House debates

Monday, 15 October 2018

Bills

Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018; Second Reading

7:03 pm

Photo of Sharon BirdSharon Bird (Cunningham, Australian Labor Party) Share this | Hansard source

I would like to indicate, at the beginning, in speaking to these bills—recognising that we're dealing with two cognate bills—that I support the amendment that has been moved by the shadow minister, but I also indicate that I think, as many of my colleagues do, that, if that amendment is to not succeed, these bills need to be supported. That is because we are in a really critically important time for the aged-care sector. In my electorate, this is certainly one of the most pressing issues that I and my staff deal with on a regular basis.

These bills before us, the Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018, are enacting some of the recommendations of the Carnell-Paterson review of aged care. In particular, the first bill is establishing a new Aged Care Quality and Safety Commission, intended to be operational from 1 January 2019. That will bring together quality assurance and complaints procedures in the aged-care sector. That's obviously as a result of the review. It's a worthwhile thing to do.

But we do have some concerns about the aged-care sector, and I want to touch on those in general. First of all, I want to say that while this bill is definitely a move in the right direction and is a response to an important review it's now in the context of the agreement to establish a royal commission into aged care. There is no doubt in my mind that the royal commission will hear very significant and important evidence from across the nation and from all of our communities about some of the things that are a real challenge to us in looking after our elders as a nation. I commend the fact that that is to proceed.

Having said that, it is also critically important that the things we already know are not left to languish whilst the royal commission occurs. There are actions that government could take, such as the legislation before us today, that can be progressed in order to make sure that we provide better care, love and attention to the elders of our community. I don't think that anybody in our community would expect any less of us in this place. So, in that context, I want to talk about two particular areas where it's one thing to have a quality and complaints procedure but where we also need to get the other aspects of service delivery in place. One of them is around funding and delivery of services and the other is around workforce and providing for the future, given that we know this is a space where we'll need to not only improve quality and skills but increase staffing levels—the numbers of staff that will be required to do the job. Why this is so critically important, and why I think that so many of us on this side of the House wanted to speak on the bill, is that we've got elders in our communities, many of whom are living much longer and much healthier lives. They're active and participating in all sorts of activities, often now for decades after retirement. Certainly it's not something that our grandparents' or great-grandparents' generations would have anticipated post-retirement, but it's a reality. And that's a great thing.

It also means that as a result of being more healthy, more active and more engaged, it's now becoming the case that most people are often going into what we used to consider a more common experience—residential aged care—when they're at the very critical end. So they go in with very complex challenges and problems and need much more professional and qualified care provided to them. Dementia is a major issue now, as are complex health problems. People living longer means that at the end of life we are more likely to have the culmination of many of those impacts of ageing happening. It also means, obviously, that for quite a lot longer in life people will be looking to stay in their own homes—and we know from health outcomes that that's a much better thing for people to do. I think there has been a very strong bipartisan view that being able to support people to stay in their homes longer is a really good thing; it's a good policy aim. It's certainly a big part of what drove Labor's reforms in government, in the Living Longer Living Better reforms, to make sure that people were supported to do that.

What frustrates me and my community at the moment—and I've spoken about this in the chamber before, so I'll just touch on it here in this debate—is the fact that post the change of government in 2013 we have seen successive cuts to funding in the aged-care sector. Certainly I was made well aware by many of the providers in my electorate—and I'm sure other colleagues found the same in their electorates—of the massive changes that were made to the funding instrument and the implications of that cut across the sector. And that continues to be the case. Before the last budget the government had put out a whole lot of stories in the media about how there was going to be a big aged-care boost in the budget. Like many in my community, I was anticipating that it would come through, because, in particular, home care packages have been a real issue for people in my electorate. We know that people are being assessed as needing the most high-level package—a level 4 package—which means that they need the highest support to stay in their own homes, which, consequently, means that if they don't get that support they are much more likely to have to move into the residential aged-care sector.

Just from a purely economic perspective for government, it's better—because it is more efficient and cheaper—to keep people in their own homes. Residential aged care per head is a much more expensive proposition. This is being frustrated by the fact that there are over 100,000 people waiting for care packages across the nation. In my own area, there are over 1,000 people who have been assessed as needing it but who are waiting. I will just remind the House that those published public figures about people who are waiting for a care package do not include people who have been assessed for higher-level care and then put on an interim lower-level care package. You might need a level 4, but there is a wait for it, so, in the meantime, the government puts you on a level 2, which is, obviously, a lower level of support.

