Tony Zappia (Makin, Australian Labor Party) Share this | Hansard source

This legislation implements recommendations of the Royal Commission into Aged Care Quality and Safety, a royal commission which came up with 148 recommendations. In particular this legislation deals with recommendations 12 and 148. As the bill's digest states, the Inspector-General of Aged Care Bill 2023 establishes an Inspector-General of Aged Care and office with a function to monitor, investigate and report to the minister and parliament on the Commonwealth's administration of the aged-care system. This includes independent reviews to identify and investigate systemic issues, and making recommendations to the Commonwealth for improvement. The Inspector-General of Aged Care will need to undertake at least two reviews on the Commonwealth's implementation of the recommendations of the Royal Commission into Aged Care Quality and Safety. It goes on to say the Inspector-General will have coercive information-gathering powers, including powers to enter premises and compel a person to provide information or documents, or to answer questions.

The bill sets out a number of offence and civil penalty provisions, including for unauthorised disclosure of information, failure to comply with the inspector-general's information-gathering powers, or providing false or misleading information, and victimisation of people who provide assistance to the inspector-general. For the benefit of anyone following this debate or listening in to it, that sums up the intent and purpose of this legislation. But in my view, what the legislation also does is it highlights the current inadequacy that existed for years and, at times, indeed, an incompetency of the Aged Care Quality and Safety Commission, which, from my own observation, has over the years failed to adequately support vulnerable elderly people in this country. If that commission had been doing the job that the broader community expected of it, perhaps we wouldn't need this legislation today.

With respect to other agencies that are there to support older people within our country—and that includes the Commonwealth Ombudsman and the elder abuse offices throughout the states—whilst they were set up in good faith, I don't believe they have led to providing families with the services and support that they expect at critical times in their lives. Again, with respect to those agencies, perhaps we need to have a look at the powers they have, so that they can actually implement recommendations and enforce changes that are asked of them when we see an injustice or someone being dealt with improperly.

The real issue about all of this also goes to the process by which concerns are raised with the various agencies. The reality is that that process in itself has been the cause of much of the grief that we have heard about and the grief that was raised in the royal commission—and, indeed, in the other 22 inquiries or so that have been carried out in the last couple of decades. One of those inquiries was a parliamentary inquiry of the Standing Committee on Health, which I was a member of at the time. Time and time again, we heard similar concerns to those raised with the royal commission. I will touch briefly on some of those concerns, because, at the end of the day, it's those very concerns that I suspect this legislation is trying to deal with.

The truth of the matter is we know that there are a lot of good operators out there, and that's the reality. There are a lot of good operators. But there are also some very poor operators. And those poor operators, even since the recommendations of the royal commission were handed down, continue, in my view, to be poor operators. That's not because of the staff they employ, but, rather, because of the management practices that they have. And, as the previous speaker referred to, in some cases they claim they are unprofitable and financially stressed, and, therefore, they can't provide adequate funding to pay for additional staff or even for the quality of care that is expected of them. The truth of the matter is that many of those operators have staff that are absolutely loyal, and if it weren't for those staff I guess the service would be even worse. These are staff that are underpaid, who work under enormous pressure and are often working unpaid hours because they care for the people they are looking after. They work under incredibly difficult conditions and are often undertrained and, in terms of total staff numbers, understaffed. They work in a very difficult environment. Most of those staff, in my view, are doing an extraordinary job, and I thank and commend them for it.

But the reality is this: every time an issue arises within one of those centres it's very rare for the families of the person involved, or for the person themselves, to raise a complaint. Firstly, that is because they believe the complaint will go nowhere. Secondly, it's because they fear that if they raise a complaint they'll be subjected to further punishment and their life will be made even more difficult. I have spoken to family members who say to me, after they have come to my office for assistance, 'We're afraid to raise the matter with any external agency, because our parent in the aged-care facility is likely to be treated even worse.' Another reason people don't complain is the inability of those agencies to intervene. That is a genuine concern. I accept that in some cases those agencies have limited powers. But the fact they have limited powers is of no help to the person who is within the facility and needs additional support.

Furthermore, I believe there's a level of incompetence within many of those agencies. I know the laws have been changed and the administration has been changed, but when you hear stories of agencies advising centres in advance that they'll be calling out to do an inspection, it beggars belief as to what they expect to find by doing that. When you hear of agencies that say they're only going between nine and five, when the truth of the matter is that these centres and the people who live within them are there seven days a week and 24 hours a day, with most of the poor care occurring outside the nine-to-five hours, you wonder where the logic is in them saying, 'Oh, we only operate from nine to five.'

