House debates

Monday, 15 October 2018


Aged Care Quality and Safety Commission Bill 2018, Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018; Second Reading

12:22 pm

Photo of Sharon BirdSharon Bird (Cunningham, Australian Labor Party) Share this | | Hansard source

The original question was that the bill be now read a second time. To this the honourable member for Franklin has moved as an amendment that all words after 'that' be omitted with a view to substituting other words. The question now before the chair is that the amendment be agreed to.

Photo of Chris HayesChris Hayes (Fowler, Australian Labor Party) Share this | | Hansard source

I quote:

In May last year I was asked to come to the nursing home to clean him. My husband was on the verandah outside. He was naked from the waist down, covered in his own faecal matter and in full view of other residents. He had been in that state for three hours.

That's a statement from Mrs Heather Mansell Brown, a very passionate advocate for aged-care reform. After several issues with regard to the substandard treatment that had been offered to her husband, Mrs Mansell Brown decided to take action over what she describes as 'systemic' problems facing aged care. I've chosen this extract not because any of us are proud of the current state of aged care but because I think it succinctly puts into perspective the dire situation currently faced by many elderly in our community.

It's stories like this that have moved me to raise my voice when it comes to the most vulnerable in our community, and this is what I intend to do today. Situations like this—the situation experienced by Mrs Mansell Brown—regrettably are not unique and are by no means one-off in the aged-care sector at the moment. I think we've all been moved by regular media stories concerning aged care and, in particular, the most recent investigative reporting conducted by ABC Four Corners into aged care, and I congratulate them for bringing this very much to the community's attention in the way they did. We've seen and heard about the Oakden facility in South Australia and, more recently, we've read about the Seaforth facility in Sydney's northern beaches. It certainly highlights the inappropriate care outcomes which have been afforded to elderly Australians today. For these reasons, I will be supporting the amendment. Should the amendment not proceed, we will support the bill because we see at least an effort going some way to addressing the integrity of the aged-care system.

In essence, the Aged Care Quality and Safety Commission Bill 2018 establishes the Aged Care Quality and Safety Commission, which will commence on 1 January 2019. The bill will give effect to one of the recommendations of the Carnell-Paterson report, which recommended bringing together the functions of the Aged Care Quality Agency and the Aged Care Complaints Commissioner. The new commission will be tasked with the most daunting of tasks—that is, to restore amongst aged-care consumers confidence in the delivery of aged-care services. Particularly I say that that's a daunting task given the current level of public concern. The new aged-care commission will provide a single point of contact for aged-care consumers and providers of aged care in relation to the quality of care and regulation. It will also be responsible for the accreditation, assessment and monitoring of aged-care services and Commonwealth funded aged-care providers, and for complaints handling. These aged-care services will include all facets of aged care: the aged-care service itself, residential home care, flexible care, Commonwealth home supported care and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. The new commission will be led by a statutorily appointed commissioner who will be termed the Aged Care Quality and Safety Commissioner. He or she will be advised by the Aged Care Quality and Safety Advisory Council. The terms will be up to five years. Hopefully that actually gives a measure of some certainty in terms of the regulatory aspects applying to aged care.

The second part of this cognate debate refers to the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018, which provides for the administrative matters associated with the transfer of functions and operations from the existing authorities to the new commission. It also provides for the continuation of appointments of those engaged on the Aged Care Quality Advisory Council. They are essentially welcome aspects of this bill. They are matters that we would certainly support, but I have to say that we do so with some degree of caution.

The government has shown no willingness to work with this side of the House to undertake a bipartisan approach to aged care. These bills reinforce that this government, quite frankly, for some time now has had a very misplaced sense of priorities. To see this, one only has to look at the recent budget handed down by the government. The government have not put the best interests of older Australians front and centre, as they claim to do. In fact, they have done the exact opposite. This government sought to play a hoax on the Australian people, pretending to allocate more funds to aged care but in reality putting not one extra dollar into aged care—not one extra dollar throughout the budget or its processes. I remind the House that it was actually this Prime Minister who, as Treasurer, robbed the aged-care system of vital funding. In just his first term as Treasurer, this Prime Minister ripped almost $2 billion from aged care. That's $2 billion that ordinarily would have been targeted at care for older Australians.

They would like us all to think that they've changed, that they've taken a new approach. I wonder how they can do that, particularly when they were the government who put, front and centre, as their signature policy, not aged care but an $80 billion tax cut to the big end of town, to big business. That included, despite what's occurred in the banking royal commission, what would have been $17 billion of tax breaks for the big four banks. That's where they set their priorities.

