Wednesday, 9 December 2020
Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020; Second Reading
It's disappointing that the debate we're having here about home care and in-home care is not about substantive reform; it's about tweaks of administrative things around the edges. Now, we won't be voting against that; we can see the merit in the measures that are being put forward. They are sensible when you consider that there was something like a billion dollars of unspent home-care funds sitting in different providers' accounts as of 30 June 2020—and possibly more, given some consumers might not have been able to use their funds during COVID. This is a sensible thing to look at, and we haven't opposed it, but I think the disappointment is that this isn't more substantive reform, particularly when the royal commission, more than a year ago, raised issues around home care and the sorts of reforms that we need.
It's all very well to rattle off numbers—we've had this many extra home-care places—but the reality in communities like mine in the Blue Mountains and the Hawkesbury is that there are people waiting for someone to die or go into aged care so that they can access a package, because this is not a demand driven system. It's a system with a certain number of packages at certain levels, and you have to wait for one to become available. In the last two years there have consistently been more than 100,000 people—sometimes more, never less—waiting for their turn to come up. That is not a system about which you can say, 'She'll be right,' because it's not right, and it's causing pain at times.
I've heard members on the other side talk about how important it is to support people in their homes. You can keep them healthier for longer in their homes than you perhaps can in other ways. It's not good enough to say, 'Yes, you'll get one, but you have to wait.' These are the sorts of realities that people are facing, and just hearing members say, 'Oh, we've done lots', is not making a difference. There are more than 100,000 people. Right now, it's 102,000 people. They're the figures we have from the last quarter. We're still waiting for the September quarter figures to come out. Funnily enough, we haven't seen those yet. Consistently, this government has delayed the release of figures that tell us exactly what that number is, and that is a disgrace.
The people waiting for home-care packages are those who want to retain their independence, and they deserve that. They want to be able to have just enough care to be in their own home. I met with a wonderful woman, Joyce, the other day. She does have a home-care package. That gives her access to some gardening that supports her. She wants to knows that, as she gets older, the extra support she'll need is going to be there. I'm sure, Mr Deputy Speaker Wallace, you would also wish that for family members of your constituents. I certainly wish that for mine.
I'm disappointed at the end of this year. I know we've had COVID, but COVID is not an excuse for not acting on a whole lot of things. There has been more than a year of waiting to get a response to the interim report of the royal commission, and we hear suggestions of a suite of packages, which one of the members opposite foreshadowed. Well, let's see it. Show us what's going to come, because right now people don't have a lot of hope that what's going to come is going to do the job.
I think it's particularly pertinent to remind people that, over the past three years, more than 30,000 elderly Australians have died waiting for a home-care package. They've died waiting for help in their home. It just isn't good enough. Over the past two years, more than 32,000 older Australians have entered aged care earlier than they would have hoped because they weren't able to access a home-care package. We all know that providing in-home care is a much more economic premise than is putting people in the position of having no choice but to enter residential care.
Work has been done in relation to this bill, Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020, by aged-care accountants StewartBrown. They have looked at how much of the current system is unspent. That's where the billion dollars comes from. They also looked at the average unspent funds per client. They put that at approximately $7,000. Now, these are people who are experts in in-home aged care and aged-care accounting. It's one of the rationales for this bill going ahead and our support for it.
Those same accountants also found that the recipients of home-care packages across Australia are getting, on average, fewer than 10 hours of care each 14 days. That's data from the 2018-19 financial year—data which they presented to the royal commission. Of that time, those 10 hours across 14 days, they found that 6.6 minutes of care was provided by registered nurses in in-home care; 1.8 minutes of care was provided by enrolled or other licensed nurses; and more than seven minutes of care per fortnight was provided by allied health professionals. Even health department First Assistant Secretary Dr Nicholas Hartland said that he found those results unexpected. It is not what anyone should have expected.
So, while we will support this bill going through, we need to see much more change before any of us in this place can have confidence that in-home care packages are available to people who need them when they need them, and that they get a level of care that they require under those packages.