Monday, 21 June 2021
Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Bill 2021; Second Reading
I rise to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Bill 2021. On 24 July 2019 I stood in this place and, in my maiden speech, said that my father, a country doctor:
… despaired at times at man's inhumanity to man, particularly the aged, who he believed should be treated with dignity in their final years, not discarded as a burden on society. In this regard, he was right … the aged-care system is bowing under the weight of demand, and residents are all too often treated as a number on a ledger to be measured in profit and loss. The need for a royal commission only validates his decades-old fear. I am pleased, however, that this government has taken steps in recent times to address aged care with record funding. However, more needs to be done. With 27 per cent of residents over 65 in Port Macquarie alone, with similar figures throughout Cowper, we must prepare now for their future.
So, two years on, it is imperative that we as the government look to continue to make change within the aged-care industry for the best interests of the residents, their families, the staff and the future of our ageing population.
This government understands that the royal commission into aged care is a once-in-a-generation opportunity to confront the inadequacies within aged care whilst bringing real change to the system. I am pleased to say that this government has responded to the challenge and is providing a first set of responses that can help meet the future needs of our residents. As a nation we must look to improve our level of respect for our senior Australians, and it must be a national priority. From this respect comes all that we value in the care of our ageing loved ones—dignity, safety and wellbeing. We should all strive to ensure the oldest and the most vulnerable within our society receive the levels of care that support and respect that dignity. We must recognise the contribution our older residents have made to the foundations of our society, and this must be reflected in our care and understanding of their needs in their later years.
There are 148 recommendations from the royal commission into aged care. This government understood this royal commission as a call to action, a call for fundamental and ambitious reform. So this bill and the government's response to the royal commission is an acknowledgement that we will embrace this generational change and provide the necessary framework for the industry into the future.
The 2021 federal budget is another example of how this government is responding to that final report of the royal commission. The proposed $17.7 billion aged-care reform package is designed to deliver sustainable quality and safety in home and residential aged-care services. These proposed changes in this bill will continue this government's ambitious drive to protect our older residents.
We've seen on our TV screens and heard on the radio in recent times that there have been a number of terrible incidents where residents in aged-care facilities have been mistreated. This bill provides the necessary framework and changes to protect aged-care residents into the future. This has been achieved through the use of, and the definition of, restrictive practices and behaviour support, which are highlighted in this bill. This government is strongly committed to providing safe and quality care to all senior Australians, including in residential aged-care settings. These amendments will strengthen protections for aged-care recipients from abuse associated with unregulated use of restrictive practices. This will be achieved by strengthening and clarifying provider responsibilities concerning the use of restrictive practices. This includes strengthening the emphasis on aged-care recipients' rights and the delivery of person centred care, and requiring providers to only use restrictive practices as a last resort, and it must be a last resort following the employment of alternate behaviour support interventions. We do not want to see any more vision of elderly, frail or vulnerable residents being subjected to degrading practices.
While the protection of our most vulnerable is key, the bill also acknowledges that there are some limited circumstances in which restrictive practices may be required around the safety of care of recipients and staff. The bill seeks to clarify that this is a safety measure of last resort where all other interventions have been employed and excluded. Restrictive practices must only be used in a way that supports good clinical practice and provides safe and improved care for care recipients. It can never be used as a method of punishment or as a substitute for inadequate resources.
In my electorate, the electorate of Cowper, we boast around 80 aged-care facilities that receive government funding and offer a range of services, including residential, transitional and short-term restorative care. Some are leaders in their field and have provided exceptional care and support for their residents while providing employment opportunities for many of our residents. I expect to see a continued expansion of facilities within this industry in the coming years, along with a rising number of residents looking to take up opportunities of home-care packages to help them stay in their homes longer. A similar number of providers offer home-care packages across the electorate.
Given the ageing population of the Cowper electorate and a strong desire by these residents to remain in their own homes longer, we have strong demand for home-care packages. The Mid North Coast has almost 5½ thousand home-care packages across all four levels. The new number of entries into home-care packages in the last quarter was almost 600. Pleasingly, the number of packages released into the system in the last quarter was 1,314. This effort and the decision made in the 2021 budget show the intent of this government to provide and match the services people need in our area and across Australia.
When we consider the number of aging residents in Cowper and across the country, it is important also to note Australia's population is aging. A detailed look at the government document Australia to 2050: future challenges shows that between now and 2050 the number of older people 65 to 84 is expected to more than double. People over 85 are expected to more than quadruple, from 400,000 people to 1.8 million in 2050. In contrast, the number of children is expected to increase by only 45 per cent, and the number of prime aged-care working people is expected to increase by only 44 per cent. This means that the proportion of people aged 65 years or over is projected to increase from 13 per cent in 2010 to 23 per cent by June 2050. With an aging population in mind, these amendments become imperative because they provide the necessary security for those residents considering their aged-care options going forward.
This government is taking positive action. One of the measures in this bill that will gain plenty of traction in the wider community is the assurance reviews. This measure is in response to growing community concerns about some providers charging unfairly high administration charges. The government has committed $6.5 billion over four years from 2021 to release an additional 80,000 home-care packages. This record-breaking investment will support more senior Australians to age comfortably in their own homes. We all want to see this level of support focused primarily on the care and assistance for the recipient. Home-care assurance reviews are designed to protect the integrity of this investment by allowing further oversight of arrangements for the delivery and administration of home care to ensure they are effective and efficient. Some of the issues that will be covered by the assurance review process include how approved providers are using the home-care subsidy and charging for home care, including justifications for amounts charged to care recipients; how approved providers are structuring their financial accounting for home-care services; and the nature and time of home care provided by providers. Whilst it is acknowledged that home-care providers need to cover business costs and overheads, it's imperative that senior Australians are getting the best value for money in the use of their package funds by providers.
The implications of this bill, specifically the proposed amendments in the bill, relate to restrictive practices, home-care assurance reviews and aged-care financing. This bill defines the term 'restrictive practices' in the Aged Care Act in alignment with the definition applied under the National Disability Insurance Scheme, bringing practice into line with the disability sector. The new definition strengthens protections for care recipients from abuse associated with the unregulated use of restrictive practices. The bill also expands the Aged Care Quality and Safety Commissioner's ability to respond to breaches of approved providers' responsibilities in relation to restrictive practices. Assurance reviews will inform the continuous improvement of home-care policy and the education of approved providers in relation to home care and home-care services.
I'm pleased to note that the government is investing over $135 million over two years to support the payment of bonuses to registered nurses who remain employed in the aged-care system for 12 months. This is part of the $652.1 million commitment by the government to retain and grow a professional and compassionate workforce within the aged-care industry. In addition, the Aged Care Workforce Industry Council is funded by the government to implement the Aged Care Workforce Strategy. Through this, contract funding is being provided to drive workforce reforms.
In conclusion, these proposed changes will emphasise person-centred care in relation to the use of restrictive practices through a new definition of restricted practice. The bill also provides legislative detail on the requirement for providers to comply prior to, during and after the use of restrictive practices. With regard to home care: this government also believes that assurance reviews will have a positive impact on the delivery and administration of home care, ensuring that they are both effective and efficient. Program assurance will deliver on the government's commitment to provide senior Australians with affordable and value-for-money home care, and will directly support senior Australians to remain in their homes for as long as possible.
The health, safety and wellbeing of senior Australians is of the utmost importance to this government. This is driving our plan for generational change in the aged-care system. These initial amendments form the first step of the government's five-year reform agenda across these five pillars: home care; residential aged-care services and sustainability; residential aged-care quality and safety; workforce; and governance. I commend the bill to the House.