Bear in mind that when we're talking about aged care we are talking about some of the most vulnerable in our community—people who require our help and people who, for most of us, are our loved ones. We want the best for older Australians. We think, when they have worked all their lives, paid their taxes and been good, model Australian citizens, they should know that they will be treated with care and dignity in their most senior years. But please keep this in mind: on top of the Abbott-Turnbull government's previous cuts to aged care, robbing billions over the last five years, we had the embarrassment that occurred in this current budget where Minister Wyatt, who I think is universally respected in this place, tried to sell the proposition that there was more money going into home care packages. Not even he seemed to realise that there was not one extra dollar going into aged care. What they did was take money out of residential aged care and put it into home care packages. It was the exact same figure. Not only was this a Treasury hoax played on the Australian public; regrettably, it was a hoax played on their own minister, who tried to argue that there was priority being given to home care packages, but didn't understand, regrettably, where the money came from. The money wasn't coming away from the banks or big business; the money was coming away from residential packages.

I think the Health Services Union—I must declare a little interest in this organisation, given that my brother is the general secretary of the Health Services Union—summed up the government's persistent attacks on aged care when they made a submission to the Standing Committee on Health, Aged Care and Sport. This is what they said:

What is undisputed among providers, unions, consumer advocacy groups and residents is that cuts to aged care funding by consecutive federal governments are having a significant and adverse impact upon the provision of quality care to older Australians.

I think that's pretty right, particularly when you think that only recently Southern Cross Care in New South Wales and the ACT cut over 6,000 staffing hours from its rosters because of the government cuts to funding. With no reduction in residents, this means hundreds of older Australians have less care, less clinical support, and less support services such as kitchen and/or cleaning services due to the government stripping residential aged-care support in its current budget.

As we speak in the House today, this is happening all across aged care. Staff are increasingly working in unsafe workplaces, doing increasingly demanding work and increasingly spending longer time at work. Many of them are getting less pay than people who are working in our fast-food outlets. Can you imagine? People are looking after older Australians—changing their nappies, regrettably, and doing all that work, trying to show dignity and care—and many of them are getting paid less than the people who work at McDonald's! What sort of situation is that, using smoke and mirrors to move around a budget situation that robs money from some of the most deserving and vulnerable people in our communities? Putting politics aside, I think those of us in this place, with the privilege to be here and represent our communities—I think we've got to be a little bit more mature than that; we've got to understand the way we set our priorities. We simply can't fund the big end of town by attacking the most vulnerable. That's not what a smart government does, and it's not what a caring government does.

As I say, despite all the rhetoric in the lead-up to the last budget, with the government promising to put an extraordinary amount of new money into aged care—it simply did not occur. Those opposite like to tug at the heartstrings of the nation when they talk about aged care, but, when the rubber hits the road, they don't want to provide the funding. They've provided funding for just over 14,000 new home care packages over four years in this budget. Quite frankly, that's nothing but a cruel hoax, when you think of the number of people lining up at the moment for supported home packages. The government, quite frankly, needs to apologise for overpromising and underdelivering when it comes to its treatment of older Australians. The government now has a proven track record of underinvesting in aged care. The Abbott, Turnbull and Morrison governments have created the aged-care crisis. They have gone out of their way to ignore that crisis and they've failed to bring down a budget that does anything to fix the crisis.

While we support the government's recent announcement of a royal commission into the abuse and cover-ups in the aged-care sector, we should not forget the damage to aged care that has occurred under this coalition government. The government cannot wait for the royal commission to finish before it starts trying to fix the problems that it has created in the aged-care system. Those opposite should stop looking after friends and big business and pay attention to the needs of the most vulnerable in our community. (Time expired)

12:38 pm

Photo of Nola MarinoNola Marino (Forrest, Liberal Party) Share this | | Hansard source

I want to speak on the Aged Care Quality and Safety Commission Bill. I want to support the wonderful aged-care providers in my electorate, and I want to thank their staff, who genuinely care for their residents and often spend many hours, over and above their actual shifts, caring for people.

One of the toughest decisions you make as a loving family member is the decision you have to make when your parent or grandparent needs high-level or permanent care, especially when your mum or dad doesn't want to go into care or is struggling to understand why they need high-level care. It's a traumatic time, and it's one that our family faced when our much-loved mother's Alzheimer's made it impossible for her to live at home. She fell in an aged-care home while on respite and broke her hip, and then she fell in hospital and broke her spine. She did not walk again, and she couldn't remember that she couldn't walk and needed high-level care. It broke our hearts to have to make the decision to put mum into an aged-care facility, and we know that we broke her heart as well, because this was the last place that she wanted to be; we'd already had that discussion. In spite of the fact that our family knew there was no alternative, we do carry that hurt today, and I know it's the same for so many families that I speak to.

Given Mum's condition and how much we loved her, my sister and I decided that one of us would visit her every single day and spend as much time as possible with her. We knew it would not be possible for the staff to spend the amount of time with her that we thought she needed. We also knew that for her, with her Alzheimer's, the only real thing that she recognised in her surroundings every day was us—her long-term memory kept us in her mind. My sister and I did an Alzheimer's workshop to better understand how to help her. We learned at the time that where she was mattered far less than who was looking after her. Some of the staff were amazing, wonderfully caring people. On the nights they were on duty, we left the nursing home with a smile on our faces. On other nights I would cry on the way home knowing she would have a long and lonely night.

