Karen McNamara (Dobell, Liberal Party) Share this | Hansard source

I rise to support the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. The government's home care reforms have been designed with the intention to create an aged-care system that supports senior Australians with greater flexibility and choice. The New South Wales Central Coast is a popular sea change destination for retirees and, coupled with an existing ageing population, there is a recognised need to ensure appropriate infrastructure services and facilities are available and sufficient to meet the growing demand. According to the 2011 census, the Central Coast had over 78,000 residents over the age of 65, a full quarter of the total Central Coast population, with this projected to increase by a further 18.5 per cent, to around 93,000 by the year 2021.

Ageing in our population is something that we should be proud of, because it points to the successes of increasing life expectancy, greater access to quality health care and medical technology, and improved living standards, to name a few. Realistically, we are redefining what it means to be 'older' more than ever, and the senior residents in our communities are maintaining healthy and active lifestyles. They are vibrant and socially engaged and continue to enjoy a full life well into their later years. Of course, it means that there are opportunities and challenges to take into account to ensure that, as the number of ageing Australians increases, they are still continuing to enjoy the active and fulfilled life that they desire and deserve.

With their natural freedoms and desire to lead active social lives, older Australians are also seeking greater flexibility in terms of support services. The home care reforms are a key element to making this happen by supporting seniors' access to the services that they require. This government is ensuring that Australians are able to freely make informed choices about their care. These reforms will strengthen the aged-care system to ensure it remains competitive, of high quality and at the forefront of innovation through increased competition.

The reforms were announced through the government's 2015-16 budget as the Increasing Choice in Home Care measure. The Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016 gives effect to the first stage of the announced reforms and is an important step towards an aged-care system that is more consumer driven and market based and less regulated. These reforms will dramatically impact the way senior Australians have access to home care services which are based on the current consumer-driven care approach.

There are two stages to the delivery and implementation of reforms to the aged-care sector. This bill creates provision for funding for home care packages to follow the consumer. What this essentially means is that the consumer—that is, the senior Australian receiving home care—will have more choice and greater flexibility in deciding on their provider.

This bill amends the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 in three main areas. Firstly, the funding allocated to a consumer for a home package will follow them, instead of places being allocated to providers to service a particular area or location, as is the current system. Secondly, there will be a consistent national approach to prioritising access to home care packages through My Aged Care, which is the government entry point or gateway to the aged-care system. Thirdly, there will be a reduction in red tape associated with the approval process for providers under the Aged Care Act 1997, which will provide an incentive for new providers to enter the home care market, in turn facilitating greater choice for consumers. This does not, however, change the fact that providers still need to demonstrate their suitability to become an approved provider and meet quality standards.

The reality is that, while Australia has a world-class aged-care system that is well respected and provides high-quality services to a diverse population, the demands of our ageing population are changing. In the Productivity Commission's Caring for older Australians report in 2011, the commission noted:

Older Australians … did not want to be passive recipients of services, dependent on funded providers. Rather, they wanted to be independent and be able to choose where they live, which provider they would use, the way in which services are delivered … There is strong empirical evidence that consumer choice improves wellbeing, including higher life satisfaction, greater life expectancy, independence and better continuity of care.

We as a government are committed to ensuring that the system embraces and accommodates changes necessary to truly empower consumers to make decision about their own care.

The current home care system has a number of weaknesses, and one identified is that at present there is limited choice and flexibility for consumer in the home care system, including a lack of portability, since the funding is attached to the provider, not the consumer. In particular, it was recognised that the baby boomers are nearing older ages. For instance, in Dobell 11.8 per cent of the residents, or 16,280 people, are aged between 55 and 64 and many in the coming years will increasingly rely on aged-care services. The baby boomers are a different generation to the one preceding them, with different economic, social and cultural attitudes, expectations and lifestyles.

The government recognises the need to keep in step with these changing goalposts in delivering aged-care services, especially in the area of home care, as senior Australians increasingly want to stay in their own homes for as long as possible and prefer to engage services that assist them in doing so. The Productivity Commission's report in 2011 identified that a lack of timely access to care and limited choices available to senior Australians were an issue.

