Thursday, 8 September 2022
Aged Care Amendment (Implementing Care Reform) Bill 2022; Second Reading
It's been very interesting to listen to the contributions from other members on this, because there are obviously some clear commonalities that we, as members of parliament, experience in our interactions with the aged-care sector in dealing directly with constituents. I can tell from the previous contributions that we all have very similar issues that are brought to us as local members of parliament. They're not all bad experiences, by the way. Naturally, a disproportionate number of people who reach out to their MP do so because they've got an issue that they need support in overcoming—I accept that—but I want to make a few comments about the inherently fantastic people who work in our aged-care system and the fantastic work that they do, and I'll do that in a moment.
The second thing to say, following on from that, is that I don't think any of us as human beings, not just members of parliament—I don't think there'd be any Australian—has not had a direct personal experience or interaction with the aged-care system in this country either at the moment or in the past. Of course, all of us will in the future. My last surviving grandparent is now in a residential aged-care facility, two of my three deceased grandparents came to the end of their lives in aged-care facilities, and many other members of my family have need of, or will in the future have need of, the aged-care system, hopefully for a brief period and not for a very long time. It's very important to all of us that we have an excellent aged-care system that provides the highest standard of care and support in the most flexible way to people needing that care in the last moments of their life.
My grandmother not only spent the last period of her life in an aged-care facility but spent most of her career working in the aged-care sector. She was an aged-care nurse for many decades. She had become a nurse during the Second World War and served in the Army, as a nurse at the Heidelberg hospital in Melbourne, nursing returned soldiers. Many of them were POWs who'd had traumatic experiences and had challenges insofar as the care they needed. Then she came back home to Adelaide and worked at the repatriation hospital for a reasonable amount of time doing similar work caring for veterans, and then became an aged-care nurse for the remainder of her career as a nurse. She was someone who absolutely loved that work. She loved caring for vulnerable people. At times it was very difficult because the sorts of care, with the circumstances people are in, are very challenging and emotionally draining. But she absolutely loved it and found doing that work so fulfilling. I think she is the same as almost everyone that works in the aged-care sector.
We all, as members of parliament, have the opportunity, I'm sure, if you're anything like me, to regularly visit our facilities and talk to management and staff as well as the residents about what their issues are and the challenges they've got. My observation is that, inherently, the people working in the sector—whilst we need to do better in the support they've got—very much get an enormous amount of fulfilment from doing the work they do. They are great heroes in our society, and I'd like to pay tribute to everyone that works in the aged-care sector. We are very lucky to have your dedication.
The royal commission brought to light some, in some cases, quite shocking examples of unacceptable circumstances in our aged-care sector. I've got no dispute with any commentary of the royal commission around that. But I think we've got to remember that, whilst there are some bad circumstances, there will always unfortunately be bad operators with bad faith. My personal experience, and I think it's the case across the sector, is that most operators are inherently doing excellent work with the resources they've got. The aged-care facilities I visit in my electorate are doing fantastic things, and the aged-care facilities I've experienced when members of my family have been cared for by them are doing fantastic things. There are people that need to lift their game but it is important that we don't let the zeitgeist become some sort of sense that we've got an aged-care sector—particularly a residential aged-care sector—that is on the whole providing very low-quality, poor care; that's not the case, certainly in my experience. I want to be a constructive participant in this place in doing more wherever we've got the opportunity to improve things.
The reality is that the demand on aged-care services will only grow exponentially into the future. A large part of that is for inherently good reasons. People are living longer. Modern medicine is changing our life expectancy and is allowing people to have longer lives and a lot more options around treatment for things that would have ended their lives much sooner. My own grandfather's circumstance, which is very common—he is very lucky to be alive at almost 93 years old—is of significant mental deterioration through having dementia. He is physically fit as a fiddle, which is great, but he is in a circumstance where, because of his dementia, he needs very significant care in a residential circumstance. Prior to him going into that circumstance, he had, I have to say, really good community care support. My grandma was in the same situation before she passed away. They had good support and access to community care packages that allowed them to stay at home for much longer than they otherwise would have been able to.