My mother, because she couldn't walk and was at great risk of falling, was strapped into her chair and her bed. One night she tried to get out of the bed but became entangled in those straps. She hung over the side of the bed in the straps for far too long. She bruised much of her body between the bed and the floor, suffered a stroke and died several days later in 2002. The staff were not allowed to talk to us at all about what had happened or how. Mum had died at night, and we were told that we could clean out her room the next morning. We were told we had until 11 am to do so, but when we got to the aged-care facility, first thing—we were early—her belongings were in a black plastic bag on a trolley and another family was already inspecting and in her room.

What we also saw the whole time mum was in this facility was that some of the other residents never had one visitor. My sister and I frequently did the rounds to simply say hello to those lonely people, and there were some staff members who also spent as much time as possible with them. We know that how we treat our senior and older Australians is a measure of our society. We were taught to respect our elders, most particularly the elderly who need our care. All of us need to show this respect and care, not just staff in aged-care facilities. It applies to each one of us—the family members, the friends, the people in our community as well as those entrusted with the care of our seniors and who provide the formal care.

There are different models of care depending on different cultures. In some countries, families have elderly family members living them, like many in the Italian community. We see this both in Italy and in places like my hometown of Harvey, with its strong Italian population, where local families do everything they can to keep their loved and respected older family members in their homes as long as possible. Some people, like those I've met in India, have several generations living in the same home—grandparents, parents, children and grandchildren. Others build facilities to provide care, like the facilities we see in our electorates around Australia.

With the calling of a royal commission into the aged-care sector, our government is determined to ensure the care of elderly Australians in aged-care facilities is of the highest quality. The royal commission will primarily look at the quality of care provided in residential and home based aged care for senior Australians, but it will also include—and I think this is particularly important—young Australians with disabilities living in residential aged-care settings.

Providing care for young people with severe disabilities is really important. One fantastic example of care for young people with disabilities is Treendale Gardens in Australind in my electorate, and I hope this model is considered by the royal commission as a model for delivering future projects around Australia. This project was a combined effort of the then Liberal state government, the local Rotary Club of South Bunbury and the Multiple Sclerosis Society and the result of the persistence and hard work of John Castrilli while he was the Liberal member for Bunbury. John Castrilli worked closely with Leanne Maher and the CEO of MSWA, Marcus Stafford. With John's strong advocacy, the then WA Liberal government provided the land. MS committed to building, equipping and operating the facility. And what a great model this is: the state government working with a genuine organisation geared towards, and with experience in delivering services to, the community.

This should be the model explored by the royal commission and the government for delivering services Australia-wide for young people. MS built double the originally planned capacity. They saw the need. MS then committed to further investment in our region, building another facility in Bunbury as well providing additional services to the community. In my opinion, this is a win-win model. People throughout the south-west really understand how important it is that we now have the first high-care facility for young people outside the Perth metro area. There was and is a very real need for this facility. Local girl Kylie Berryman was only young when she had a major car accident. She suffered brain trauma and needed permanent care. Her mother, Helen Demarte, worked tirelessly with John Castrilli to find the right facilities for her daughter. Unfortunately, both Helen and Kylie passed away before Helen was able to realise her dream with the facility in Treendale.

In his speech at the opening of the facility, John said, 'A dream came true today: Treendale Gardens, an accommodation and respite facility for people who have high-care needs due to disabilities but are too young to live in nursing homes.' The Rotary Club of South Bunbury contributed over $82,000 to the project, which were the proceeds from their charity house project, which involved an enormous amount of work by club members, and, as always with this type of project, very generous and direct support from the local business community. In this respect, I also want to acknowledge and thank key contributors and Rotary members Kevin, Annette, Terry and Jennifer Coote. It was land at their Treendale development that was bought by the then state government to build Treendale Gardens.

In relation to aged care, it is really important to put the facts on the record. Funding for aged care is at record levels. In 2017-18 alone, aged care spending will reach an estimated $18.6 billion, and funding will grow by $5 billion over the next five years. The sum of $1.6 billion has been provided to create an additional 20,000 higher-needs home care packages and in excess of $50 million is being provided every year for dementia-specific programs.

The issues facing both the aged care sector and people in the later years of their lives are very many and very complex. Those of us who have or have had relatives in aged care really understand this. It is very, very complex. The royal commission will see Australians providing a great deal of evidence in this space. In my view, in many instances our aged care sector provides some of the very best care in the world. I can think of many such facilities in my electorate. There are many in which I would be more than happy to spend my last days, weeks, months and years, if it comes to that.

The incidence of elder abuse and people not being provided appropriate care will be examined by the royal commission. Our government has made some significant changes in the aged-care sector, legislating for new Aged Care Quality Standards, the first upgrade of standards in 20 years, and has introduced a bill to create the Aged Care Quality and Safety Commission, supported by $106 million to support better facilities, care and standards in aged care. We have ensured that the department has the power to inspect facilities and to conduct spot audits. This has led to the closure of one aged-care service per month, with more under sanction to improve their services. This is a really important part of what the government is doing. We are putting in place clear requirements for better standards and we are providing the resources and powers to police those standards and to shine a light on the problems that exist. That's the whole point. These findings demonstrate the effectiveness of the measures we've been taking. I want to congratulate the Prime Minister and Minister Ken Wyatt for taking this decisive action.

