Nola Marino (Forrest, Liberal Party, Shadow Assistant Minister for Education) Share this | Hansard source

I'm pleased to support the Inspector-General of Aged Care Bill 2023 and the role of the Inspector-General of Aged Care for a number of the reasons that've been outlined by previous speakers, but in particular the capacity to provide that independent oversight of, or for reviewing, systemic issues and constantly drive improvement. For those of us who've had a loved one in residential aged care we understand very well the need for this role, and I can speak personally having had my mother in that situation.

The former coalition government accepted this recommendation and committed to establishing the Inspector-General of Aged Care for that express purpose of providing that independent oversight of the aged-care system to provide the transparency, the accountability, the confidence for all involved, be it the families, be it the individual—that monitoring reviewing process and the public reporting capability that goes with this. In my view it will increase the transparency. That's something for us, in this House, to make sure does happen and to have that process that occurs across the aged-care sector in general.

For me, being a rural and regional MP, I really will be looking for what comes out of the role of the Inspector-General in relation to rural and regional residential and aged-care facilities, given that they face additional challenges in providing services into regional areas. That often involves a lost more cost. And the more remote these facilities become the greater the challenges they're currently facing. Yes, we committed, in government, another $19.1 billion to the sector to assist in this process.

All of us know we've got some wonderful aged-care facilities in our electorates and wonderful people who work very hard. They really do care about the people they care for and we want to enable those people to do so even more.

One of the issues our residential aged-care facilities are currently facing is around the requirement for 24/7 registered nursing available in each home environment. That's really concerning for the aged-care facilities in regional and more remote areas that literally have no chance of doing this, and we know there are so many of them in regional and more remote areas and even in my part of the world. This has put a level of stress and pressure on my wonderful aged-care facilities, which are working their hearts out, literally, to provide really great care to the wonderful people they look after. But this has added another layer yet again, and they are very worried about what this will mean for them. Again, this is where I hope to focus on the specific issues in rural, regional and remote areas. How are these actual facilities going be able to provide that 24/7 care? I've spoken to a number of those in my part of the world, and there is no doubt they are desperately concerned. They're already getting a cross in a box because they are unable to provide that full 24/7 care, and they're concerned about what this means for them as an aged-care provider ongoing.

We know there's a need for another 20,000 or 21,000 additional workers. A UTS report says fewer than five per cent of surveyed aged-care facilities actually have the direct care workforce needed to meet this 1 July deadline, but I don't know where the government thinks, in regional and remote areas, these nurses are going to come from. They're physically not there and they can't attract them. We've raised this repeatedly with government. There is a different issue for rural, regional and remote residential and aged-care providers. Where will the additional registered nurses, enrolled nurses and workforce come from when there are labour shortages right around Australia? What I don't want to see is where we take workers from one part of the health sector simply to move them to another. That creates pressures and stresses everywhere. Also, in WA the government has moved to a one-to-four staff ratio during the day and one to seven at night, and that's in the health sector, which adds to the challenges of supplying the staff. I don't want to see rural, regional and remote areas lose any aged or residential care providers. We are struggling to get them and keep them there, and we have been for some time. You know, 64 per cent of the facilities in major cities operate at a loss, but it's 70 per cent in regional, rural and remote facilities.

I spoke to a provider not long before coming here last week, and they said the process to even apply for and administer an exemption takes an extensive amount of time for people who are already under the pump. They're a small facility in a regional area struggling for staff now, and they've got to go through this process of applying for and administering this particular application for an exemption and keeping that up to date. There's a constant reporting time attached to it and additional cost for them, taking those good people away from the job of looking after our people. They simply cannot source the required number of registered nurses. They've been looking overseas and in Victoria; they're simply not available. The facility, when at capacity, are going to actually need eight to nine full time to be able to service that 24-hour cycle for the number of people they have in their facility.

How on earth do you fund and manage that in a regional and remote area? It's just so hard on them, and they are desperately worried as to what this means for their facilities. This has put on another layer of stress and pressure they do not need when they're doing a great job as it is. It is very difficult and expensive to attract suitably qualified overseas trained nurses as well, if you can find them. They've tried using a third party, an agency, to help source these nurses. They've even gone to the expense of subsidising accommodation for those people they can employ in a regional and more remote area. It's already affecting their star rating—the tick in the box; the cross in the box—that they cannot provide 24/7. This is not okay. They are very good facilities doing a great job. This will have a greater effect when the clinical care minutes apply post 1 July. What I don't want to see is that the respect and value for those places is undermined because they can't tick that box, yet they're providing very good quality staff. They are already struggling to survive. And what will happen to our people that live in small, regional communities when they can't access a residential aged-care facility in their own community? That connection to their community needs to be for life—life and wherever it brings you. I have a list of some fantastic places, but each one of them is under the pump for different reasons. There is a whole different model of aged-care delivery in regional and rural areas.