That's another thing that's really important as we look at addressing aged-care reform and how the system will change into the future—that we make sure we are helping people to stay in their homes for as long as they can, provided they want to and it's safe to do so. That's a difficult circumstance to confront for any family. In my family's case, my grandparents had to go into residential aged care. Of course they didn't want to, and we did the best we could as a family to support them to stay out of residential care for as long as it was safe to do so. But it will always get to a point where that's not tenable.
It is important that we have a good, flexible system that can, for as long as possible, have people in a circumstance where they are able to stay in a home-care situation where supports can be funded, as we do through community aged-care packages. They've changed a lot over the years, but the principle of helping people to age in place, in their home, is one that's very important for them. And of course it is important that we make sure that, particularly if they want to, we can keep them out of the residential system for longer, in a safe way. It takes the burden off the explosive growth we would have in residential care if we weren't doing as much as we could to further support people in that circumstance to stay in home care.
This bill has been well commented on through a very long list of speeches and contributions in the second reading debate, and I do note, in particular, my colleagues who have talked about being in other electorates. I'm in a metropolitan electorate and I understand the issues that are acute in the sector in my electorate. But it has been quite valuable to hear contributions from members whose constituents, particularly on the residential aged-care side of things, have very different circumstances and challenges because of those circumstances. Smaller communities have much smaller facilities that are more commonly community developed and run, and they have very difficult challenges around viability. I don't have that challenge in my electorate, but I have to say that I recognise and back to the hilt people who represent electorates where they do have those facilities and how vital it is that we support those facilities to stay operating and open.
It is very traumatic for people to go into residential aged care. Some have lived their entire lives in a particular community, compounding the trauma which happens at times when people are taken from their home into a residential facility because it's not tenable for them to stay in their home anymore. To then also remove them from their community—adding that additional burden of having many people that are part of their family and their social circle at a long distance from them and, therefore, clearly not able to provide that nourishment they need of regular visitations et cetera—would be a very distressing and disappointing outcome.
So I commend the comments of the many members who have talked about some of the challenges that are associated with mandating certain requirements on operators which will be near impossible for some existing operating residential facilities to meet. I hope the government is very much attuned to and concerned by this, and that they make sure they think through how they structure exemptions for facilities that could have their viability dramatically impacted if we're not careful. I think that point has been made comprehensively by a lot of my colleagues, and I add my weight to those comments to make sure that it is really reinforced to the minister and the government. I hope that in good faith they are able to structure exemptions that ensure those facilities can be viable.
I've talked about community care, and, in concluding, I make the point that I want to see the community care side of this sector very much focused on, and being about people accessing care and support and not about becoming some huge profit-centre industry. The aged-care sector is not there to make people extremely wealthy; it's there to support that greatest generation of people who have served our nation and built this nation, and who need us, as a government and as a society, to give them the highest standard of support and care.
When it comes to community care, a lot of my constituents' experiences have been very disappointing. I won't go into the specifics of those details publicly in this debate, but I think that every member of parliament would have similar experiences of certain providers of community care clearly making a lot of money rather than necessarily delivering an excellent outcome for the people that the system is there to support. I am certainly a happy participant and supporter in this place wherever I get the opportunity to support further change if it's necessary to make sure that's the outcome we're getting around community-care provision.
With that, I'd like to reiterate my thanks to everyone in this sector. It's been a very difficult few years with the compounding challenges of COVID and the workforce in aged care. We know that what they have had to struggle through, in some states in particular, was extremely taxing, brutal and draining, so thank you very much to the people that work in the sector. I hope that we as a parliament will continue to deliver change for you that improves the quality of care to people that need it and also ensures that the great heroes of the workforce of our aged-care system are properly valued for the work they do. I thank the House for the opportunity to contribute on the second reading.