Lisa Chesters (Bendigo, Australian Labor Party) Share this | Hansard source

I am glad to see this bill come forward so we can try to work through some of the issues that many are facing in the aged-care space, whether they be families of older Australians, whether they be older Australians themselves, whether they be any of our not-for-profits providing aged-care services. There have been issues with the implementation of the Living Longer Living Better package since it was first introduced. Reform in this space needs to be continuous and ongoing to ensure that we do get the best possible model for our older Australians.

Close to $7.5 billion is allocated to the Commonwealth-funded Home Care Packages across the forward estimates. Home Care Packages allow our older Australians to receive aged-care services in their own home and community. It was a significant part of Labor's Living Longer Living Better package of reforms. In the legislation that we have before us, the first and the second stages are about ensuring that the Home Care Packages would follow the consumer and enable the consumer, or the person with the package, to choose and to change their provider. It is one of the critical things that is needed. I always feel a bit uncomfortable to refer to people seeking these packages as 'consumers'. Yes, technically, there is that element to it, but there is a level of care and support that goes into what a lot of this work is.

I thought it would be important to highlight some of the challenges that we have had in Central Victoria and the intersection of this new reform before us—the package about Commonwealth-funded Home Care Packages—with some of our local government areas in regional Victoria. In my own area, our councils still deliver their own HACC services, as they are called in Victoria. They receive block grants from our state government. There was some confusion among families when these packages first rolled out over whether they would be better to stay with the council service, which they could qualify for if they reached a certain criteria, or whether they should switch into the Commonwealth-funded service. A lot of families spoke about how confusing it was between which option they should take. That, I guess, is one of the great challenges when you roll out such a bold new reform and try to transition. I hope that some of the lessons we are learning through this process can be applied to the NDIS as it rolls out in our area. I am sure that some of those challenges will come up in that space, as well.

Some of our providers, like our councils, are quite nervous about the impact these reforms would have on their own client base. At one stage, it looked like they were going to outsource—contract out—their HACC services because they believed they would not be able to attract enough clients to keep the service viable. And they are not the only council area in Victoria that have gone through that challenge. I have two other Victorian council areas in my electorate, and they, as well, are having this debate as we speak. At this stage, they are keeping them in house and rolling them over.

It is incredibly nerve-racking and stressful for the clients—the people that are seeking these services. They want to know the person coming in their door every day. Whether it be for low-level support, such as helping with the cleaning, doing the gardening or providing their meals, or whether it be for more high-level support, such as assistance with showering and support in some of the most personal ways, the person seeking the care wants to know the person coming in. It is a very intimate and close relationship that they have. They want to know that the person, the aged-care worker who is coming in, is someone that they trust. They are opening up their home to this person. A lot of concern that came through the HACC debate in the City of Greater Bendigo was on: who will be my carer? Who will be my aged-care worker if this work is outsourced? I will touch on that a bit later—that is, with any system, we need to make sure that we have an element of funding and support for workforce development to ensure that we get the very best working in this sector so that our older Australians and their families do have that peace of mind and security.

The other issue with the HACC services was about the level of service. Once you apply a cost price to something, that worker is then under stress. They only have 15 minutes or 20 minutes. They do not have the time to sit down and have a cup of tea or share a story. We need to ensure that within this system and this package that we are funding that opportunity for the person to genuinely engage. The language we have about 'consumer' is just so transactionary. We have to remember that these are people and that people are social creatures. It is important that we do allow time for the very basics—not just, 'Hello. Good morning. I'll see you tomorrow,' but a chance to really engage and understand and support one another.

Some of the other issues that came up in the very early stages of the rollout of the package were complaints from BDAC, Bendigo & District Aboriginal Co-operative. They said that a number of their clients, the people that they know who had been signed up to these packages, had actually lost 60 per cent of their package in administration fees. There was not proper education; there was not proper engagement. So they went through the process of renegotiating a fairer package on behalf of a number of their clients. I believe that the reforms before us today will help clean that up, streamline it and make it easier for people to, if they do believe that the package they are getting is not delivering the quality of care, move to a new provider.

