House debates

Monday, 20 August 2018


Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018; Second Reading

10:04 am

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

I move:

That this bill be now read a second time.

Ageing Australians and their families should not be kept in the dark. If adopted by the government, this bill would shine a light upon residential aged-care facilities by requiring them to publish their staffing ratios by qualification, and an optional accompanying explanation. There is no cost to government for this transparency.

The reality is that most elderly Australians who move into nursing homes are making their last move in their living circumstances, and it is certainly not a decision that older Australians or their families take lightly. It is a difficult and extremely important decision, all too often made under trying circumstances, and currently those decisions are not being fully informed because important information about the level and quality of expert care that they can expect is being kept from them.

In my view, a better-informed public is a more discerning public; they have a right to know what they are signing up for.

Earlier this year, I invited the Minister for Aged Care, the member for Hasluck, to meet with aged-care stakeholders and my community in Mayo. Mayo is the oldest electorate in South Australia, and the eighth-oldest electorate in the country, and so the quality of and access to aged-care services is a critical issue in our community.

The minister graciously accepted my invitation, and together we had what was, by all accounts, a very constructive day across the Mayo electorate. I and the community thank the minister for his time, his generosity, and his consideration.

In the community forum held in Victor Harbor, the aged-care issue that was raised the most with me and with the minister was that of staffing ratios.

There was a repeated and insistent call for mandatory minimum staffing ratios for residential aged-care facilities, echoing the sentiments the community has expressed to me since I was first elected in 2016. The contrast is often made to me in our community that we have staffing ratios in child care but we don't have them in aged care, and why is it that ratios are applied to child care but not to aged care? There is no good answer to that question.

The minister respectfully explained his concern for setting mandatory minimums, namely, that it might legitimise and inadvertently encourage aged-care providers to adopt lower targets than otherwise they would have set. I must confess that I am not wholly convinced by this argument, but I do recognise the government's rationale, and certainly take note of their continued reluctance to introduce mandatory minimums.

It is for this reason that, in my private member's bill, I have sought the pragmatic intermediate step of requiring residential aged-care providers to at least disclose their staffing ratios, a step which I believe will grant peace of mind to the Australian community and which the government, I believe, could not reasonably oppose.

Even when argued on pragmatic and detached economic grounds, reducing the information gap between the residents and their families, and providers, will lead to a more efficient, competitive market upon which competing residential aged-care services can more easily attract people through the greater quality of their service.

The bill thus requires the quarterly disclosure of staffing ratios by each residential care facility, which would then be aggregated and published by the government.

In their disclosure and publication, the staffing ratios are broken down by staffing category, namely, by: registered nurses, enrolled nurses, nurses with a certificate IV or equivalent qualification, personal care attendants, allied health staff and other staff members. If, between reporting dates, any of these ratios change by more than 10 per cent, the aged-care provider must also notify the government, within 28 days.

I recognise that different facilities have a different composition of residents with a differing profile of needs. As such, the aged-care provider may accompany their staffing ratio disclosure with a short written explanation. This written explanation from the aged-care facility could provide the context for why they have the particular staffing ratio and therefore will provide even greater clarity to the general public.

Again, I see no persuasive reason not to shine a light on this important facet of residential aged-care services. With the parliament's support, I will be seeking to refer this bill to an inquiry so that residential aged-care staffing ratios and other issues can be raised further and investigated and inform the government about the compelling need for greater transparency and public accountability in residential aged-care services.

I do not believe this to be an onerous task on providers and is designed to inform, not to prejudice.

I might talk briefly about an elderly gentleman in my electorate who was, some period of time after this particular incident, still visibly distressed. He happened to be visiting his wife in an aged-care facility. He was not living in the facility; she was. She began choking on her food. It took more than 20 minutes of him continually pressing the alert button for somebody to come to her room. He said to me: 'What would've happened if I wasn't there? There was nobody around. I yelled out. I was down the hall. I was yelling out to people. Nobody was there to care for my wife.' This was some time ago, and yet this man was in tears talking to me.

Together, in this parliament, I know we can reach a positive and constructive outcome for elderly Australians and their families, and I strongly urge the House and, indeed, the government to support the referral of this bill to an inquiry. I'd like to thank the minister for being in the chamber to hear my bill. Thank you. I will pass on the rest of my time, if it is allowed, Mr Speaker, to the member for Indi.

10:10 am

Photo of Cathy McGowanCathy McGowan (Indi, Independent) Share this | | Hansard source

I'd like to second this motion that the Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018 be read a second time. I will start by supporting the member for Mayo by reading a note from a constituent, Angela, who wrote: 'Over the past 13 years, chronic understaffing has had a huge increase in preventable deaths of elderly Australians in aged care, with people dying from falls, choking and suicide. They are our parents and grandparents, people who looked after us and loved us. But how many of them, especially those in need of high care, are left unfed, unwashed and even in soiled nappies for hours? Staff ratios in aged care must be legislated, as a matter of urgency, to protect the vulnerable, older nursing-home residents, who are the victims of Australia's crisis in aged care. In the absence of mandated ratios, dangerously low levels of nurse and carer staffing continue to put the lives of the elderly at risk. Hard-pressed nurses and care staff do the best they can in impossible circumstances, but they are run off their feet and can't provide the care they want to.' And Angela finishes with: 'This crisis in our aged-care system has been ignored for far too long. Now is the time to take action and pledge your support'—that's her request to me—'to legislate minimum nurse-to-resident ratios in aged care, to ensure our elderly get the care they need.'

So, with that sort of letter from my constituent, I'd like to bring to the House some statistics from my electorate. As you know, we have an annual budget survey, which took place in May. As a result of that survey, 9.2 per cent of survey respondents listed health and aged care as their most important issue, 30.7 per cent listed health and aged care as one of their top three issues and 79.4 per cent of respondents rated aged care and health care as very important. In my electorate of Indi, 22 per cent of residents are aged between 50 and 64, and 21 per cent are over 65. In my electorate of Indi, there are 44 aged-care facilities, and a huge issue is how we, as a small rural electorate, manage to provide the level of service we want in rural and regional Victoria.

Like the member for Mayo, I, too, would like to acknowledge the aged-care minister. Thank you for being here. You've also been to Mayo and Indi, and I know you've met with my boards of management and you've taken a particular interest in how we operate, and I know this is an issue dear to your heart.

But, in bringing this issue to the House today, I want to say: particularly for rural and regional Australia, one size doesn't fit all. We've got particular concerns in more isolated communities—say, for example, in Corryong, a small rural community two hours away from a major health service, that of Albury Wodonga Health. In that community, the multipurpose service provides so much: not only health care but also outreach, support for families, transport and social services that enable the community to continue to provide. It's never going to reach the same level of services of our cities, but it's a vitally important service to that community.

So I say to the minister and to your government: could you please look at this issue and support the call for an inquiry. Let's come out with some really solid, long-term, sustainable services to our communities. And, Minister, we'll back you in this effort and bring our communities with you. But also—I know the member for Mayo—huge understanding of public policy would be really helpful in this area.

Photo of Tony SmithTony Smith (Speaker) Share this | | Hansard source

The question is this bill be now read a second time. The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.