Dick Adams (Lyons, Australian Labor Party) Share this | Hansard source

These bills are very important and should pass. There should not be these hold-ups being mentioned by the member for Parkes; that is just playing games with this very important legislation. It should be passed in the parliament, and the opposition is frustrating that by bringing in amendments and saying they want to wait for reports out of the Senate—absolute nonsense! The whole aged-care industry of Australia is calling for these bills to be passed, and they should be.

We should not consider Australia's ageing population as a disadvantage to our country. As we are growing older we are living longer and with better health. By 2050 the proportion of people aged 65 and over is expected to increase from 13 to 23 per cent—from around three million to over eight million people. We have to start thinking differently about ageing. Australians can now expect to have an extended period of healthy, active retirement that we would never have thought about a few years ago.

Our challenge is to make sure that, as we live longer, we continue to lead happy, healthy, productive and connected lives. Older Australians have the energy, experience and wisdom to contribute to business, education and the community, and we need to be more creative in the ways we encourage and support these contributions.

Therefore, the Minister for Mental Health and Ageing, Mark Butler, has been going around communities, listening to their ideas and needs. I had a forum recently in my home town of Longford where about fifty people contributed their ideas and beliefs about ageing. These consultations were part of many all around Australia and, as a result, these bills are being put forward to implement quite a revolutionary aged-care package.

The bills relate to the Living Longer Living Better aged-care reform package, as was announced on 20 April 2012. The package encompasses a comprehensive ten-year plan to reshape aged care. The Aged Care (Living Longer Living Better) Bill 2013 is one of five bills amending the Aged Care Act 1997, and related legislation, to give effect to the Living Longer Living Better reforms. The legislative package comprises: the Australian Aged Care Quality Agency Bill 2013; the Australian Aged Care Quality Agency (Transitional Provisions) Bill 2013; the Aged Care (Bond Security) Amendment Bill 2013; and the Aged Care (Bond Security) Levy Amendment Bill 2013; as well as the Aged Care (Living Longer Living Better) Bill 2013.

The Aged Care (Living Longer Living Better) Bill 2013 implements reforms in four key areas: changes relating to residential care; changes to establish a new type of care, home care; changes relating to governance and administration; and changes that are minor, administrative or consequential. These bills: amend the Aged Care Act 1997 to remove the distinction between low-care and high-care residential care; provide for a means test combining income and assets tests, and annual and lifetime caps, on means-tested care fees; provide for a dementia supplement, veterans' mental health supplement and workforce supplement to be payable to providers who care for eligible care recipients; enable care recipients to choose the method by which they pay for accommodation, including by a fully-refundable lump sum, a rental-style periodic payment, or a combination of both; replace community care and some forms of care delivered in a person's home with home care; extend the Community Visitors Scheme to people in home care; appoint and provide for the functions of an Aged Care Pricing Commissioner, require the commissioner to prepare an annual report, and provide that an independent review of this package is undertaken and provided to the minister by 1 July 2017. The eight acts are to make consequential and technical amendments.

Through these bills we have established a new type of care, home care, to replace community care and certain types of flexible care currently delivered in the home. As part of these reforms, this government has already increased the number of home-care places, with over 5,800 additional places available just this year. This will continue to increase each year with the total allocation of home-care places rising from around 60,000 to almost 100,000 over the next five years. From 1 July 2013, four levels of home care will enable consumers to access the packages that best suit their needs.

In addition, there will be two new supplements: a dementia supplement and a veterans' supplement. These supplements will be available across all care levels for consumers whose care needs might be greater due to dementia and for veterans with mental health conditions who may also need greater support.

A new workforce supplement will also provide additional funding to eligible home-care providers so that the workforce can better meet the needs of consumers. The new supplement will mean more workers can access more appropriate pay and improved training and development.

The aged-care workplace will be better and it will be safer. We will seek to ensure that the increasing numbers of elderly people remaining in their homes are not socially isolated by extending the Community Visitors Scheme from residential care to home care as well—a great initiative.

I know that, in Lyons, Tasmanians have sent us a resounding message: that they want to age at home. But the need for residential care will continue to grow. To support this, from 1 July 2014 the different treatment for low-level and high-level residential care will be removed. There will only be one type of approval for permanent residential care. Anybody assessed as needing permanent residential care will be able to access any residential care service that meets his or her needs at the time of entry into care.

