Shayne Neumann (Blair, Australian Labor Party, Shadow Minister for Veterans' Affairs and Defence Personnel) Share this | Hansard source

Last week in the Federation Chamber I mentioned a number of instances in relation to constituents of mine in respect of aged care. I have a 96-year-old hard-of-hearing woman who is legally blind—a widow in Ipswich—who can't get an ACAT assessment. I had a 91-year-old man who was eligible for a level 3 home-care package and eventually got it. He then became eligible for a level 4 package, but died waiting for that package. I have a 92-year-old stroke survivor and widow who languishes on a level 2 package, and has done so for two years while waiting for a level 3 package. These are just three of the stories, from my electorate, of a system that's failing. I speak today to the amendment moved by the shadow assistant minister, the member for Cooper. The system that we have in aged care in this country is abysmal. It's cruel. It's unfair to frail, older citizens in this country and it's inadequate. The government's response to the royal commission is a squandered opportunity.

This legislation that we have before the House today, the Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Bill 2021, deals with three issues only in relation to that royal commission, which handed down an interim report titled Neglect and a detailed report providing a pathway forward, which the government has not taken up. These amendments that are before the House are to strengthen legislation on the use of restrictive practices—which were commented upon and condemned heartily and wholly by the royal commission. Again and again they found the excessive use of restrictive practices. There is some alignment here with the Aged Care Act and the definition under the NDIS that's necessary. There's also an expansion of the Aged Care Quality and Safety Commission's ability to respond to breaches of approved aged-care providers responsibilities in relation to restrictive practices.

Women massively outnumber men in residential aged care by almost two to one. Close to two-thirds of the people living in residential aged care—up from just 50 per cent a few years ago—are living with dementia. Indeed, dementia is the biggest killer of women and the second-biggest killer of men, yet this government has failed in relation to aged care and dementia. They've had a consistent minister for aged care but not a minister for ageing. There is nothing about an age-friendly Australia or dementia-friendly communities across this country that this government has taken up.

The royal commission, that's the subject of this bill, found extraordinary themes: neglect, maggots in the wounds of residents, about two-thirds of residents being malnourished or at risk of being malnourished. This government has been warned by report after report after report. But the government has done almost nothing in respect of workforce development. Indeed, you'd have thought they'd have had a workforce strategy across eight years of being in government. But I pay tribute to those people who are dealing with the Commonwealth Home Support Program; Home Care Packages; Meals on Wheels; those men and women working as nurses, enrolled or registered; and the personal carers, administrators and financiers. These are the people, in both the for-profit and not-for-profit sectors, who are working hard to care for older Australians, so many of whom are incapable of caring for themselves.

In its infinite wisdom, this government has decided to give about $3.2 billion, with no strings attached, to residential aged-care providers. There are no linkages in terms of better nourishment, better care, better accountability or better transparency. This is simply ignoring recommendations of the royal commission. Where is the requirement by this government to clear Home Care Packages? We have tens of thousands of Australians who have died while waiting for Home Care Packages, and I mentioned a constituent of mine before. We've had tens of thousands people going into residential aged care prematurely because they can't get Home Care Packages. There are 100,000 Home Care Packages needed, and this government has failed to deliver them. What about the recommendations ensuring that we have nurses on duty in residential aged care 24/7? There is nothing from this government.

But I think it's important to know that the substandard care we're seeing now is not a recent phenomenon—not by any means. When it came to the election in 2013, we saw that the government had seven pages in their aged-care policy. Does anyone remember that blue book they used to hang onto all the time in the 2013 election? It only had seven pages on aged care—that's what they had. They must have realised, surely, that more than 80 per cent of the funding for aged care in this country comes from the federal government, and that 100 per cent of the responsibility for quality and safeguards in the system is the federal government's. Whether it's in vaccine rollout, quarantine, the NBN, the NDIS or robodebt, aged care is up there on the podium of failure for this government. I'm not sure whether it gets the bronze, the silver or the gold medal, but it's really up there on the podium. According to the latest population trends, 38 per cent of Australian men and 55 per cent of Australian women end up in permanent residential aged care, and their average stay is about two to three years. This means that so many of our fellow citizens, including many people in this chamber who were here in question time, will go into residential aged care.

