Monique Ryan (Kooyong, Independent) Share this | Hansard source

Every quarter, the government is now obliged to report on the state of its new aged-care system. This was supposed to happen on 28 April. Instead, the government withheld that report for two weeks, dropping it while journalists and the crossbench were in the budget lock-up. The government stealthily and sneakily, I would say, released a report which showed that Australians are now waiting an average of 12 months to access aged care—12 months for a place in a residential home and 12 months for support at home. More than 48,000 older Australians are waiting to even get on the waiting list in addition to more than 230,000 waiting for an assessment or a Support at Home package. Budget estimates will likely reveal that these waiting lists have now blown out even more.

Older people are going without the support that they need. Some are dying while they wait. The Royal Commission into Aged Care Quality and Safety described this failure as cruel and discriminatory. The same royal commission recommended that home support waitlists should be cleared immediately by increasing the number of packages available and that packages should be allocated to new entrants within one month of assessment. This has not happened. Around 3,300 older Australians are now stranded in public hospitals—a 35 per cent increase in six months—because there are no aged-care places or Support at Home packages available to them.

There are issues with residential care as well. In January last year, the government raised the market price cap on aged-care beds from $550,000 to $750,000 without increasing the accommodation supplement. The result was that low-means residents became financially unviable for providers. Providers are warning and telling us that the system is becoming unsustainable, not because they don't want to care for disadvantaged Australians but because they can't afford to. The federal budget's $1.1 billion restructure of the accommodation supplement is a step forward, but it still falls short of the indexed market price cap for many residents. The industry already estimates that we have a shortfall of about 10,000 beds. For older Australians waiting today, having money stuck in the contingency reserve provides no surety.

Then there's the integrated assessment tool, the algorithm that the government uses to determine what care people receive under Support at Home. From November last year to March of this year, there have been 834 requests for review, many of which are a result of decisions by that algorithm. The previous financial year saw just 170 requests for review. I'm hearing from constituents with progressive conditions, constituents with dementia or motor neurone disease, that they're being assessed as needing less care by this algorithm. Thankfully, the Human Rights Commission has endorsed a Commonwealth Ombudsman review of the tool. It's absolutely critical that automated decision-making remains reviewable by a person, not just by an algorithm.

Just six months after the Support at Home program commenced, the government was forced to abandon co-payments for showering, dressing and continence care after some recipients had to forego aspects of basic hygiene and care. The sector has welcomed the backflip, but that should never have been necessary. The basics of ageing with dignity should have been protected from the outset. The episode reflects reform that was not adequately tested against the lived reality of the people who it was meant to serve.

The people waiting in our aged care system built this country. They paid taxes for decades on the understanding that when they need care, it would be there for them. We are not holding up our end of the bargain. So I ask the government to take action on immediate fixes in aged care by doing the following: firstly, by setting a binding date for price caps on aged-care services; secondly, by committing to indexation so that Support at Home packages keep pace with the real cost of care; and, thirdly, by ensuring genuine human oversight of the integrated assessment tool.

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