This bill is a further step in our government's efforts to provide better quality care for consumers of aged-care services in Australia. It establishes a new single, independent commission that brings together, streamlines and makes more efficient the functions of the Australian Aged Care Quality Agency, the Office of the Aged Care Complaints Commissioner and, from 1 January 2020, the aged care regulatory functions of the Department of Health. It brings together all issues relating to regulation in one body, which has the power to police the regulations it sets.

The commission will be responsible for promoting the confidence and trust of aged-care consumers in the provision of services, including Commonwealth funded aged-care services. It will also promote engagement with aged-care consumers and representatives within the aged-care sector about the quality of care and services that are provided. It will be led by the independent Aged Care Quality and Safety Commissioner. A single statutory office will enable flexible and responsive regulatory powers—flexible and responsive; those things are really important in the aged-care sector. This will enable a holistic risk based approach to aged-care regulation.

Many of the facilities I see, and some in my electorate, were built many, many years ago. We know that the expectations of family and people who are in aged-care facilities have increased significantly. The government is determined to ensure that the aged-care system has, at its heart, the consumer and the consumer's care. Consumers are at the heart of this reform, and, to me, that is the key in this space.

On the complaints side, the commission will have the powers to enforce the regulations it makes as a tough cop on the beat. The commission will engage with aged-care consumers to promote best practice models for engagement and for providers, again showing how consumers are at the heart of this—and the government's intention. Consumers are at the heart of these reforms.

But, in concluding my remarks, I believe that it is up to all of us. Whether we're family members, whether we're members of the community, whether we're the wonderful people who work in aged care—we all have a role to play. I'll go back to the comments I made about the numbers of people who are in aged-care facilities who never receive a visitor. If your families are not in the area, in some instances I can understand this. But when our relatives and when our dearly loved people are in aged care, it is up to each one of us to make sure that we get there as often as we can and love them in the same way when they're in aged care as we did when they lived in their own homes.

12:53 pm

Photo of Anne StanleyAnne Stanley (Werriwa, Australian Labor Party) Share this | | Hansard source

I rise to speak on the Aged Care Quality and Safety Commission Bill 2018. Like many Australians, I watched last month's episode of Four Corners. On Four Corners, I watched footage of the disgraceful, inhumane and undignified conditions that vulnerable older Australians are forced to endure in our aged-care facilities. These are people who have spent their lives building Australia to be the nation we are today. They are Australians who have worked, have toiled and have fought for their country. They are certainly Australians who deserve better.

As I watched Four Corners last month I was disappointed and disturbed, but I was not surprised. Those of us who have had loved ones in aged care have watched the standards and quality of care slip for far too long, particularly on this government's watch. This is no way to treat our most senior and some of our most vulnerable members of the community. I acknowledge the member for Forrest for sharing her mother's and family's experiences of aged care. It is unfortunately too often a story that resonates in many of our electorates and it certainly resonates with my family's experience of my mother's 13 years experience in aged care.

In light of the Four Corners expose, the government seems to have remembered the Carnell-Paterson review. This review came out in October 2017. I would like to ask why it has been sitting on the minister's desk for the better part of a year. The Carnell-Paterson review outlined 10 recommendations on how to improve quality regulatory processes in aged care. Now, nearly a year later, the government has produced legislation enacting one of these 10 recommendations. The government says the purpose of the bill is to establish a new Aged Care Quality and Safety Commission. We in the opposition welcome this. Having a single point of contact for aged-care consumers and providers in relation to quality of care is a good thing. However, it does not fix an aged-care system that is broken beyond the help of a single bureaucratic measure. This bill is inadequate, just in time for a government that is out of touch and out of sight of vulnerable older Australians.

The opposition also welcomes the royal commission into the abuse and cover-ups in the aged-care sector. But action on this crisis can't wait until the royal commission is finished. This government is well aware of the woeful state of aged care in Australia. It has commissioned dozens of reports and reviews and it knows what needs to be done to fix the problems in the sector. But, like the Carnell-Paterson review, these reviews are also sitting on the minister's desk. The royal commission is badly needed, but many of the issues in the aged-care sector are a product of the government's cuts to aged care. This delay in action is the failing government passing the buck.

We do not need to wait for a royal commission into aged care to deliver its final report. We can act now. We already know the quality standards and reporting systems are not working. We know there are not enough aged-care workers, and that those who do work in the sector are not adequately paid, respected or sported to do their jobs. Aged-care workers undergo limited training—some may suggest inadequate training. Currently, workers are able to enter the aged-care industry with a certificate course and are often paid a minimum wage to do so. Given the level of care and attention those with high-care needs require, there seems to be a clear gap between the standard of care older Australians deserve and the way that we train and develop our aged-care workers. However, I do recognise there are wonderful dedicated workers who do their best in demanding conditions within our aged-care facilities. We need to ensure that there is adequate support to ensure all workers in the sector are able to perform to the best of their ability.