But this government has failed. We only have to read the 12-page foreword of Neglect to get a sense of the rage, heartbreak and failure in the aged-care system in this country. Let's look back at the history of the failure of this government. We have a government which came to power in November 2013. What did they do? They scrapped the Advisory Panel on Positive Ageing—they scrapped it straightaway. What did they do then? They decided that they would get rid of the $1.2 billion that was designed to help workforce development. They haven't got a workforce strategy at all. There was an aged-care workforce supplement given to providers, with strings attached, to make sure that there was training, development and growth in the aged-care workforce. We need to treble the aged-care workforce by 2050. So what did this government do? They got rid of the supplement—they canned the $1.2 billion. Then, a few months later, in June 2014, they axed the dementia supplement. That was just fantastic, getting rid of the dementia supplement—and the veterans supplement, I might add—that was being provided to help people who were living in need to be cared for. It was there because the Aged Care Funding Instrument, or ACFI, doesn't cover severe behavioural issues and issues for people who are suffering from dementia. It doesn't cover those, but the government decided to cut that funding. Again and again we've barely seen a budget or MYEFO where this particular government hasn't decided to cut funding for residential aged care or home care. Even when they said they were going to provide assistance, it was usually a sleight of hand.

I'll give a couple of instances of why we're where we are today. Think about this. In September 2017, they decided they were going to provide 6,000 home-care packages. That was in response to the first release of the Home Care Packages data. It was because it was a political problem, and they had to try to do something. The HCPs were a result of a change in the ratio, and they were fully exhausted by December 2017. They announced it in September, and it was fully exhausted by December 2017. There was no new funding at all. In the 2017-18 budget, they decided that they would create 14,000 new home-care packages. It was entirely funded by a reduction in more than 26,000 projected residential aged-care places from 2017-18 to 2020-21. There was no new funding. They took money from residential aged care and put it into home-care packages and then patted themselves on the back.

In the MYEFO, in 2018, just a few years ago, they decided they would provide another 10,000 packages. What they really did was not provide any new funding; they just brought forward funding they'd previously allocated in the budget—$287.3 million. They brought it forward by one year and they released 5,000 level 3 packages and 5,000 level 4 packages. There was no new money. They just brought it forward a year. In February 2019, they announced another 10,000 packages on the eve of the beginning of the hearings of the royal commission into aged care. Just before the hearings started they decided, 'We'd better do something to show we're doing something,' so they announced $282.4 million over five years for the next level 4 packages. There was effectively no new money, and it was actually re-announced in the budget in May. They announced it once, and they announced it again. Then, in November 2019, they announced another 10,000 home-care packages. They were announced prior to MYEFO in response to the royal commission recommendations from 1 December. There were 5,500 in the first year. But it was almost impossible to know, when you looked at it, where they got the money from and whether it was or wasn't new money.

So, there were a number of years when this government shuffled money around from residential care to home-care packages, when they provided no new money at all, but they wanted to pat themselves on the back and say: 'We've done a good job. We're responding.' But it was always in response to a political problem, whether it was the release of home-care data, a hearing that was coming up, or a royal commission that was about to commence. This is simply not good enough. You can barely find a budget or a MYEFO where they didn't cut funding. An amount $1.7 billion was cut when this Prime Minister, the current Prime Minister of Australia, was Treasurer. They kept cutting and shuffling money everywhere, and then they wonder why a royal commission found there's neglect, no workforce strategy, people living in terrible conditions, one in three people malnourished and substandard care. They wonder why we've got a problem. How about you actually fund the system properly? Where's the $10 billion per annum that's required, as was submitted to the royal commission? Where's that? Where's that in the budget? They give a bit of money, no strings attached, ignore the requirement that you have to have transparency and better supervision, and then think they've solved the problem.

Aged care is in crisis in this country. We need to treble the workforce. We need to deal with the idea that it's not an aged-care issue; it's an ageing issue. We should be proud of longevity in this country, but we should deal with the challenges that come with aged care and with longevity. The median time for older Australians waiting to get into residential aged care has grown by more than 100 days under the Liberals and Nationals. It's gone from a month to about five months. This government is not serious about this issue. They find a supplement anywhere, whether it's a dementia supplement, a veterans supplement or a workforce supplement, and they get rid of it—and then they wonder why there are consequences.

This particular legislation that we have before the chamber today deals with just three issues—three issues only. They need to do much, much better. You can't say you're going to deal with the challenges of ageing if you don't improve quality and safety. You can't say you're going to improve transparency if you have no strings attached to funding. It's a bit like when Campbell Newman came to power in my home state of Queensland; they rolled out money—and this government did the same thing—on education without any transparency or accountability. You've got a $3.2 billion budget allocation to supplement the basic daily fee by $10 per day per resident. The royal commission recommended that; yes, that's true—that there should be an increase in the daily fee. But there are no strict reporting requirements, and the government didn't follow it as required.

We need to do things differently in this country. We need to make sure that aged-care providers can do what they need to do. We need to make sure that residents, whether in residential aged care or living in community and getting home-care packages, or just getting meals on wheels, are funded properly, that the services are funded properly and are accountable. The government need to do much, much better than they're doing currently with respect to aged care and ageing, and they should hang their heads in shame if they can't do better.

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