House debates

Wednesday, 17 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

4:15 pm

Photo of Kevin HoganKevin Hogan (Page, National Party) Share this | | Hansard source

Before debate is resumed on this bill, I remind the House that it has been agreed that a general debate be allowed that covers the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018. The original question was that this 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 moved with a substitute other words. In continuation, I call the member for Eden-Monaro.

Photo of Mike KellyMike Kelly (Eden-Monaro, Australian Labor Party, Shadow Assistant Minister for Defence Industry and Support) Share this | | Hansard source

I was reflecting upon the enormous blowout in the waiting list for in-home aged care before I broke my speech on the Aged Care Quality and Safety Commission Bill 2018 and the related bill. It really is getting quite distressing for all of those people who are in these incredibly attenuated waiting periods now. People are dying, waiting for in-home care. It's just a completely unacceptable situation, and I'm getting feedback on that at every community forum, mobile office or interview I have around the region. Of course, this is exacerbated much more in rural and regional areas.

It's a shame that the coalition government did not build on what was the successful concept of the Living Longer Living Better program. I guess it's just another testament to the failures to build on Labor's initiatives in many areas in this respect. I'm also very proud of the investment that we put behind aged care along with that program. In Eden-Monaro we invested not only in facilities but also in relation to the workforce issues that have been presented to this country with the demographic challenge of an ageing population. I was very happy to get funding for the Bega and District Nursing Home—half a million dollars there is an example of facility support.

In relation to that challenge of the workforce, we are looking at a 300 per cent increase in demand over the next 30 years. That has to be met; we have to be planning for these sorts of skill challenges. Most of our good, full-time and rewarding jobs in the future may be in areas like the NDIS and health and aged care. So where is the plan for that? We're not seeing any plans in the Defence skills area either, frankly, or a plan for supporting the Snowy Hydro scheme—we know there are going to be 5,000 new jobs there. All of our TAFEs have been gutted, with the $3 billion that this government has cut from TAFEs. That has also been compounded by the damage that the New South Wales state government has done to TAFEs. This is heinous, in that we've seen a 140,000 loss in apprentices over that time.

In contrast to that, when we were in government we saw hundreds of thousands of dollars invested in training for the aged-care workforce in Eden-Monaro, including at the Eurobodalla Adult Education Centre, where $675,000 was dedicated to providing the skills and training that that workforce needed for the demand that was really increasing, particularly in my electorate. We have a number of aged-care facilities right around the region. Obviously, it's an attractive place for people to come to and retire to—to enjoy facilities in a beautiful environment, surrounded by caring communities. But they need that support.

The other aspect of it, of course, is not only the workforce but in relation to those facilities. There is a greater demand on the nature of those facilities. There is astronomical growth in dementia in Australia at the present time. In 2016 dementia became the leading cause of death among Australian females, for example, surpassing heart disease, and in 2018 we know there are an estimated 436,366 Australians living with dementia. And we're also seeing a lot of early onset dementia that we never used to see. There is a lot of speculation about the causes of that—of course, some of the baby boomers may have experimented with different types of cigarettes or whatever in their time—but, certainly, this growth in dementia is a huge problem.

That means we have to provide higher-end facilities to deal with that demand. I've talked to a lot of our aged-care facilities in Eden-Monaro, like, for example, Horton House Nursing Home and Warmington Lodge in Yass, where there is a lot of knowledge and experience that have been gleaned from international best practice in designing facilities and centres in that space. But it takes money, and we've got to be helping there. When you stump up to the budget that we've just had and say, 'We're putting an extra 3,000 home care packages out there,' but then you take that money from the residential care side of the budget, that's stealing from Peter to pay Paul. And it's hurting these aged-care facilities and their ability to deal with this huge challenge in the growth of dementia. Specifically in Eden-Monaro, we're looking at 3,110 people suffering from dementia in 2018, and that number is going to grow. It's projected to be, in 2028, 4,242 and, by 2058, 6,165. That's a huge challenge for our country and it's one that we must begin planning for in terms of facilities and workforces, because people dealing with those high-end needs really need particular training.