It has been two months since the Minister for Senior Australians and Aged Care received the Aged Care Workforce Strategy Taskforce's report A matter of care: Australia's aged care workforce strategy. Only now has the Liberal government publically released this strategy. We call on the government to implement the workforce strategy as soon as possible. The government must work with unions and aged-care providers to implement the strategy to meet the growing demand within the sector.

The state of aged-care facilities in Australia is disgraceful. Constituents in my electorate of Werriwa have long been raising concerns about the standards of care in the aged-care facilities in my electorate. Whilst there are really, really good facilities that care deeply about the people in their care, some have reported to my office that they fear raising concerns due to the mistreatment of other residents who have spoken out. The thing that most concerns me about the latest revelations from the Four Corners story and what I learned from constituents is that aged care has not changed in decades. The treatment of our elderly and most vulnerable has not improved; indeed, for many, it has deteriorated significantly.

All of us in this place must have personal experiences of family members needing aged care. My mother needed nursing home care 25 years ago. As a younger person in aged care with multiple sclerosis, she along with my sister and I, faced many challenges—waiting lists, loneliness, quality of the food, the lack of staff to feed her and look after her needs. We had to supplement and supply personal care items because of the inferior quality and quantity. We were there every day to ensure she was given dinner and lunch because overworked staff didn't have time to get around to everyone while it was hot and palatable. I saw how hard the staff worked and how much they cared about the residents, and this was back in the days when there were registered nurses—most often, more than one—on every shift.

Seven years ago, my husband's grandparents entered a facility. There I saw the same dedicated staff, but it was clear that they were more overworked and that their level of experience and training had further reduced. Given the revelations of Four Corners, it seems that the quality of aged care has not improved and this just isn't good enough. There has been report after report about the situation.

We have known that the baby boomers were going to start needing this sort of supported care for several decades, and yet for five years the government has not enacted any policy and has made no progress to improvement. The reforms introduced by Labor in 2012 were the beginning of this and that government did not let aged-care policy fall by the wayside. This is what happens when funding is ripped out from the aged-care sector. In his first year as Treasurer, the member for Cook cut almost $2 billion from the sector. The royal commission must examine the impacts of those cuts. You can't fix aged care by making cuts like this in an already stretched system.

This is a system intended to support the ageing population. The aged-care workforce is supposed to increase by over 300 per cent in the next 30 years, and it's time to get things right now. As reports about the problems in the sector pile up, the government seems to brush them aside. The government must respond and stop cutting and cover-ups. I say to the government: 'You must do better. You must put compassion and care for older Australians ahead of the cuts.' The government owes an apology to Australians who've been let down by this system. Older Australians have lived lives of service and contribution; they deserve better than the overpromises and underdeliveries of this government, and the failures that older Australians see again and again.

How we treat our most vulnerable of citizens is a true measure of Australian society. If we want to do better—and we should—we must act on changes and fix aged care now. We must not wait for the findings of the royal commission to do so; we must fix what we already know to be broken. These proud Australians affected by the inadequacy of the aged-care system built this nation and fought to secure the future we now enjoy. They are our mothers, our fathers and our grandparents. They deserve better, and this government should do better.

1:01 pm

Photo of Andrew WallaceAndrew Wallace (Fisher, Liberal Party) Share this | | Hansard source

I rise to speak on the Aged Care Quality and Safety Commission Bill 2018.

Older Australians deserve a comfortable and a dignified retirement. The current generation of older residents of my electorate of Fisher literally built our modern Sunshine Coast and the Australian community, transforming what was a quiet and sparsely populated rural area in the years after last century's wars into today's thriving, economically diverse region, filled with opportunity. Across the country, there are 1.3 million older Australians who receive aged-care services. This issue is of particular importance to my community. In Fisher, we have more than 26,000 residents who are over the age of 65, and we have more than 30 aged-care facilities and services.

Debate on this bill is extremely timely. The need for an Aged Care Quality and Safety Commission has never been clearer. At the end of September, The Courier-Mail reported that assaults and rapes of nursing home residents rose by a third last year to a record 3,773. That represents one such assault for every 55 occupants of residential aged care. Those statistics are truly shocking. There was also a 31 per cent rise in aged-care operators reporting residents missing in 2017-18, representing a fundamental failure of their duty of care. As a result of the stepped-up audits conducted at the Minister for Aged Care's request following the Oakden tragedy, the Aged Care Quality Agency has identified 61 homes which were considered a serious risk to residents' health and safety in 2017-18. That's 177 per cent more than last year. The Aged Care Quality Agency was forced to shut down 12 homes and sanction a further 26. In total, 209 nursing homes failed this year's quality audit.

These statistics were illustrated very starkly in the recent Four Corners programs. Alongside the harrowing footage, the testimony from people working in care homes themselves was deeply concerning. Tony Northcote, a consultant of 12 years experience, said:

It's regular, if you're on a night shift as a registered nurse, to be in charge of 100, 120, 150 people …

…   …   …

… I found that over 60 per cent of their bed-bound residents had forms of pressure injuries. 90 per cent of the residents that are incontinent had rashes.

