Rebekha Sharkie (Mayo, Centre Alliance) Share this | Hansard source

In representing Mayo, the oldest electorate by median age in South Australia and among the top 10 oldest in the nation, I have the privilege of assisting my constituents with their aged-care issues and other issues they and their loved ones experience. I wish to lend my voice to support my older constituents as we consider the Aged Care and Other Legislation Amendment Bill 2025.

This bill will provide for technical and consequential amendments to give effect to the Aged Care Act 2024. It aims to ensure the act's smooth implementation through transitional changes from the old to new act, including ensuring correct payment of aged-care subsidies; provision for interim services to be provided in high-demand periods; allowing access to unspent funds; clarifying information-sharing between the Department of Health, Disability and Ageing and Services Australia, which will be very important; provision of substantial penalties for misuse of personal information; and requiring five-yearly reviews of the Aged Care Quality Standards.

The bill refers to aged-care rules, the final version of which are not due to be tabled until October. I hear of a 1 November start date. This seems to be cutting things very fine for providers, who will need to prepare for implementation, and for recipients of aged-care, who need to know what to expect. I understand the bill includes a time limited rule, making power to enable the government to move more quickly to address emerging issues following the implementation. This is highly unusual and concerning, and I do not think this place should write a blank cheque by providing the minister with the power to make rules which could alter and override rights, entitlements and obligations set out in the act. That is the express intent of the parliament, without parliamentary consideration. That's the purpose of us being here.

This bill also includes automatic processes to support decisions on the classification level of aged care to which a person is entitled, the prioritisation and allocation of aged-care places and means-testing to calculate how much a person should co-contribute financially to their care. Automation warrants real concern and caution, in my view. That's particularly so given the sobering example of robodebt and the unfriendliness of online systems for older members of our community and those for whom English is a second or third language. I therefore urge the government to guarantee improved availability of services to assist older people with that transition.

Over the last 12 months, my constituents have reported sporadic difficulty and lengthy waiting times on the Services Australia aged-care line and My Aged Care. People will need quick, easy access to these supports and to aged-care service offices to address any questions or problems that may arise out of the implementation of the new act. I note the bill avoids substantive changes to the Aged Care Act passed late last year. Unfortunately, this means some worrying policies, such as charging increasing co-payments for personal care, will not be revisited. I remain concerned that increasing co-payments or personal care may be detrimental to older people, who may feel they cannot afford the care they need.

While help with a daily shower is not clinical care, a person's health can decline quickly, necessitating clinical care if they, for example, suffer an infection or a fall in the shower due to receiving inadequate personal care. I've asked advocates from the Council on the Ageing, COTA, National Seniors Australia, the Older Persons Advocacy Network, known as OPAN, and provider peak, Ageing Australia, for their comments on this bill, and I thank them for their ongoing feedback on all things aged care. I regret, as do these well-respected bodies, the delay in commencement of the new rights and protections for older people under the act but understand the need to defer the commencement from 1 July this year to 1 November this year to enable providers and older people alike to properly prepare for change.

I was pleased when the government heeded our calls by making a pre-election commitment to fund an additional 83,000 home-care places from 1 July to address the huge number of people waiting a year or more for their approved home-care packages to be allocated. The government's decision to defer delivery of these additional packages until after the new act starts on 1 November, rather than 1 July as promised, is a great disappointment. This will do one of two things. People will either end up injuring themselves and going into hospital or, perhaps prematurely, into an aged-care home—that is, of course, if they can get a bad; or, indeed, they will die at home, perhaps prematurely.

The peak bodies are also very concerned. National Seniors has pointed out that, every time we refer to a backlog of the 87,597 packages, we are actually talking about nearly 90,000 people. These are people, not packages, who are not getting the care that they need and so rightly deserve. During that year of waiting for care for their approved level of care, their health will likely deteriorate. They may have to be hospitalised or, as I said, relocate to residential care. And, as I said, some will pass away.