In the time that I have, as the co-convener of the Parliamentary Friends of Dementia and Palliative Care groups, I encourage everybody out there who's watching to pay attention to their of end-of-life care planning. Put plans in the place to manage your end of life. Make sure you get exactly what you want, where you want. Take control of that and do that work.

To assist some of the residential and aged-care facilities that are dealing with increased numbers of people with dementia—and Australia's going to be dealing with this—Dementia Australia is a leader in technology apps, and only yesterday they were here in this house demonstrating cutting-edge technology to improve the experience of dementia for everyone. With professional Graham Samuel and the amazing Maree McCabe, Dementia Australia provided a tech showcase demonstrating and showing the virtual reality dementia experience technology. This is a very good tool for training purposes for people providing aged care and residential care. What was really disturbing was the meeting I had with Megan about people dealing with dementia from babies to the age of 18. That is also something we need to be considering in this space. Everyone who attended and tried the technology was so impressed, and many didn't even know such technology existed to educate and train residential and aged-care staff and carers. I strongly encourage any and every residential aged-care facility and the dedicated people who work there to take advantage of these practical training opportunities.

They recently introduced the BrainTrack app to learn about your own brain health throughout your life and track your cognition over time using virtual reality technology. That's where your end-of-life early planning comes in, so you can get things sorted. There's Ask Annie, a free mobile app that offers short learning modules for healthcare workers. There's Talk with Ted, a workshop using an artificially intelligent avatar to simulate a typical conversation experience between a care worker and something living with dementia. There's A Better Visit, a free tablet app designed to enhance a really good interaction between people with dementia and their visitors, particularly for those living in residential care. I've had that experience with my own mum in how to communicate well. I went and did a workshop along with my sister so that we could make what is a really tough, heartbreaking situation with dementia the best we could make it.

We also heard from a wonderful woman, Bobby Redman, a retired psychologist who was diagnosed with frontotemporal dementia and is a very active community member. She talked about how she's able to live independently and continue to be active in her community with the help of technology. She lives alone without a family carer: in her own words, 'Technology is my carer.' Bobby was at high risk at home: she was burning food, leaving taps on and suffering falls. She didn't want to move into residential aged care, so she worked with researchers, she sourced timers and alerts to turn off her cooker, she uses a cane, and she wears a falls alarm and a GPS tracker. Her unit is monitored with unit sensors to make sure she's active and moving between rooms, and she has alarms on her phone to provide personal reminders of what she's supposed to be doing at any given time. Most importantly for Bobby, she has been able to retain her freedom and her independence, and to be safe at home and in the community, with that technology. Why is that so important? Deputy Speaker Freelander, I think you would know. For those of us who have shared the dementia journey with someone we love, and suffered along with them, anything that improves the quality of their lives is what we so desperately want—and they want it too. It's what people suffering from dementia desperately, desperately want. There's no doubt that dementia breaks the hearts of those living with, and of those of us who love those who are living with dementia.

And this is going to become even more relevant, Acting Deputy President Freelander, as you know best: last month the Australian Institute of Health and Welfare announced that dementia is now the leading cause of disease burden for Australians aged 65 and over. It's the second leading cause of death for all Australians, and provisional data shows it's likely to become the leading cause of death. So I encourage everyone to go to the Dementia Australia website at dementialearning.org.au/technology. I encourage people to have a look at what's available there for so many families and individuals affected by dementia. Anything that helps in both the experience of the person living with dementia and the family and friends who support and love them and want them to stay as independent and connected for as long as possible is good. Please take advantage of these technologies.

I really want to encourage anyone over the age of 18 that if you don't have an end-of-life care plan in place, please do so. None of us are guaranteed tomorrow, no matter what our age is; none of us knows what's ahead. But what is within our power is to make plans for the day that we cannot speak for ourselves. I had a very good friend who found herself on the floor of her kitchen, having had a severe stroke and unable to speak for two days after that event. She spent her last days in a facility, able only to move a couple of fingers and not able to communicate. If that were you, what would you want? What would you not want? Please make sure that you put in place advanced care plans to take care of all the things you need to take care of. Make sure that you plan for the things you want and need whenever that end of life comes.

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