The third area—and I hear this time and time again—is staff themselves. These are staff who, for whatever reason, firstly, care about the residents within their care and, secondly, need the job they have. Therefore, they too are unwilling to raise concerns about what is happening within the centre where they work, out of fear of retribution on themselves by management. I have had people contact me both anonymously and having given me their names and having said: 'Please keep this confidential. I cannot afford for my name to get out there, but this is what's happening in the centre where I work, and something needs to be done about it.' People who work within the centres see the inadequate level of care on a daily basis and want to do something about it because they genuinely care, but the truth of the matter is that they can't. Those are the sorts of concerns that I hope this new position that is being established by this legislation is going to be able to address, if not directly then at least indirectly.

I want to touch on two other matters in the time I have. The first is the home care packages themselves. I note that the Albanese Labor government introduced legislation in December last year to cap care management fees at 20 per cent and package management fees at 15 per cent. I applaud that and support it, but it's come to my attention that some of the operators are finding ways around that. Whilst the legislation has every good intention, the reality is that those operators who want to do so find ways to circumvent the intent of the legislation and are still overcharging their clients.

I will use the case of one person. I won't name the person. This person had a package of $35,000, of which $4,000—and I'm talking in round numbers—was contributed by the person themselves. Of that $35,000 package, the person worked out that, in real service to him, the net amount was about $11,000. The rest of the money was going into admin services to the provider of those services. When the caps came into effect, the provider of the services found a way to circumvent that and is still taking about the same amount of money. Again, that's no fault of the legislation. It simply highlights how, when you want to do something in this world, there is always a way around the laws in place.

The last issue I wanted to raise with respect to all of this is an issue that has arisen more so in recent times. I haven't had time to check, but I don't believe it was addressed in the royal commission findings. It is a matter that has been brought to my attention in my office on several occasions. In recent days, there have been several reports about it. I'm referring to the issue of the intervention of the public trustee in managing the affairs of a person who has perhaps been diagnosed as not competent to look after their own affairs. I'll quote one particular story that was published by the ABC on 26 March, only a few days ago, because I think it really encapsulates what I'm trying to say. The story says:

He is being kept against his will in a nursing home at a cost to him of more than $75,000 a year.

He's been denied access to his own medical and financial information—all in the name of protecting him.

It then goes on to quote the person himself:

I've got no rights at all and I haven't done anything. I've been in business all my life. I've paid my taxes and done everything.

…   …   …

I'm in an aged care facility with very old people that go to sleep in the mess hall and all this sort of stuff. I don't belong there. I belong in my own home that I've worked hard for all my life .

This is a person in his late 70s who's got the early stages of dementia. Those were not the words of a person who has lost his mind but rather the words of a person who has lost his freedom and his rights.

I have personally spoken to people in similar situations in my own state—people who have now been diagnosed and how that occurred I don't know—who now in the care of the public trustee, a state government office. They are right throughout Australia. It seems to me there are too many examples where these offices show no more compassion or empathy than the corporate service providers in this world. I would expect better from state government offices. Even worse, and this is the critical point, they are at times financially exploiting the person whose affairs they are managing the money for. The stories I referred to from the ABC go into a lot more detail about that. I don't intend to do that today, but I simply raise this as a matter of concern that also needs to be addressed.

With respect to the that person I referred to earlier on, the person in his late 70s, I note that the Western Australia Auditor General has called for an urgent review into the state's public trustee, and I commend that line of action. I think that is very appropriate. It will be interesting to see where it leads. The point I'm really making though is that these issues, these concerns, I believe from my observations and from the stories I've read, are very widespread. This is not an isolated case. And it is time that people under the care of the public trustee, right across Australia, are looked at in terms of are they being properly cared for, do they deserve to be in the condition they are in and should they have more rights about managing their own finances and their own wellbeing in the future as to whether they should be at home or not? I have spoken to residents in aged-care facilities who have been put there for the convenience of others and who quite rightly don't deserve to be there and with a little bit of support at home could be living in their own home. People have all their faculties, have a clear state of mind and know exactly what is happening to them and would be able to care for themselves in their own homes if they had a little bit of support.

I believe this legislation is a good step in the right direction. I hope the Inspector-General will be able to delve into some of the matters that I and other speakers in this debate have referred to and bring some accountability and transparency to the process of managing people under aged-care services in this country. I commend the legislation to the House.

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