on the grounds
of age. I am sure there are many of you here today who feel that you would
like to be judged on your merits rather than your age. I certainly do.

Positive initiatives

I have covered many
issues here tonight. There is no doubt that many older people, especially
in rural and remote areas, are missing out on health services, face discrimination
and stereotyping, and have been excluded from much of the recent technological
change. Certainly supporting older people in rural Australia is about
looking at a range of solutions to these problems, whether health programs,
information services or ensuring legal protection against discrimination.
But as I said at the beginning, I did not want to leave you tonight with
an utterly negative picture of the problems facing older Australians in
the country. Because that is by no means the 'whole picture'. In Bush
Talks
we met many individuals and groups actively involved in their
communities and supporting others more disadvantaged in their communities.
There are also many good initiatives - based in local communities - which
look creatively at solutions to problems such as declining health.

One example we have
come across is in the Aboriginal community in Nyirrpi, Northern Territory.
Health professionals were not working effectively with local Aboriginal
communities to alleviate some health problems among women such as poor
nutrition, cancer and sexually transmitted diseases. In the Grandmothers'
Women's Health Program older women work with health professionals in creating
awareness about health problems and solutions by sharing their knowledge
about women's health business and their knowledge about family and the
law and by teaching the women about their law and culture. As one woman
said,

Before we
had the Grandmothers Program the old ladies just sat around all day. The
women played cards. The young girls didn't have anything interesting to
do.

This sort of program
is a good example of harnessing wisdom. It encourages close cooperation
between generations and uses, in a practical way, the experience of older
people to assist the young.

Another example I
have come across in recent weeks is the VISE program - Volunteers for
Isolated Students Education, an organisation which provides educational
assistance to children in the outback through a volunteer program. VISE
maintains a database of trained teachers, mostly retired, who are able
to go and stay with isolated families or communities for a minimum of
six weeks to assist young students with their education. It is a wonderful
example of how the talents of retired people can be utilised to assist
disadvantaged children.

These programs are
inspiring to us all.

Although the Commission
is able to respond in some ways to the human rights needs of older Australians,
our consultations have shown us that country Australians themselves are
working continually to develop innovative solutions to the challenges
they face. I trust that Australia will harness their wisdom and reap the
harvest of their experience and commitment.

Endnotes

1 Northern
Daily Leader, 26 July 1997, page 1 cited in Australian Catholic Social
Welfare Commission, Valuing rural communities (1998) page 12.
2 Australian Institute of Health and Welfare, Health in
rural and remote Australia
(AGPS, 1998) page viii.
3 Australian Institute of Health and Welfare, ibid, page 92.
4 Tennant Creek Bush Talks, NT, 6 October, 1998.
5 Alice Springs Bush Talks, NT, 5 October 1998.
6 Ballarat Bush Talks, Victoria, 20 November 1998.
7 Report of the Regional Financial Services Taskforce, 1997,
page 5.
8 Asa Wahlquist, 'Great Dividing Rage', The Weekend Australian,
26 September 1998.

Last
updated 1 December 2001

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