Last year, I asked the former minister for aged care how many people had passed away or entered residential aged care during the 2023-2024 year while waiting for their approved level of home care. I was informed that 3,383 people died and 7,380 entered residential aged care while waiting for their home-care package that had been approved but was still not with them. These people had expressed the desire to receive help at home, preferred by them and cheaper for the taxpayer, and applied for this, but, in the end, they didn't receive it and their wishes were thwarted. The government's choice to continue this state of affairs when they have the power and the budget to address the delay in delivering home care is unkind to our most vulnerable citizens. I would say it is unjust.

Advocates share these concerns, and they have also called for the release of the additional packages per the government's pre-election commitment. Sadly, this has not been heeded. Delays are exacerbated by lengthening the wait times for aged-care assessments at the start of the process before someone is approved to go in the national priority system waiting list for home care. The government previously advised that the introduction of the single assessment system for aged care would help streamline assessment processes and clear backlogs. My constituents and peak bodies tell me that this is having the opposite effect. While it may slow the growth of the actual waiting list—those numbers waiting for packages, those people waiting for packages—it inadequately reflects the buildup of unmet demand, which continues to rise.

My constituents Valerie and Peter have been trying since April to secure a reassessment for Peter as his needs have changed markedly since his initial aged-care assessment in 2021. Despite growing urgency, their family's concerted efforts to contact My Aged Care and the assessment provider every week or two and support from my office, they've only just secured a telephone reassessment for Peter this week, three months later. It's unreasonable for families to have to advocate to this extent simply to secure an assessment date. We're not talking about the actual package; we are talking about someone conducting the assessment on a person, particularly when their needs change. Peter's family say there were advised by My Aged Care to book respite care for Peter in October without having an assessment conducted and approval in place. This was not tenable since they were told it would be costing $600 per day, compared with $40 to $60 per day if he had an assessment and approval for respite.

Advocates advise that they are hearing from many older people seeking assistance with long assessment wait times. Some aged-care assessment providers are resorting to telehealth to address the delays. While this may seem quicker, telehealth aged-care assessments are unlikely to deliver the best outcomes for older people, particularly those with more complex needs. Some carers report being asked by the assessor to comment on the abilities of the person being assessed without having the training to accurately describe this, all in the presence of the person that's being assessed. So, after waiting three to six months for an assessment, and then up to a year—and now it's over a year—for the home-care package, when they finally receive care, older people will be paying more for it under this new system.

Increases in the hourly rates for personal care and domestic assistance of up to 100 per cent have been flagged by some providers in Mayo. These increases are proposed to commence from 1 November. Some increases are above the indicative price guides that have been issued for Support at Home services. This will dramatically erode the care that people will receive from their package money, even for those guaranteed to be no worse off in terms of personal co-contributions. Charging twice as much per hour will only reduce the amount of care and services received.

My constituent Beryl was provided with spreadsheets from her home-care provider. They showed that, if she were to maintain her current hours of personal care and domestic assistance following the introduction of Support at Home in November, she would have a funding shortfall of nearly $1,500 per month. Further, Beryl's funding would no longer cover the services she has received for years, including continence aids, Webster medication packaging, occasional meals, emergency alert monitoring and more.

Despite receiving aged care since 2020, and thus being no worse off in terms of co-payments, this price hike would create a stark deficit in Beryl's care from 1 November. It is clear that she would be worse off in so many measures. Fortunately, Beryl has since been approved for a high-level home-care package. Rather than increasing her care as hoped, a significant proportion of this additional funding will be absorbed by increased hourly rates for core supports and trying to maintain some of her other pre-existing services. Government assurances sent to Beryl in May that there were measures in place to ensure reasonable home-care fees appear empty, given the price hikes that she is going to experience. I'm concerned about the cost of this new system for our older generations who have built this country, raised younger generations and paid their taxes to support others in times of need.

I also recognise the many benefits of the reforms, including an independent complaints process, safeguards for decision-making, protections for whistleblowers, enhanced quality safeguards and a rights based aged care system. However, we are not doing right by older Australians in terms of the current waitlist for home-care packages and the enormous unknown volume of people just waiting to be seen.

In conclusion, while I support this bill, and despite a royal commission, there are still many failings in how we deliver aged care in our nation. Overall, we need to do much, much better by our older Australians.

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