To lose 60 per cent of your package in administration fees just demonstrates how it is not always a fair market and you do not always have good providers in this space. You do have some providers out there who will look to make money, and we need to make sure there is integrity in the system so somebody can move to a new service if they do not believe that they are getting the quality that they deserve.

Advocate Ruth Hosking has met with me several times to talk about the delays in getting these packages processed. Those waiting for residential care packages, she mentioned, need to provide Centrelink with an asset and income statement every six months. However, it is often longer than six months to wait for a residential aged-care bed, so this is another challenge that we have within the aged-care space. Ruth is incredibly passionate about ensuring that these documents are easy for people to fill in and that, if you fill one in and it is valid for six months, you can have some surety that your claim will be processed within six months. You do not have to complete a new form as you are required to do every six months. This means that families think they have done all the paperwork with regard to their application only to be told once they get a place that their asset and income assessment is out of date.

Aged-care advocate Ruth Hosking has regularly told my office that this paperwork is overly complex, confusing and stressful for older people, and I do believe that that is one of the reasons why we need to continue to look at, reform and make this space as practical and easy as possible, ensuring those integrities are in place so that people do not get, as I mentioned earlier, tricked like BDAC and lose 60 per cent of their package in administration fees.

Some of the other issues that have been raised with me include the greater demand for home-care packages. There has been some great demand for them, and people have been told that there are none available in their area, particularly for people who live in regional areas where there are smaller towns and they may not have a provider or only have one provider in that space. Denise has been waiting for a package since 2014 and her situation has been made worse because she lives in Woodend, where there is only one provider. This bill will help change that. Another example is in Heathcote and, while Heathcote Health has not been allocated any packages, they have been subcontracted by Bendigo Health to deliver these packages in Heathcote. So there is that tussle that has occurred between Bendigo and Heathcote Health about how many packages they can have in Heathcote. These changes, again, will help relieve some of that tension and help address that situation.

People who have signed up for home-care packages are not always aware of how much it would cost. I have mentioned the example of BDAC. Another example is someone who signed up to a home-care package at level 1 and received five visits for cleaning for 1.5 hours per visit and two hours for gardening maintenance. Despite the minimal service, the customer was charged $29 per day for the 63 days they were on the package, totalling $1,700. Their complaint was that they were not aware that they would still have to pay $29 every day even though they did not get support every day. Again, education and understanding for older Australians and their families helps them know exactly what they are signing up for. It is always tricky when you introduce a market into a space which is about quality and care, and it is important that people have the information and know who to go to if they do not believe that they are being treated appropriately.

The final things I wish to touch on are workforce and workforce issues. Aged are is one of the lowest paid sectors in Australia and has a very high turnover. People who stay in the industry a lot time tend to work for the employers, businesses, not-for-profit organisations or councils that have been around and involved in a service for a while. They tend to have the higher pay and conditions. My fear is that we need to do everything we can to ensure that those providers stay in the system. My fear with any kind of market driven, consumer driven care system is that it could be a race to the bottom and we would see good-quality providers undercut by those who do not offer the same quality of care and support for our older Australians.

The wages are too low. This is a sector where they rely heavily on penalty rates, yet some of the providers have said to me that they are not compensated for those Sunday penalty rates. I have had some people raise with me that they cannot get someone to come out on a public holiday for their father or their mother, because the providers are not willing to pay the penalty rates. It is really sad that it is because of people's rates of pay that this service is denied. So we need to make sure there is enough money in the package to pay people's minimum entitlements.

These are not workers who are earning a million dollars. They are not even earning anywhere close to decent wages. They are people earning the basics, the minimum income in this country. They are on very low wages. They love their work. They will tell you when you meet with them that they do not do it for the money; they do it for the work, for the people, that there is a love and a care that they have. But they still should be properly rewarded for the work that they do. That is why it is so disappointing that this government when it was first elected cut $1.8 billion from the aged-care sector. That had largely been towards the development of the workforce, whether it be through professional development, extra funding for training to continue to skill up the workforce or workforce pay supplements.

We need to do more if we are going to have quality aged-are providers that have quality, well-paid staff. We do not want to see a race to the bottom in this sector. We want to make sure people working in this industry have good, secure jobs so that we can ensure that any of those providers who do want to cut corners are cut out of the industry.

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