Wednesday, 9 December 2020
Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020; Second Reading
I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020. This bill changes the way that home-care providers are paid for the care and services delivered to a home-care recipient. Labor has a significant number of concerns about this bill—namely, that there may be increased financial risks for some smaller service providers and those in regional and remote areas who don't have adequate cash flows to deal with the payment changes and who are unable to hold unspent funds, which is something that other speakers have touched on—I know that's a concern, particularly for a couple of people in the Liberal Party, so I appreciate their contribution; that services providers who are currently losing money will face significant difficulties changing over to an arrears payment type arrangement; that some service providers may be reluctant to take on new consumers during the transition to the new arrangements; and that the Royal Commission into Aged Care Quality and Safety has not yet handed down its final report, which is due in February next year, and that report may flag some further reform for the home-care payment system.
The Morrison government needs to take urgent action in relation to home-care packages, but changing the funding arrangements is not what would have been my first priority. The Royal Commission into Aged Care Quality and Safety delivered its interim report more than a year ago. I don't imagine that all Australians would have read the report but they would remember that it was called one word and that that one word was Neglect. That interim report identified three areas where immediate action could have been taken. The first of those areas was to provide more home-care packages to reduce the waiting list for higher-level care at home—a recommendation handed down to Prime Minister Morrison over one year ago. Surely that should have been the first priority for this government.
The Morrison government has had 405 days since that report, Neglect, was handed down to make some changes—making some fixes. For some of that time, the Prime Minister was in Hawaii working on his sun tan, but this crucial issue still hasn't been fixed. Over the past three years, more than 30,000 older Australians have actually died while waiting for their approved home-care package, and many then received notices saying that they'd moved up in the queue—moved up in the queue after their friends and family had actually signed their memorial books. As at 30 June this year, 2020, there were 142,436 older people in receipt of a home-care package. That's good news for them. It's great news for those 142,000 people, but there are still 102,000 older Australians on the waiting list for home-care packages. That's like everyone in the city of Toowoomba waiting for a home-care package. Anyone can see that this is completely opposite.
Those opposite keep saying—I have listened to some of their contributions—that the Morrison government is committing record spending, and they keep talking about record numbers. Well, newsflash to the people of Australia: there is a record number of senior Australians. They're called 'baby boomers' because there was a boom in babies after World War II and the Depression. We've known this was coming for about 70 years. There are more elderly Australians. Those in the government keep saying: 'Wow! We're giving more money!' Newsflash: of course you should; you're just doing your day job. Don't give yourselves a pat on the back for doing what the Australian Bureau of Statistics has said you should've been doing for the last 50, 60 or 70 years.
The royal commission interim report, as I said, was called Neglect. It explained in detail the difficult journey that older Australians make as their needs change. They need more help around the home and more help with doing the grocery shopping and getting to medical appointments, and eventually they will need help even in personal care, in things such as showering and caring for wounds, toileting and taking medications.
I've got a father in his 80s, Brian Perrett. He is in this position. He lives a long way from me, in the member for Maranoa's electorate. But with just that little bit of help, he has been able to stay in his home. Between family and some professional carers, he's been able to stay in his home, with all the dignity that comes with that, so that he can spend his time in his shed, making more wooden gifts for his children and grandchildren and great-grandchildren, which I'm sure we'll all appreciate, Dad, come Christmas. Merry Christmas to you, and to all the carers who make it possible for you to stay in your house.
But, when it comes to negotiating a way through the aged-care system, it can be confronting and often very frightening for older Australians. Older Australians who want to stay in their home—and that's completely understandable and commendable—will need to access My Aged Care, on the web page or the phone system, and undergo a face-to-face assessment to determine care needs and to receive a home-care package. Having negotiated this with my father, I have some familiarity with the process that people go through. It is complicated, and it's easy to see how this process for older Australians, who are already frightened, just gets a whole lot worse when they are then faced with long waiting times.
The royal commission heard from those older Australians who are on the waiting list about how they felt, and this is what one of them said:
We are kept in the dark and given false hope. There are many unanswered questions about how the system works. Is the government hoping it all gets too hard and that we drop out of the 'queue'?
Even if that's not the plan, the reality is that 30,000 of those on the waiting list died before receiving their package—a package that they were owed, that their taxes paid for. Some of the carers shared their experience of waiting for home-care packages for their loved ones. One carer said:
Due to me not being able to lift her we had problems, I remember sitting on the bathroom floor with her for hours waiting for an ambulance to come, I have never felt so helpless.
My mother is suffering with dementia, she requires 24 hour care and is very fearful of being left on her own for even 5 minutes. She will wander, scream, cry and become overwhelmed easily and suffers from delusions and severe anxiety.
This is distressing reading. For those who have looked at the report entitled Neglect, it is depressing reading.
I'm actually going to recommend another piece of reading for those contemplating aged care who don't want to read the report. It's an article by Sarah Holland-Batt called 'Magical thinking and the aged-care crisis', and it's in Griffith Review No. 68, titled Getting On. It's one of the most gripping bits of reading that I've ever read, and I've got an honours degree in literature. It is incredible writing, and it makes you think about what we're doing as a nation. So a big shout out to the editor, Ashley Hay, and the associate publisher, Jane O'Hara. Keep up that good work.
But for those older Australians who've been approved for a home-care package and are stuck on the waiting list, and for their carers, this is their life, day in and day out. There is no end in sight for them and no help forthcoming, until they reach the top of that very, very, very long queue, of 102,000 people. Just picture how many blocks that queue would stretch for, if all these people were lined up at a My Aged Care office—if one existed. Under the Liberal government, the waitlist for home care has grown from 88,000 to 102,000 older Australians—not something that those opposite mention. This distressing number underscores the failure of the Morrison government's response to this ongoing crisis in aged care. Labor has been calling for action on reducing the wait lists for home-care packages since the first release of data revealed too many older Australians were waiting for care. Aged-care reforms were meant to give older Australians more choice about where they live as they age. Instead, the Liberals' policy chaos has completely failed to care for our older Australians.
The Productivity Commission released in January the median wait time for a home-care package. It has blown out in the last year by more than two months. Many older Australians are waiting for more than 12 months for the package that they've been approved for, and some are waiting for more than two years. Some older Australians are entering residential aged care or even emergency departments instead of receiving their approved home-care package. The aged-care system is broken and, as the royal commission has noted, it suffers from neglect—and that was the title they gave to their interim report: Neglect.
The Liberals have almost been asleep at the wheel for seven years, now in their eighth year. In his first budget as Treasurer, Treasurer Scott Morrison ripped $1.2 billion from aged care. There have been four ministers and the aged-care system has lurched from one crisis to another. It is shameful that, in a relatively wealthy country like Australia, older people can't get the care they need when they need it. The royal commission said it believes that significant additional funding is needed immediately—as I said, 400-plus days ago—and in the future to increase access to home-care packages. The royal commission said that more than a year ago, and yet we still have 102,000 people on the wait list. There's just one word—neglect—that covers what the government is doing. The word 'neglect' should be hung, in shame, around the neck of Prime Minister Scott Morrison like a dead albatross.