Obviously, when we see the state government pulling registered nurses out of aged-care facilities, like they're doing in New South Wales, there's a huge outcry. I've had meetings around my region. There was a huge forum in Merimbula, for example, with a very big roll-up of people from the sector and people trying to deal with the sector. The big things that were raised were exactly these issues: staff issues, in terms of the ratio to residents, and the heart-rending stories they tell you of being unable to sit with dying residents because they're now completely focused on tasks that they're getting paid for, in theory, with no extra ability to actually provide the human care and contact that the residents need. I've seen this firsthand through some personal experience, but they are telling the heart-rending stories of their inability to provide the basic human contact and service that our aged citizens deserve and earned. They've earned the right to be treated that way.

We talk about the great generation that suffered and delivered to us the peace, freedom and prosperity we enjoy. How are we looking after them now? What's the return for them on all of that sacrifice? The workers in those facilities also deserve our respect and our support. We've seen the horrendous images in the Four Corners reports, but there's a larger systemic issue. The royal commission that's being put in place needs to address and deeply dig down into the systemic issues that are causing the problems that have so shocked the nation.

People also complained about the My Aged Care portal. The government are trying to force a lot of stuff online now and so many of our citizens are not just capable with dealing with those types of online portals. They're really struggling with them. Their lives don't necessarily fit into the dialogue boxes that have been created. We know what a terrible record the government have with digital and online services, as my colleague the member for Chifley has highlighted on many occasions. My Aged Care is just another example of the failure of that digital service provision that the government are becoming notorious for. The meetings have been extremely useful but alarming. I put my hand up and say to those people we met at those forums: I thank you so much for providing your personal stories and information. We're feeding that into the policy process. Labor believe in providing you that help, and help will hopefully be on the way if we can win the next election.

The answer to these issues will require a budget strategy, clearly, and that brings me back to the tax reform suite of measures that Labor is proposing. It has been extremely honest and forthright and, some would say, brave in putting them forward to the community. We took the community at their word when they said they wanted politics to be more honest and they wanted respective governments to be honest with them and put forward policy, not come to government and then suddenly surprise them, like we saw with the Abbott administration, which said there would be no cuts to health, no cuts to education, no changes to pensions and no cuts to the ABC or SBS, and immediately proceeded to do all of that. This is a bit of a cautionary warning to the voters of Wentworth on Saturday: before the Griffith by-election, they all ran around and said, 'There's no plan for a GP co-payment. It's outrageous to assert there's a plan for a GP co-payment,' and what did they do after that by-election? Wham: they tried to go ahead with a GP co-payment. So, people of Wentworth, beware. When the government tell you they're going to do a review or do something or not do something, don't believe them.

With our tax reform measures, we will provide the budgetary support for the things that must be done, and that is why the dividend imputation reform is so important. I say to people who have raised this issue with me: think about your retirement income. In retirement, we know that, in the last three years of your life in particular, you will be drawing the most heavily on health services and aged-care services. That's when you're going to need it the most. We could have an American-style, dog-eat-dog, user-pays environment where you will be left to your own devices and it will completely destroy and eat into your retirement income, or this nation could do the right thing as Australians, who have always believed in providing you with that support so that it doesn't come completely back onto your income. So we need to do things like the dividend imputation reform to assist you with your retirement income and give you the support in your retirement that you have earnt. It's not like it is being taken away from you; it's being given back to you as security and support to get the health- and aged-care services that you will need, you will want and you will turn to government to provide. And there will be many more people turning to government to provide that.

This is the necessary reform that has to take place, and it's in areas like closing off tax loopholes, not increasing tax. We're talking about closing all those loopholes out there that the nation can no longer afford. You should not be able to claim this tax relief for tax not paid. It's quite simple and it's fair. So we're about fair tax reform at the same time as putting ourselves in the position to do good budget reform to enable ourselves to also invest in the health facilities, education and aged-care services of the future. That's what you're going to get from a Labor government, and the choice is very clear.