Under the current arrangements for home care, once a consumer has been assessed and approved as eligible for a home-care package, they have to source an approved provider with an available package that suitably meets their identified needs. Choices are limited because providers can only accept new consumers if they have not exceeded their allocation of places. In speaking with home-care providers in Dobell, I note this issue has been reiterated as an ongoing obstacle in the provision of services to consumers. There are four levels of home-care packages for consumers, ranging from basic at level 1 to high care at level 4. I am advised that there are little to no levels 3 and 4 available on the Central Coast at present. So, when a consumer is assessed and approved for home care, they need to find a provider that has a place available at the level of care that they have been approved for. If they happen to be assessed at a level 3 or level 4, it is an unfortunate reality at present that it is difficult for the consumer to get the care that they have been approved for, due to the lack of available places. More often than not, it requires them to be placed on a waiting list until such time as a place becomes available. Likewise, if an existing consumer has been receiving care at a level 1 or 2 but reaches the stage, particularly through illness or injury, where they are relocated to level 3 or 4, unfortunately, they likely have no option but to go on a waiting list until a place becomes available, either with their existing provider or, if transition is possible, with another provider.

The government's aged-care and home-care reforms address this situation. Providers in Dobell have expressed great optimism for the changes, citing a number of benefits, particularly in increasing the number of clients that they can take on and the fact that they will no longer be limited by the number of packages that they have been allocated to deliver. By attaching the funding to the consumer, providers are now able to service the actual number of clients they have the capacity to manage. They will be able to offer the delivery of home-care packages at any level to consumers without the need for places to become available. They are also enthusiastic that the changes will drive the quality of service delivery because consumers will have the freedom to vote with their feet. If they are unsatisfied with services offered by a provider or if the chosen provider does not adequately suit their needs, the consumer will now have the flexibility to move to a more suitable provider.

These reforms represent real and positive change for senior residents as well as service providers in Dobell. They present an opportunity for growth in the aged-care services sector. In turn, this will provide more jobs and better services across the board, driving forward the quality of delivery to meet the needs of senior Australians and facilitating their increased quality of life and greater freedom and independence. The aged-care services sector will, as a result of these reforms, transition into a more competitive, market-driven environment and will be consumer focused, which not only benefits the consumer in terms of the quality of service delivery but also opens up a world of opportunity for providers to expand their business to meet the demand without being constricted by the number of places that they are allocated. It will provide more surety for consumers in having the freedom to relocate, knowing that they will have continuity of care and access to a range of quality service providers who are able to meet their needs.

The government recognises that, in order to provide the best options and flexibility in home care, it is necessary for the funds allocated to the consumer to move with the consumer, enforcing the concept that the home-care package belongs to the consumer. Adssi is a not-for-profit organisation on the Central Coast that provides outstanding aged-care services to the community from low care to care for the frail aged, the disabled or those living with dementia. They offer a holistic approach to care, and, like many existing service providers, are excited about the opportunity these reforms represent and are embracing the opportunity to grow. Adssi have over 8,000 clients between the Hunter, Central Coast and northern Sydney regions. They are currently allocated 75 home-care packages. Adssi pride themselves on concentrating on the goals and needs of each individual client, believing that having a person centred approach is key to quality service delivery. They believe cultural change is empowering for the local community, and, even though the competitive market will open up in terms of service delivery, it has given them an opportunity to look at their whole business model and identify possibilities in terms of growth and change in the way things are done.

Just as Adssi provide quality services in the aged-care sector, the government is ensuring that any newly approved private provider will be required to demonstrate they are capable and suitable to provide home-care services and meet quality service delivery standards. The current process and criteria for becoming an approved provider are considered outdated and inefficient. There have been no substantial changes to the suitability criteria since 1997—almost 20 years ago. Feedback submitted by various stakeholders expressed the concern that there is too much focus on personnel, who may change over time, rather than the capability of the organisation as a whole to provide care services. Potential providers are also required to go through separate processes to gain approval as a provider for home care and residential care, despite significant overlap in the types of details required under both applications. This has created an onerous red-tape process in becoming an approved provider and a disincentive for entering the aged-care service provision market in the first instance. Providers will still need to be approved by the department under the act in order to provide subsidised home care, but the process for becoming an approved provider will be simplified. All approved providers will be required to meet the home-care standards and will be subject to independent quality reviews.

These reforms provide senior Australians greater choice in who provides their care and establish a consistent national approach to prioritise access to care through My Aged Care. The prioritisation process takes into account the relative needs and circumstances of individual consumers, which are determined through the comprehensive assessment undertaken by an aged-care assessment team at the time a person was waiting for care. But, overall, these changes demonstrate the government's commitment to reducing regulatory burdens and increasing choices for Australians. The government is strongly committed to working closely with the aged-care sector in preparing these reforms, and the changes are widely supported.

I am looking forward to Dobell's senior residents having the opportunity to choose their care providers and service delivery after February 2017. I commend the Minister for Aged Care and all the government agencies and departments, organisations, groups, committees, businesses and individuals who have contributed to the formulation of these outstanding reforms. These consumer-driven home care reforms are a momentous achievement for our senior Australian and the organisations that provide their home care services. I commend this bill to the House.

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