Brian Mitchell (Lyons, Australian Labor Party) Share this | Hansard source

I thank my good friend the member for Parramatta for her excellent speech pointing out the shortcomings of this government on aged care. It's been some time since this bill, the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020, was before the House, so I'm very pleased to have the opportunity to speak to it. One of its key purposes is to change the payment of Australian government subsidies for home-care packages from payment in advance to payment in arrears. This change is part of intended reform to the home-care payment arrangements to move towards an NDIS-like system where home-care providers are paid a fee for service for the older Australians they are caring for. This does raise some concerns as to the potential risks to the financial viability of service providers, especially smaller rural and regional service providers, such as those in my electorate, which may struggle with the cash flow to deal with payment changes with the change to an arrears payment system. Some service providers have indicated that if the new payment arrangements increase their administrative costs then those costs will end up being passed on to consumers, which in turn, of course, reduces the level of services available to a consumer under their package.

As the member for Parramatta pointed out, it may be somewhat premature that we're dealing with this now, given that the final report of the aged-care royal commission is to be handed down imminently. It may well be the case that the royal commission makes a recommendation around home-care payments and unspent funds, which have been part of the evidence presented in hearings. These are issues that need to be looked at in more detail, and Labor will move to have this bill referred to a Senate committee for that reason.

More broadly, I'd like to speak in support of the amendment moved by the member for Franklin, the shadow minister, which notes this government's piecemeal approach to aged-care reform. I recently received an email from my constituent Anna. Anna is in her late 70s. She lives in one of the small rural towns in Tasmania's north-east, in my electorate. After a lengthy wait and difficulties with her service provider, Anna is now receiving two home-care hours a week to help with housework and that sort of thing. Unfortunately, the process of getting this support in place was so drawn out that these two hours are no longer enough to meet Anna's needs. She is dependent on a walker, needs help with her shopping and getting to and from appointments. Most urgently, she requires modifications to her bathroom, as the current configuration is entirely unsuitable and unsafe. Despite these urgent needs, Anna is essentially right back at the start of the process, with no idea about how long she might be waiting to get the support she needs to remain in her home.

You can see the vicious cycle that is going on here. Somebody makes an application for a home-care package based on their needs at that time—these are older people already—and they wait so long for the package to come through that their needs have increased. They make a further application based on their new needs, and they've got to wait for that. By the time that comes in their needs have increased again and they may well be on their way into a home, which could have been avoided if they'd had the payment when they needed it. You can really see what happens there.

Despite her urgent needs, Anna is essentially right back to where she started. In her email to me, Anna wrote: 'I'm still having trouble with my provider and administrator of my home-care package. My bathroom renovation has flown into an uncertain future. I was approved for a level 3 package, but, thanks to the infinite national queue, I have now joined the many unfortunates that have to wait, regardless that I need help now. But one cannot be selfish.' Isn't that what we hear all the time from older people in our community. They put other needs before their own: 'One cannot be selfish.' She continues: 'Thanks to the inadequate funding for the release of more packages and the lack of available packages, we will wait in limbo until we either finally give up waiting or die.' It's not right that an elderly woman like Anna has to feel that she's in such a terrible state that she has to either give up or die for a home-care package that she's perfectly entitled to.

Anna's frustration is clear, and she has good reason to be frustrated. She is just one of 103,000 older Australians who are waiting for home care. As the member for Parramatta pointed out, it was 100,000 before the royal commission, and all these years later it's still 100,000. Despite all the evidence that we've heard over the years—all the stories and the incident reports of neglect—we still have 100,000 people on that waiting list. In Tasmania there are 2,000 people waiting for a home-care package, and the waiting list for that is about three years long. My office has a veritable laundry list of constituents struggling with wait items and issues with the aged-care system more generally, as I suspect most members in this place would have. David, for example, is in his 80s and lives alone in Devon Hills in the north of my electorate. For several months, David has been receiving two hours a fortnight of support through a home-care package. It's a minimal amount but essential to supporting David to remain in his own home. That is the best solution not just for David but also for the economy. If David doesn't get the minimal support he receives to stay in his own home, he will have go to an aged-care home, with all of the expense and inconvenience to the Commonwealth that that entails. It makes good economic sense to keep David in his home. In March the visits for those two hours a fortnight of support stopped with no contact from his service provider. It turns out that the service provider had expended all the funds from David's package, but instead of notifying David, they simply stopped showing up.

My office also has assisted Marie from Sorell, in the south-east of my electorate, to try to navigate the aged-care system. Anybody who is familiar with the computer systems of this government would know that navigating the aged-care system is no easy task, despite years of experience with such things. Marie cares for her husband, and he receives 19 hours a week under his home-care package. Marie applied for home-care help in her own right and was offered a level 2 package. If Marie had accepted this package it would have meant fewer hours overall for her and her husband but at a much higher cost. So Marie rejected this package, as any sensible person would, and as a result was placed on a non-priority waitlist, meaning a wait of up to three years for the support that she needs. I could go on, but I think the point has been made loud and clear that the wait times for home-care support are simply unacceptable.