4:26 pm

Photo of Julie OwensJulie Owens (Parramatta, Australian Labor Party, Shadow Assistant Minister for Citizenship and Multicultural Australia) Share this | | Hansard source

We were all horrified at the appalling record of abuse of elderly in care in nursing homes. It's a full-blown crisis, as Four Corners demonstrated all too clearly, and Australians are rightly appalled by the shocking stories we've seen and the crisis in our nation's aged-care system—particularly by the standard of care being delivered in some of our nursing homes. One of the worst in the country is actually in my electorate of Parramatta. But we shouldn't actually be surprised by what we saw on Four Corners, because the warning signs have been there for quite some time. There have been reports that have languished on ministers' desks. The Labor opposition called for investigation and action quite some time ago and said that the sector was in crisis. The signs have been there, and it's clear that the government has not acted on those signs. It's clear that, in many nursing homes across the country, the standard that we all expect is not being met.

So Labor is supporting these bills. The purpose of the Aged Care Quality and Safety Commission Bill 2018 is to establish a new aged-care quality and safety commission from 1 January 2019. The new commission will be tasked with helping to restore the confidence of aged-care consumers in the delivery of aged-care services, given the context of recent public concern. It does become essentially a one-stop shop. The new commission will provide a single point of contact for aged-care consumers and providers of aged care in relation to quality of care and regulation and will be responsible for accreditation, assessment and monitoring, and complaints handling of aged-care services and Commonwealth-funded aged-care services. That covers all four areas of aged-care services, including residential aged care, home care, flexible care services, the Commonwealth Home Support Program and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. So it is a one-stop shop and it is a significant move to address some of the many problems we have in the sector.

There is a well-known growing need in the aged-care sector, something that we've known about for a long time. We've known for a long time that our population is ageing. Even back in the Howard-Costello years we had reports from the Treasurer on the ageing of the Australian population. An ageing policy is a rapidly changing environment and it's been driven essentially by the Living Longer Living Better reforms delivered by Labor in 2012. Those reforms were designed to deliver important benefits to older Australians, including more support and care at home, better access to residential care, increased recognition of carers and those from culturally diverse backgrounds, more support for those with dementia and better access to information.

I remember those years leading to 2012 when we engaged in the consultation with our many diverse communities, who all have different attitudes to how they support their families as they age and their partners as they age. For many of our communities—and the member for Chifley would know this quite well—the idea of putting a parent into a nursing home is just not an option. It's so far beyond their cultural understanding of support for their parents and their partners. So, provision of home care and culturally-appropriate home care was incredibly important at that time, and it was very well received.

They were really important reforms, because we also know, if you think about it, that what the person wants for themselves and what is best for them and their families, which is to stay at home as long as they can, is also, strangely, cheaper. It's better for everybody. Renovating a bathroom so that a person can get in and out of a shower or a bath, installing a winch so that a person can assist their partner get in and out of bed—these things are relatively inexpensive and allow a person to stay at home. And they're incredibly inexpensive relative to the alternative, which is putting a person in a nursing home or having people come daily to assist. So there are lots of options.

The Living Longer Living Better reforms were designed to provide that flexibility so that families, with all their cultural differences and all their different capacities and needs, could make the decisions that were best for them. The main focus was about consumer directed care that would give older Australians greater choice about the care they wanted but the independence and support to live in their homes for as long as possible, preferably until they passed away. The aged-care reform package provided $3.7 billion over five years. It was legislated in June 2013, three months before the Abbott government was elected.

We know how important it is, because 1.3 million Australians are currently receiving some form of aged care provided by 400,000 nurses and carers. And by 2056, which is getting closer by the day, it's projected that the aged-care workforce will need to triple to around one million workers required to deliver services for more than 3.5 million people, and older people will represent one in four Australians. Public expenditure on aged care is expected to double as a share of the economy by the 2050s. We've known this for some time. This is not new information. We have known for a long time that we need to work hard and consistently on making sure we have the appropriate aged-care system in place for our ageing population.

