House debates

Thursday, 5 March 2020


Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020; Second Reading

12:16 pm

Photo of Joanne RyanJoanne Ryan (Lalor, Australian Labor Party) Share this | Hansard source

Deputy Speaker Mitchell, I appreciate you giving a few moments for my colleagues to leave the chamber after listening to the significant contribution by the Leader of the Opposition, the member for Grayndler, on Labor's thinking, optimism and positivity around what could and should be happening in this country in our aged-care sector and the care for our older Australians. I stand here very pleased to support the amendment moved by the shadow minister for ageing and seniors to the second reading of the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. We won't decline to give the bill a second reading, but we note the government's piecemeal approach to aged care. I stand here while my mum is at home. Hopefully, she is watching on the telly. Mum, g'day; how are you? She is 92. For me everything in the aged-care space is not only about the people I represent but also about the person closest to my heart besides my own children, and that is my mum. At 92 my mother is still independent. She still lives in her own unit and completely looks after herself, but she does have some home-care package support.

The government's approach to aged care and home-care packages in my time here has been absolutely piecemeal. I am struck today that we are here talking about legislation in this space while the royal commission is occurring. The royal commission has made an interim report and yet this legislation does not address any aspect of that interim report. Like when we were speaking on education yesterday, it again feels that, really, we are here talking about money bills and not actually talking about aged care. This legislation has scant implications for any kind of improvement in the aged-care system. I think that's a crying shame and that the government should be called out, and that's what we're standing here doing.

I note the legislation does a few things. The first phase is set to commence in June this year and will trigger a change to the way providers are paid. Rather than providers of home-care packages being paid upfront so people can access those funds and the care that comes with them, this legislation will mean that they will get paid in arrears. I note that this really means that money—and we're struggling to get an accurate figure, but we think between $250 million and $350 million—will not come out of government coffers and go to providers for aged care but would be held back until the new financial year.

I'm sorry if I sound cynical. I apologise to the House if my suspicious mind puts me in a different space from everybody else, but it seems pretty clear to me that this legislation, particularly the part of the legislation in front of us, is a budget saving measure by this government, given the other two factors in this legislation don't commence until 2021. There doesn't appear to be a rush to do those. But we're for standing here today because this government wants to save potentially $250 million to $350 million in this year's budget. This is about protecting an early crow on the surplus rather than protecting our elderly and ensuring that they're getting quality aged-care and quality home-care packages. I can't stress this enough. You only have to look at the facts.

I think that the number of Australians waiting for home-care packages is now out to 120,000 people. As we heard the member for Grayndler say so recently, we've gone from a one-month wait to a five-month wait to get into an aged-care facility, and we're now waiting up to three years for people to get to the level of the home-care package that they've been assessed for. We know that people are being encouraged by those opposite, 'If you can't get the higher levels just take the lower level and get yourself on the waiting list,' which is now out to three years. We know what the outcomes of this are. The outcomes are that people are dying before they get into aged care. The outcomes are that people are dying while waiting for home care packages. There is not an Australian, not one person in this country, who thinks that's okay except those opposite, who after six years still have no fix for this and who seem to be completely ignorant of their drip feeding of this information. They hold it back, waiting three months to tell us what the lists say now.

We know from the interim report of the royal commission that half of older Australians are malnourished. We know that the name of the interim report is 'Negligent'. We know that this government was planning to privatise the assessment processes for the aged care packages, what we call ACAT, the aged care assessment teams. They pulled back from that, but only because of pushback from states and a campaign run by the opposition around what that plan would actually mean. The campaign said, 'You want to privatise the one thing that's working while you ignore all the other problems in the system.' We know that this government has now had four ministers in six years and that all of those ministers have been responsible for billions of dollars of cuts in the sector. We're in the middle of a royal commission where some of the worst things are having a light shone on them. So they've been asleep at the wheel for six years—four different ministers, billions of dollars ripped out—and they have lurched from one crisis to another.

We're in the chamber today talking about a piece of legislation that contains a critical point that is a budget saving for this government, and we're doing this while in every question time we have 10 questions about coronavirus. Who is most susceptible to coronavirus? The elderly! So we're going to not put $250 million into the system, into home-care packages where people may be isolated and may be unaware that they're carrying the virus and what that means for them and their respiratory system. It is an absolute shame.