Katrina Legzdins, an enrolled nurse, told the program:

Some people get really depressed, and you have a resident saying, 'Can you give me a pill to kill me?'

They just want to die, and you don't have five minutes to spend sitting there with them.

She added:

You walk out there knowing that the residents deserve better than what you can give them.

Rebecca De Haan, a personal carer of 10 years experience, said:

There were people that were in bed that needed to be fully fed, they couldn't feed themselves at all, and you'd see staff members just quickly going to offer the resident a bit of food. If they didn't take it immediately, [the staff would] just go out and ditch the lunch. And that was really common. You can see these people are so hungry.

The impact on the mental health of staff who work in aged-care residences which do not meet the required standards can also be serious. Once again, the testimony of aged-care workers on Four Corners was distressing to hear. Tanya Bosch, a personal care assistant, said:

It was the most exhausting, confronting, distressing job I've ever had. It was really frustrating to know that on a daily basis, you were failing to meet the needs of some of the most vulnerable people in our society.

…   …   …

… it's just heartbreaking to have to walk away from someone who just wants a bit of kindness and a little bit of a chat.

Troy Mann, a personal carer, said:

I suffered a mental breakdown because of it. I put myself in the residents' shoes. I thought to myself: 'Would I be happy in their position?'

This experience is known as 'moral distress'. It results from care workers feeling helpless in the face of structures which prevent them from taking the course of action they believe is right. A study presented at the American Psychological Association convention in 2014 found that 97 per cent of aged-care workers have experienced moral distress in the workplace, with 47 per cent considering resigning. One in five have taken time off work as a result of these feelings. Associate Professor Denise Jepsen of Macquarie University has said that 50 per cent of home care workers she's interviewed report that they currently suffer or recently suffered from anxiety or depression. The consequences of failures in the processes, practices and structures of aged-care providers are not limited to the harm done to consumers of the services. They also extend to those workers who already do one of society's most emotionally challenging jobs.

For our part, the government have demonstrated significant commitment to providing older Australians with access to care that supports their dignity and recognises the contribution that they have made to our society. Funding for aged care under our government is at record levels. In 2017-18 the government spent $18.6 billion, while over the next five years funding will grow by a further $5 billion. This has helped to support an extra 140 aged-care placements in my electorate of Fisher. We've also invested $1.6 billion to create an additional 20,000 home care packages and allocated $50 million a year for dementia-specific programs.

However, it is clear that in too many cases this additional funding is not delivering the standard of care for older Australians that they so rightly deserve. The Prime Minister should be commended for his decision, in response to recent revelations, to set up the Royal Commission into Aged Care Quality and Safety. The royal commission will give us a chance to go beyond the cases highlighted by the two previous parliamentary inquiries and those described in recent media stories, and conduct a fundamental review of all parts of this sector. It will also give us the opportunity to take a wider view and consider what the future of aged care should look like in Australia.

However, that does not mean that we do not need immediate action. We cannot afford to wait more than a year to begin to turn this ship around. That is why the Minister for Senior Australians and Aged Care already asked for increased inspections and compliance activities from the existing Aged Care Quality Agency, resulting in a non-compliant facility being shut down every month this year. The immediate action we now need has two parts. The first is a new set of aged-care quality standards unified across the sector and focused on the needs of consumers so that everyone in the system—providers, users, employees and families—knows just what to expect. We legislated these this year under the Aged Care (Single Quality Framework) Reform Bill 2018. The second step is the bill before us today. Just as it recreated the Australian Building and Construction Commission to enforce the new Building Code and get tough with the bad behaviour of unions, so is the Morrison government creating an Aged Care Quality and Safety Commission to enforce the new Aged Care Quality Standards and get tough with aged-care providers who are doing the wrong thing.

The bill before us will establish the Aged Care Quality and Safety Commission, which will provide a single point of contact for aged-care consumers, their families and providers of aged-care services to deal with issues of quality and regulation. It will comprehensively cover all parts of the sector, including residential care, home care, and flexible care services. A single commission will be responsible for accreditation and approval of providers, reviews of quality, monitoring of services, and complaints handling, giving the commission all of the levers it needs to ensure appropriate compliance. But the commission will go beyond enforcing compliance; it will help to improve the sector itself and the public's engagement with it. The commission will be responsible for working with consumers and industry leaders to develop best-practice models in delivering aged care and then disseminating them among providers. The commission will also be responsible for helping to provide information on aged care to consumers, their families and the wider public to build confidence in the reformed system and to help them to understand how to engage with it. Through all of this we will properly resource the new commission, with $106 million allocated in the 2018 budget.

Neglect and abuse in the aged-care sector needs to stop. We must have no more stories like those we all heard on Four Corners. The royal commission announced by the Prime Minister will get to the bottom of what needs to be done. In the meantime, this bill will create the tough new cop on the beat that will take what the royal commission has to say and make sure the aged-care sector listens.