These approvals will not lapse, unless expressly time limited, so there will be fewer reassessments and it will be easier for consumers to access the care that they need—something that I think consumers are asking for constantly. These changes will mean continuity of service will be available from home care through to residential care. They will make it easier for people to move through the system. From 1 July 2013, all new home-care places allocated to providers are offered on a consumer directed care basis. From 1 July 2015, all new and pre-existing home-care places must be offered on this basis.

Consumer directed care is the future of aged care. This means that consumers will work with their home-care providers to choose the elements of care that best suit both their needs and their home-care package budget. This does not require legislation but will be a condition of the allocation of home-care places.

Secondly, care recipients and their families in residential care will be able to purchase additional amenities or supplementary care. Through these bills, we will continue to allow residential care places to be offered on a dedicated extra service basis, whereby an agreed set of extra services are paid for under one fee. Importantly, care recipients, whether or not they are in an extra service place, will also be able to opt in and opt out of additional amenities offered by the provider.

Thirdly, the bills change the arrangements relating to accommodation payments for residential care. For the first time, consumers will have real choice and real control. Approved providers will continue to be required to enter into an agreement with each care recipient in relation to accommodation payments. Importantly, care recipients who can afford to contribute to their accommodation costs will have real choice regarding how they pay for their accommodation. They will be given the choice to pay either a fully refundable deposit or a periodic payment, or a combination of both. They will also be able to draw down periodic payments from that refundable deposit.

In relation to home care, the bills will introduce new income-testing arrangements from 1 July 2014. All home-care recipients may be asked to pay a daily fee of up to 17.5 per cent of the single basic age pension amount, as is the case now.

In addition, those who can afford to may also be asked to pay an income-tested care fee. There is already an income-tested care fee in community care. The new arrangements will ensure consistency and will embed protections for consumers. While some home-care recipients will need to contribute more to the cost of their care through an income-tested care fee, safeguards are being introduced.

For example, no full-rate pensioner will pay an income-tested care fee; no care recipient will be asked to contribute more than the cost of their care; no care recipient's home or other assets will be included in assessing their capacity to pay an income-tested care fee for home care; and there will be both annual and lifetime caps on income-tested care fees.

Once a person reaches the applicable annual or lifetime cap, they will pay no more income-tested care fees. The annual cap in home care will be from $5,000 to $10,000, depending on the income of the person. The lifetime cap will be $60,000 and all caps will be indexed.

The Living Longer Living Better series of bills are historic and will allow a fundamental change in how aged-care recipients, workers and providers can develop a modern, fit-for-purpose aged-care system. These bills build the foundations for reforms now and in the future. They also give force to a major review, to be undertaken in 2016-17, to ensure these reforms meet and continue to meet the needs of Australians. This review will focus on measuring the effectiveness of the reforms and will determine further steps which can be taken to reduce supply controls and increase choice for consumers.

Overall, these bills build on the work of the Productivity Commission to begin a 10-year program of reform to improve Australia's aged-care system. So it is really important that these bills pass the House of Representatives and then go on to the Senate. They should not be held up by the opposition wanting to play politics—and that is what they are doing. There has been a lot of press today, asking everybody in the industry about this legislation. I did not read one article which said, 'No, we don't want these bills to pass.' I think it is really important that members on the other side of the parliament really put pressure on their shadow minister and tell him to stop playing politics and to get on with passing these bills. People want these changes.

The member for Parkes, who preceded me in this debate, took exception when I interjected during his speech. He was speaking about his own electorate and how there were some very good nursing homes, and I am sure there are. I am sure there is great care within them and I am sure their communities make great contributions. But so does mine and so do those in electorates of members all around the country. But you have to find ways to fund them. It is difficult to find ways to continue to fund regional areas when you have small centres with 40 to 50 beds.

The member for Parkes also referred to getting workers to work for very low wages. Nursing homes have very low income levels for people who are carers. It is difficult to get people in there. We have to endeavour to improve workplace issues such as those. It is no good trying to run away from them; they need to be focused on.

People want to stay in their homes. Home care will start to deliver more of that. I think that is critically important and it is what people have been asking for for a long time. We have to get developers to look at independent living units and to build units around the country for people to go from a three-bedroom house to a unit or a smaller centre. They need to do that. People want it and we need to make sure that that happens. I certainly hope we can pass these bills this week and I call on the opposition to get behind them and give them full support.

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