The government have been really quite inept over the last five years. They don't have a minister for ageing and aged care in the cabinet, for example. Given that we're talking about a quarter of the budget within 30 years, given that we're talking about one in four Australians being in aged care within just 30 years, that is quite remarkable. They've had three aged-care ministers across the Abbott-Turnbull-Morrison government, and their carriage of the reforms for the past five years have failed to do anything, in any real way, across the Ageing portfolio.

The former health minister, Sussan Ley, did little or nothing to progress the Living Longer Living Better reforms. What she and Tony Abbott will be remembered for is cutting billions from aged care and dumping Labor's $1.5 billion workforce compact, even though we know we're going to need hundreds of thousands more aged-care workers over the next 10 to 30 years. More than a dozen reviews and reports, including hundreds of recommendations, are still sitting on the minister's desk without being actioned. The government has cherrypicked its way through some of the recommendations but has done little or nothing to drive long-term reform, and any changes it's making are piecemeal in nature. Now that it is acting, we know that it's acting in response to a crisis brought on by the public sector.

Many years ago, when I was in my late 20s, I was a great fan of an old Chinese book called Bing Faor The Art of War. It was written by a group of Chinese philosophers but is credited to a man called Sun Tzu. It forms a foundation for a lot of business strategy right through the Asian region. I had about seven translations in my early 20s. It's a phenomenal book. A lot of people misunderstand it. Essentially, it says that the greatest generals are the ones you've never heard of, because they manage not to go to war. They manage to avoid war. The greatest doctors don't have sick patients. You've never heard of them, because the patients don't get sick. If a person lets a problem get to a point it's visible, they've already failed. So the ones known for presiding over the rise of a problem and then solving it are not the ones you should really be praising—they're the ones you've never heard of.

I look at this government sometimes and I watch it do almost the opposite. The idea that this government would see a problem coming and act early to avoid it, to minimise its effects, to make it go away—I don't think they're capable of it. It's as if every time they act it's because they've let the problem get so big that everyone can see it. And, once everyone can see it, they act on it and seek credit for the solution. It's completely the opposite to what a great leader does, it's completely the opposite to what a nation needs, and it's certainly the opposite to what all those people in aged care needed when they were being treated the way the Four Corners report showed.

The extraordinary growth in the number of older Australians waiting for care underscores the coalition's complete inaction and failure to address the crisis in our aged-care system. As the list gets longer and longer, fresh stories emerge daily of older Australians waiting for care, particularly in the all-important home care area, which keeps people home with their families as long as possible. It's incredibly important and the choice that most Australians would make. None of us are saying: 'Woo hoo! I'm looking forward to going into an aged-care facility.' None of us are doing that. We all want to stay home as long as possible, and home care allows that. But older Australians are entering residential care, or even emergency departments, rather than staying at home and receiving the home care they were approved for, because the waiting list is so long. Since the first release of data, the waiting list for home care has grown from 88,000 older Australians to more than 121,000, and it includes around 96,000 older Australians with high needs, many with dementia, and around 56,000 older Australians who have no home care package at all.

In the budget, the government announced with fanfare the funding of 14,000 new in-home care packages over four years. I want to break that number down. That's about 3½ thousand places a year. We have 150 electorates. If you assumed—quite wrongly, but probably quite reasonably—that each electorate had roughly the same number of people who were over the age of 70, you would be talking about 23 places per year per electorate. In Parramatta we have 12,300 people over the age of 70. It's inconceivable that the number of new places required in my electorate per year would be 23, when I have nearly 12½ thousand people over the age of 70. Many of those people are in communities where it would be inconceivable for a person to put their parent in an aged-care facility. Home care is actually the necessary solution in order for them to live within their cultural norms and, essentially, sleep at night. So that was an amazing announcement that the government made with such fanfare. We also know, by the way, that they funded it by taking money from residential aged care. We've seen, instead, the waiting list grow, and it will continue to grow until the government take this seriously.