Just as a government cannot cure all ill in our society, as the member for Forrest said in her speech, there must be recognition of responsibility among us as families of people living in aged care. I recently had the aged-care minister come to my electorate of Fisher. He was talking about the number of people in aged care who do not get a visitor at all for over 12 months. I appreciate that some families may be geographically located away from their loved ones in aged care, but for some people not to have received a visitor for 12 months is a blight on our society.

Once upon a time, our community—and, in fact, many communities in Europe—looked after their old. I'm addressing this to the young people in the gallery: once upon a time, we looked after our aged in our own homes. With the advent of modern society, that is becoming increasingly more difficult, as we all—both men and women, or couples—work. But we've got to take greater responsibility for our family, for our loved ones. The Europeans would look after their aged relatives—and still do, so much better than we do in this country.

And it falls upon us, as a community, to try and take a leaf out of their book, as best we possibly can, to ensure that our loved ones are appropriately cared for in their own homes, or our homes, or—in the worst-case scenario—in an aged-care facility. But if people are living in an aged-care facility then for God's sake visit them. Some of the loneliest people I've ever met are those living in aged-care facilities.

There's a place here for our community groups to offer the kind of friendship and love that some are missing out on in aged-care facilities, by just sitting down and talking to an older person and holding their hand. And it's not charity. The gift that they will give you—the gift of their stories—is priceless. So I'm calling upon all Australians to do their bit: even if it's not your family member, go to an aged-care facility and spend some time with a resident. You won't forget it.

1:17 pm

Photo of Brian MitchellBrian Mitchell (Lyons, Australian Labor Party) Share this | | Hansard source

The member for Fisher's words remind me of something I've said before: if we ran Australia like a family instead of like a business then things like those the member for Fisher talks about would be much more possible, I think, for many Australians. If we run the place like a business and people are treated like units of production—they're worked harder and harder and faster and faster, and all that matters is money—then it becomes much more difficult for people to take time out to do the sorts of things that he's talking about. If we ran the place like a family, we'd still have to balance the budget, but we'd look after people. We'd look after grandma in aged care. We'd make sure our kids got the best education we could afford. So maybe, if we just changed the thinking of the country—stopped running it like a business and ran it like a family—then I think we'd all be better off for it.

No-one could have watched the Four Corners programs and been unaffected by them. It's the view of many in this House, certainly of those on this side, that the royal commission that the government announced before the program even went to air was to pre-empt the inevitable—that the government knew the revelations would be so nauseating that nothing short of a royal commission would satisfy the public. Of course, the reason Four Corners decided to report on the state of aged care in this country was the unprecedented flood of calls and emails that the ABC received when it put out the simple call to Australians: 'Tell us your story about aged care.' More than 4,000 Australians hit their phones and keypads, and, from those many stories—themselves a fraction of the number of people working in, cared for, or otherwise related to this sector—a tiny number were chosen to reflect what is going on.

So I have a plea that I hope those opposite will heed: do not wait for the royal commission to wind up before taking action to address the issues exposed in the Four Corners reports. The government must not wait for the royal commission to finish before getting to work to fix this crisis.

We have all known for some time that all was not well in aged care. There has been report after report, recommendation after recommendation. The Leader of the Opposition said in May that there was a crisis in the sector, and the minister lectured him for it, saying it was like committing elder abuse to claim that there was a crisis. And that was an appalling—and, frankly, out-of-character—overreach by the minister, and it was demonstrably false, as the government's calling of the royal commission has demonstrated. If there was no crisis, why is there a royal commission?

There have been many inquiries into the issues confronting aged care, and the findings are the same: not enough aged-care workers; too many unreasonable deadlines and expectations; not enough staff per client; and not enough pay, respect or support. The recommendations of these inquiries often aren't acted upon because they cost money, and so a new inquiry gets launched—perhaps in the hope that the new recommendations won't involve spending more money. Well, that would be a false hope.

We all in this place share responsibility for the parlous state that the sector is in today: not enough money invested, not enough staff trained, not enough oversight of standards and not enough care at the highest levels of government to ensure that people who are at their most vulnerable, in the twilight of their lives, are cared for with dignity, compassion and respect. I am ashamed, as a parliamentarian and an Australian, that elderly people in care facilities have been left for hours in their own faeces or left to cry for assistance but not heeded because of either a lack of staff or a lack of care. I am ashamed that people whose only crime is age have been fed slop barely fit for dogs because providers either do not have the money or do not care enough to cook them decent meals. Each and every one of us in this place needs to take a good, hard look at ourselves and ask the questions: 'What can I do to improve things? Where are my priorities? What do I regard to be a proper level of public investment in aged care? What will I do to progress a better outcome?'

I know the minister to be a decent man—a thoroughly decent man—and I know that the shadow minister has a cordial and respectful relationship with him. I know the minister would always prefer there to be bipartisan support on aged care, and normally I'd agree with him. The parliament and the operations of government generally work better when there's more cooperation and less conflict. But it is this opposition's job to hold this government, and this minister, to account, and under those opposite aged care has lurched from crisis to crisis. And it has lurched because of the deliberate actions of the government.