What does the holding back of these funds really mean? Let's have a look at it. Most Australians this will have very little impact from it. They'll be very aware that this is a budget measure. They'll be unaware of what is going on in this House today. But I'll tell you who will find out: it is people getting home-care packages in regional and remote areas, where the providers are most likely to be operating on the margins and are most likely to find themselves with an incredible cash shortfall that might mean they close their doors, which might mean that someone doesn't arrive to assist my mum next week. That's what might happen if we let this go through today. That's what we're up against. It is people in country areas, where the providers are most likely to be in this circumstance and may not take on new clients because of this cash shortfall that's going to be thrust upon them so quickly and with such little planning time, who will be affected. We've had that feedback from the peak bodies. So three years may become three years and three months. Who cares? It doesn't matter. The legislation in front of us today is an absolute indictment of this government.

We know that in January the aged-care royal commission had to issue an extraordinary public correction in response to the false assertion of the Minister for Aged Care and Senior Australians that they supported the plan to privatise aged-care assessments. This government should be in here apologising for their behaviour around the potential privatisation of ACAT. The minister actually claimed that the aged-care royal commissioners supported the privatisation of the ACAT system, a system that's working perfectly fine and that, in fact, the states say is working very well. In Senate question time in early February the minister admitted he hadn't even read the interim report of the royal commission. No wonder older Australians are suffering at the hands of this government, when they can't be bothered even reading the interim report from the royal commission, a royal commission that was called in response to television footage of things that were happening in some aged-care facilities that horrified and mortified Australians around the country.

I don't want to put too fine a point on it, but it seems to me that this government—if we do the compare and contrast and look at the sports grants fiasco—is very good at putting money out the door when it's for its own jobs, but, let's face it, now they're going to pull back money from home-care packages for elderly Australians in a piece of trickery—again, to save face. Let's get this clear, this is to save face. This is so that the Treasurer doesn't have to come in here and say they're not going to get a surplus. That's what this is about. It's absolutely disappointing. I will be absolutely ensuring that members in my community understand what this is about.

The providers are going to be put under pressure because of this piece of legislation and because of the rush of this piece of legislation. There are some things in this legislation that need to go through, the things that are set to happen from April 2021. Providers will only be paid the subsidy for the goods and services they actually provide to the consumer, rather than receiving the full monthly subsidy amount of the receipt. There are some areas there that may well have merit, but again we're doing this in the middle of a royal commission. We can't do anything about increasing the number of home-care packages, because we are in the middle of a royal commission. We can't do anything about the quality of our aged-care services, because we're in the middle of a royal commission. But there is this little thing that we could get through the parliament that would mean a budgetary save, or pushing down the road payments to providers of home-care packages into the next financial year. Although we don't want to hold up the bill going through the parliament, we have to get into this place and stand up one after the other to make sure that Australians understand what is going on here. We have to draw this to the House's attention, to ensure that those members opposite understand what it is they're going to walk in and vote for and understand what it is that they've put in front of this House today.

The change from advanced to arrears will commence in June 2020. It's an extraordinarily tight turnaround for service providers. There's an increase in financial risk for some smaller service providers, who may not have adequate cashflow to deal with the payment changes. There are some service providers who may have to revert to finding other financing arrangements, including loans or equity injections. Those home-care providers currently losing money will face significant difficulties changing over to an arrears payment arrangement. Service providers are also concerned whether the new payment arrangements increase administrative costs. Of course, we're all concerned about this, because we know that we have a waiting list of 120,000 people for aged-care packages and we've got many who are on home-care packages but are not on the appropriate levels and are waiting to go onto those appropriate levels. The ramifications of any strain we're putting onto the providers through this system are going to play out on elderly Australians who are still living in their homes and are dependent upon these services.

The Royal Commission into Aged Care Quality and Safety is to hand down its final report in November. There will be an immense amount of change before the aged-care sector. Right now, in a critical area, the home care packages area, this legislation is asking for changes in their financial arrangements—not in their provision-of-care arrangements; not in reviewing to ensure that the people that they're employing are being remunerated appropriately for the work they're doing; and not in ensuring that, with the services they're providing, there is a feedback loop and that the people they're caring for are having their plans and their packages appropriately managed. This legislation is not about improving service to the elderly. This legislation is purely about funding. It's an absolute shame that, when we know that half of our elderly Australians in aged-care facilities are malnourished, we don't have figures on the nutritional state of people relying on home care packages. We don't have those figures, because those people are not in the facilities. But it seems to me, and it seems to my colleagues in this place, that this government could spend a lot more time focused on improving the care for our elderly Australians and a lot less time worrying about their bottom line and a lot less time juggling money around—and a lot more time focused on the things that Australians care about. They don't care about your surplus, but they do care about their mothers and their fathers.


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