Ann Sudmalis (Gilmore, Liberal Party) Share this | Hansard source

The inevitability of growing older means that as we see our friends and parents ageing we wonder if the system is up to the demands that will be part of our collective future. In 2011 the Productivity Commission report on caring for older Australians identified some key weaknesses of the system. These were that the system is a little difficult to navigate, that choices are limited for consumer services and that there are inconsistencies or inequities in pricing, subsidies and user co-contributions. We have a great record for caring for the aged, and the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016 is an extension of that ethic.

The policy changes that are introduced with the legislation are to address the reported weaknesses. Some were initiatives of the previous government, but we have developed those concepts in line with consultation processes, creating a system that is more in line with the Productivity Commission's recommendations. In January this year the government created a more independent and robust approach to complaints by transferring responsibility for the Aged Care Complaints Scheme from the Department of Health to the Aged Care Complaints Commissioner. The My Aged Care gateway has been established to be the one identifiable place to go for information and support in order to access aged care. This is now assisting people to find their way through the aged-care system and, despite some initial difficulties, is now undertaking assessments for those people who need low-level care at home.

The government has worked hard to address inconsistencies and apparent cost inequalities in the system in terms of the prices to be paid and the consumer contribution. One of the main considerations is that competition rather than regulation will be a catalyst for increasing innovation as well as better-quality services that are both sustainable and efficient. Naturally the government will maintain a central role in setting policy and in ensuring safety and compliance in aged-care services. Our aged-care system is the envy of many other nations. We must retain that quality, service, affordability and accountability. We are a diverse population and living much longer, mostly because we have a healthier lifestyle but certainly because we have a great healthcare system. However, as an ageing population in which there is to be a shift in the demographic prevalence of our older Australians, we really must make sure that our aged-care services work well into the future. Older Australians want more choice and control over the care they receive. That demand will only increase.

The government's home-care reforms, announced in last year's budget, place a priority on ensuring choice and flexibility for older people. In addition, the reforms will strengthen the aged-care system to provide high-quality and more innovative services through increased competition. There is a staged reform process; all good things take time. After February 2017, someone qualifying for a home-care package after being assessed will be able to direct government funding to the provider of their choice. A very important change that will be available is that the consumer will have the flexibility to change their provider if they need or want to, and if they move to another area or state they can take their package with them. Importantly, once the changes are introduced, the aged-care provider will not have to apply for care packages from the government. In addition, there will be a consistent national approach to prioritising access to care. This major policy change has received widespread support, and the implementation arrangements for these changes have been developed in close consultation with stakeholders, including the National Aged Care Alliance and groups representing consumers, carers and providers.

The second stage of home-care reform will further simplify the way services are delivered and funded and will commence from July 2018. After establishing the first stage, the government will, as has been clearly signalled, move to a single, integrated care-at-home package. Once again, the main theme is to enable greater choice for the consumer, exploring different funding and service delivery models, including activities that promote restorative care.

The integration of the Home Care Packages program and the Commonwealth Home Support program in the second stage will be informed by extensive consultations with stakeholders. This is an absolutely essential step. This was loudly demonstrated by many groups in Gilmore when the concept was first floated. There will be many individuals and groups, such as Meals on Wheels volunteers, who will need to be part of the build for stage 2. This bill implements stage 1 of the reforms and will amend the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 in three main areas. The first allows consumers to choose where to use the package with their provider of choice. Such a choice may also include the need for a provider to be culturally suitable. The package will be portable, including the utilisation of unspent funds, and approved providers will no longer have to apply through the Aged Care Approvals Round to receive home-care places. This reduction in red tape will also increase competition in the sector, allowing more consumer focused and innovative providers to expand their businesses to meet local demand and consumer expectations, including the needs of consumers with dementia and other special needs.

There will be a consistent national system for prioritising access to subsidised home care. Currently, waiting lists for packages are managed by individual providers. There can be significant variations in the waiting periods for such packages across Australia, with no systematic way of measuring or addressing that variation. Just recently a family came to me after four years of waiting for a package to be allocated to their older mum. They had a package before they moved to the local area. It took four years to get a new one. At the moment these packages are actually applied for and distributed by the providers. This change will make a difference to so many people.

Once these changes take effect, there will be a national system to manage eligible consumers' access to packages within My Aged Care. An effective national system is important to ensure that there is equitable access to care, as the total number of home care packages will continue to be capped in line with the aged-care planning ratio. A prioritisation process will take into account the relative needs and circumstances of consumers, determined by the comprehensive assessment undertaken by an aged care assessment team and the time that a person has been waiting for care. A consumer who has been assigned a package will be supported by the My Aged Care gateway with referrals to approved providers, but the consumer will be able to choose which provider delivers their care. There will be close monitoring of these new arrangements to ensure that all consumers, including people with special needs and those living in rural and regional areas, are able to access care in an equitable manner.

The final part of the proposed changes will mean that the red tape associated with providers being approved under the Aged Care Act 1997 will enable more providers to exist, giving a whole lot more choice. But they will still be required to show their suitability to become an approved provider. All approved providers will need to meet the home care standards and will be subject to independent quality reviews. The legislative criteria for assessing the suitability of a person to become an approved provider will be streamlined and made more contemporary.

Most of us would prefer to live our wise years in our own home—a location that is familiar and special. As I began my support for this bill, I also mentioned the aspect of caring for the aged that is so important to this government. Our older citizens need to be respected holistically. Getting great provider services is most definitely part of the responsibility we have, as is monitoring of the other aspects of being an older person.

Following the establishment of the Aged Care Complaints Commissioner, just this week Senator Brandis has released a report by the Australian Institute of Family Studies, which was commissioned by this government to conduct a scoping study of elder abuse in Australia. As a consequence of that report, the Attorney-General has now tasked the Australian Law Reform Commission to conduct an inquiry into laws and frameworks to safeguard older Australians from abuse. The government is, by such action, putting the respect and recognition of the human rights of the elderly fairly and squarely on the agenda for government attention.

Consumer choice is absolutely significant and essential as we go forward, but consumer protection is important, both socially and legally. There have been instances of potential elder abuse brought to my notice, and now we have the correct pathways to investigate how to improve the system and protect our elderly. Those abuses can range from physical abuse to legal abuse, where the power of attorney can be manipulated and older people, who are not aware of what is happening, can change their will. Different family members can change that. We need to have an avenue and a process where the rights of our older people, who may not be aware of those changes going on around them, are protected. Some of the cases that have been brought to my attention have already resulted in families becoming financially bereft and an older person not being in a position to go into care.

My government is taking the best, most appropriate and most relevant steps forward in these most important aspects of safeguarding and caring for older Australians. I am both proud and grateful to see these changes, for, after all, each of us is moving to that very same place, in our wise and mature years, as our senior friends and family. We all need to be respected and safe.

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