In the 2016 budget, the Prime Minister, who was then Treasurer, cut $1.2 billion from the Aged Care Funding Instrument. The problems in aged care were not unknown at the time, they just weren't in the headlines. The Prime Minister told this place in the last sitting that there have been no cuts to aged care, even though they are there in his own budget, in black and white and in unambiguous language. Perhaps he thinks if he repeats the lie long enough it will simply be believed, irrespective of the fact that the cut was announced in his own budget, was reported far and wide in headlines across the country and was talked about with alarm inside the aged-care industry.

We can't cut our way to better care. We need to be investing more, not less, in the care of our elderly. And if anyone in this place starts muttering about the impact on the budget or fiscal irresponsibility, they can mutter all they want. This is a matter of priorities, and I know that my priority as a parliamentarian is to ensure that elderly Australians live out the final years of their lives with dignity. We need more staff, better wages and better conditions for those who undertake the important work of caring for our elderly. And it's important that when we talk about staffing levels we talk about more than just nurses. Nurses are vital, but so too are personal care assistants, cooks, kitchen hands and cleaners. Much of the heavy lifting in aged care—and I talk literally here, as well as figuratively—is done by non-nursing staff. These are the people who help move immobile residents from place to place, who turn up in the middle of the night to shift people to avoid bed sores and who help with cleaning, toileting and other personal care. So, yes, more nurses are important. But if we are really serious about improving the level of care in aged-care facilities we will provide more staff across the board, including overnight, and in non-nursing roles as well.

I am pleased to offer my support for this bill, the Aged Care Quality and Safety Commission Bill, and to the new agency that the government is intending to establish. I am disturbed, however, that the aged-care sector has been allowed to deteriorate to the point that such an agency is necessary. It is not like we weren't warned. The Health and Community Services Union, HACSU, and other health unions have been warning us for years that this crisis was headed our way. They see it every day on the front line with their members, who battle with unreasonable demands to meet deadlines, inadequate staffing and massive turnover—so many good people leave the sector, burned out by poor pay and grim working conditions.

Australia is a wealthy country. It is unacceptable to me that the government has failed to appropriately support this crucial sector, its employees and its clients. Across Australia, the aged-care sector is an enormous contributor to the national economy. It is a $20 billion sector, employing more than 224,000 Australians, across more than 1,800 businesses, companies and agencies, who care for more than 270,000 elderly and disabled Australians. As the Four Corners program demonstrated, we are beyond the tipping point when it comes to acceptable standards. Over the past year, my own office has received numerous complaints from constituents about the standard of care that their loved ones are receiving. They come to my office, helpless and distraught, unsure of where to go or what to do. Many are scared to complain to the centre itself, worried that by raising their concerns their loved ones will be resented for it.

Aged care is especially concerning to people in Tasmania, which has the oldest population per capita in Australia. The Council of the Aged indicates that more than 19.4 per cent of the Tasmanian population is 65 or older, that the state has a median age of 42 and that, across our state's 29 local government areas, the proportion of the population that is over 65 years is increasing. Tasmania's population is also ageing at twice the rate of the rest of Australia, with over-65s increasing by 3.4 per cent between 2011 and 2016, compared to 1.7 per cent for the rest of the country. This suggests that many of the people who are coming to live in Tasmania from other states are already in their senior years. In June 2017, during a hearing for the inquiry into the future of Australia's aged-care-sector workforce, the committee was told that by 2025 Tasmania alone will need an additional 4,000 aged-care workers to meet demand. It is clear that simply putting recruits through a training sausage factory is not good enough. We need an aged-care sector that values its employees, pays decent wages and offers secure employment and fair conditions. We need to recruit good people and keep them in the sector, not burn them out.

For some time now, my office has been trying to help Ron navigate the aged-care complaints process after his wife, Maureen, who suffers early onset dementia, was neglected during a short stay in one of Hobart's more reputable aged-care facilities. Over just a few short weeks of care, which was supposed to offer respite for Ron, he would visit Maureen to find her lying in bed or propped up in a chair—soiled and unshowered—sluggish after being dosed with valium, a medication she'd never previously been prescribed. He complained to the service a number of times and then to the Aged Care Complaints Commissioner, but Maureen's care did not improve. At one point, Maureen managed to leave the facility undetected. Where she went Ron does not know, nor has he been told how long she was missing. Having withdrawn Maureen from the service, Ron now relies on her home care package for assistance and respite, which is a challenging process and service to negotiate in and of itself. As we all know, there are hundreds of thousands of people on that list. Is this the kind of care we want Australians to experience? Is this the type of care that is appropriate and acceptable? No, it's not. We need to do better for our elderly. We need to do better for aged care—every single one of us.

Photo of Rob MitchellRob Mitchell (McEwen, Australian Labor Party) Share this | | Hansard source

Perfect timing! The debate is interrupted. In accordance with standing order 43, the debate will be resumed at a later hour.