The government did announce, in the recent budget, an additional 23,000 home-care packages, but that is just a drop in the ocean for what is needed. Stakeholders have described the budget measures as merely tinkering with the aged-care system, an aged-care system in severe distress. Patricia Sparrow, CEO of Aged & Community Services Australia, argues:

The kind of financing and budget reform that is necessary to set up Australia for our ageing population means a total rethink - not just a series of announcements that prop up the current system.

That really gets to the heart of what we are talking about here. As has been touched on by the member for Parramatta and many others, this is a government that is addicted to announcements. It confuses announcements with action. It thinks a slogan is a solution. It's not good enough. There is more to governing than putting out a press release, getting your head on the telly, putting out a meme on Facebook that you are down at Bunnings having a snag. There is more to governing than that. There's actually looking after people and making sure you are doing the right thing, not just getting good press to try and win an election.

Grant Corderoy, senior partner at aged-care accountants StewartBrown, shared a similar sentiment to that of Ms Sparrow, noting:

…it's a holding-the-fort type budget. It's waiting for the royal commission and I believe that some reforms really need to be introduced prior to the royal commission's recommendations.

Clearly this recent budget announcement is insufficient. Once again the government's announcements of new home-care packages have consistently failed to address the true scale of the aged-care crises in this country. Documents recently presented at the aged-care royal commission revealed that the government would deliver just 300 new home-care packages by 2024, despite a series of announcements promising thousands more.

It is important to note that the aged-care workers who are on the frontline working under tough conditions, and particularly over the last few months, for relatively low pay are not in the gun here. They are just working like Trojans. I've been on the floor with some of these guys when I've done 'a day in the life of an aged-care worker', and I can't even pretend to know the conditions that they really work under. They work extremely hard for relatively low pay. They are not in it for the money. They are dedicated people who want to do the best for the residents in these places. It is really important to make that distinction. What we are concerned about is the state of the system. This is nowhere near an attack on the people who work in a broken system. Labor will not allow workers to be used as a scapegoat.

The interim report of the royal commission called for action on the unacceptable number of Australians waiting for care, referring to the current wait list as 'neglect'. That is the title of the report: Neglect. You would think that would spur the government into action. You get a royal commission interim report titled Neglect, that's something that you act on immediately. You don't wait months and down the line and say, 'We will get and to it when we get around to it.' In the words of the interim report:

Many people receiving aged care services have their basic human rights denied. Their dignity is not respected and their identity is ignored. It is a shocking tale of neglect.

This is royal commissioners saying this. Royal commissioners have said this is 'a shocking tale of neglect'. Yet months later we have tinkering from the government. No real call to action from those opposite other than, 'We are going to wait for the final report before we maybe get around to doing something.' It is nothing short of heartbreaking when neglect is a word used to describe, by royal commissioners, the aged-care system in Australia, but that is the legacy of this government on aged care. Just last week, there were devastating revelations of more than 100 reports of assault and sexual assault in Australian aged-care homes each week. That is something else to confront. So, despite completely unacceptable figures and reports, the Morrison government is still yet to introduce a Serious Incident Response Scheme that would respond to cases of assault and abuse in Australia's aged-care system.

The Morrison government does not have a plan for aged care. It does not have a plan, despite everything, but Labor does. Labor has an eight-point plan that the government can consider to immediately address known issues in the aged-care sector, which has been pushed to the brink by the impacts of the coronavirus pandemic. First, set minimum staffing levels in aged care. Second, reduce the home-care package waiting list so more people can stay in their homes for longer. Three, ensure transparency and accountability of funding to support high-quality care. Four, have independent and public reporting as recommended by the royal commission. Five, ensure every residential aged-care facility has adequate personal protective equipment. Six, have better training for staff, including on infection control. Seven, have a better surge workforce strategy. Eight, provide additional resources so the aged-care royal commission can inquire specifically into COVID-19 across the sector while not impacting or delaying the handing down of the final report. I would like to commend here my colleague and friend the member for Franklin, the shadow minister, who has done a magnificent job holding this government and particularly the failed minister to over this diabolical situation facing aged care. The member for Franklin has done a superb job.

Labor knows that older Australians deserve dignity and respect in their later years of life. Those opposite have presided over an aged-care crisis in this country, robbing people of that opportunity. With that in mind, I will leave you to ponder this recent statement from the royal commission:

Had the Australian Government acted upon previous reviews of aged care, the persistent problems in aged care would have been known much earlier and the suffering of many people could have been avoided.

That says it all.

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