The reality of that impacts another group of people for whom I think this legislation, and the whole issue, is so important: families, loved ones and carers. I cannot tell you the number of times that I've had family members in tears talking to me and my staff, waiting for a home care package to be delivered. The reality is that most families who have an elderly relative are in one of two situations. Some people are working themselves, so they have the stress and worry about being at work all day when they've got an elderly relative in their own home: not being able to pop over at lunchtime and check on them, or, if they ring and they've got a problem, not being able to duck over to see them. This puts enormous stress and pressure on people. And that, obviously, has productivity implications for people in the workplace. Getting this right would have a really important economic flow-on for those workers in our communities who have caring responsibilities in families.

Often, people are not only are working; the way our demographics are these days—people not having families until much later in life—they often have kids of their own that they're also juggling in terms of child care and school commitments and so forth, at the same time that they're dealing with older parents and family members. So this is a huge issue in our community, and it's an enormous stress on people, particularly when they've got a loved one who they know has been assessed and is entitled to support, but it's taking up to a year to get that for them. Imagine that you are a son or a daughter of an elderly person in that circumstance, where you're trying to work, you're trying to support your own family, you love this person and you're trying to do everything you can for them, and for month after month that pressure continues on you even though that person has been assessed as entitled to support. It is unacceptable, and the measly 14,000 places that were in the last budget barely make a dent on that long waiting list—and the funding for that came out of residential care funding anyway; it wasn't additional money. So this has real implications not only for our loved elders in our community but also for their families, their work colleagues and the businesses that they work for.

The third group of people who I want to talk about in terms of the aged-care sector are the providers. By that, I mean the aged-care providers who are caring, quality providers. In this environment, with what's happening, they really are going to have a hard time of it too. It's very unfair to those providers to be put under the pressure of funding cuts and also under the pressure of delivering quality services and trying to match those up. I'm very conscious in my own area of providers who were running particular programmes to really give some quality of life to residents and who, through changes to the funding instrument and so forth, were not able to do a whole lot of things that they really wanted to do. I want to acknowledge them in this situation.

Most significantly, I want to acknowledge the aged-care workers. These are just amazing people. I'm sure all of you in the chamber will have visited aged-care providers in your own area. You would know that, by and large, they are women, but increasingly more men are working in this sector. You would know how deeply they care for the people that they're working for—their residents or older people that they're visiting and providing services to in their homes. It's just an amazing aspect of this sector—how deeply dedicated the workforce are. But they're not supported well enough.

That means some challenges for us around a female-dominated sector's pay rates—certainly Labor's had something to say about how we get better in that space—but also around training and development. The job is becoming more complex; it requires higher levels of skill. Part of that is also about resilience and about helping people get the skills and knowledge they need to feel competent and, therefore, confident in their work and not stressed by it. It also goes to sheer numbers. We're all ageing. It's one of those industry sectors that's unlikely to take a downturn. We're all going to hit that point and we are going to need a huge increase in the number of people working in the aged-care sector. It has already been a challenge for many providers to recruit people. It's hard to get young people to see the sector as a viable long-term career option, although it is one and it provides great opportunities. They're seeing a sector under stress, under pressure and underfunded, without appropriate recognition of skills or support through upskilling and retraining, and when people look at that it's very hard to encourage them to come into the sector. We have to get much better at workforce planning. I do think it was a great error by the Abbott government, when they were first elected, to abolish the over $1 billion workforce strategy that Labor had put in place alongside the reforms. I think it was very short-sighted.

I want to acknowledge that I attended a forum with many of those workers in Wollongong in June. Our local Labor councillor, Arthur Rorris, spoke, and so did Gerard Hayes from the Health Services Union as well as locals Amanda Hampton, Karen Singh, Lisa Walker and Lyn Martin, who between them have decades of experience in the sector. The thing that they were there for wasn't about their own educational opportunities or their own pay rates; it was about their despair and about making sure the system delivered for the people they loved and cared about and the clients that they were working with. It was just inspiring to hear that dedication. I want to pay huge respects to those workers and say to the whole parliament that we need to do better.

Many of the people I have spoken about are carers, and in my final 20 seconds I want to acknowledge it is National Carers Week. The website's up and running, and I encourage people to support a carer. Go and have a look at the website and support National Carers Week.

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