I don't have the figures for the electorate of Parramatta itself, but I do have them for Western Sydney. As at 31 March, there were 2,160 people in home care packages in Western Sydney, and in June this year there were 968 people in the prioritisation queue who had not been assigned even a lower level package. They hadn't been assigned anything. So we had close to a thousand people in the queue in Western Sydney in June 2018. There were 492 home care packages released in the June quarter, but we had 968 people on the prioritisation list—and that's not counting the people who are not in the prioritisation queue. So there's no way in the world that what this government is doing is keeping up with what is actually required.

We on this side of the House support the royal commission into the abuse and cover-ups in the aged-care sector, but we want to stress again that we've been saying for quite some time that there is a crisis. And we want to point out again that the government mustn't wait for the royal commission to finish before they start fixing this crisis. The Abbott-Turnbull-Morrison government cut $1.2 billion from aged care. The former Treasurer, Mr Morrison, cut $1.2 billion from aged care in the first budget, and he cut residential aged-care places in this year's budget. He called this cut—$1.2 billion from aged care—and further cuts to residential aged-care places 'efficiencies'. Well, they are not efficiencies for the families whose loved ones are being treated the way we saw on Four Corners. These aren't efficiencies; this is horrific for families who know that they have no other alternative but to have their parent or their partner in an aged-care facility and know that every day they are being treated in that way. Families are justified to have deep concerns about the quality of care being delivered in residential aged-care facilities for their loved ones, and they saw it proven on Four Corners.

Prime Minister Morrison is characterising his $1.2 billion cut to aged care as a little fact. That's an insult to every older Australian who relies on care. This Prime Minister, when he was Treasurer, actually cut the per resident funding for aged care. Every time he tries to talk about the numbers and says, 'It's more money,' remember that there are more older people. The key here is that he cut the per resident funding for aged care. Each person in an aged-care facility gets less funding per person than they did before this man became Treasurer. Of course the budget grows; it has to grow. The number of older people is growing and the number of people in aged care is growing, but they get less per person, thanks to this government, than they did before. That is the thing to remember when you worry about your family. When you worry about your loved ones in aged-care facilities, just remember that: less money per person under this government. (Time expired)

4:41 pm

Photo of Graham PerrettGraham Perrett (Moreton, Australian Labor Party) Share this | | Hansard source

I rise to speak on two bills, the Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018. The purpose of these two bills is to establish a new aged-care quality and safety commission from 1 January next year. The establishment of the commission was one of ten recommendations included in the Carnell-Paterson review. Whilst Labor supports these bills—I say that up front—I would just like to make the comment that it is almost one year since the Carnell-Paterson Review was handed to government. Why has the Morrison government taken so long to action this review, when the aged-care sector is clearly in crisis? Labor has known for a long time that the aged-care system is in a state of national crisis, but this shambolic government has been too busy dealing with their own internal crises to notice.

It is hardly surprising that the sector is in a mess when they've had three different aged-care ministers across the Abbott-Turnbull-Morrison governments—the ATM governments. The aged-care minister is not in cabinet, and the coalition does not even have a minister for ageing. There have been dozens of reports and reviews into the aged-care sector, but none of them have been actioned. The only action the coalition government has taken in aged care is to cut. Let's have a look at it. When Prime Minister Morrison was Treasurer, the member for Cook was responsible for ripping out almost $2 billion from the care of older Australians at a time when the number of older Australians was increasing. Is it any wonder older Australians are suffering with ever-decreasing levels of care? In 2012 under a Labor government, Labor introduced the Living Longer Living Better reforms. These reforms were designed to deliver important benefits to older Australians, such as: more support and care at home, better access to residential care, increased recognition of carers, recognition of those from culturally diverse backgrounds, more support for those with dementia, and better access to information. The main focus of Labor's reforms was to give older Australians a choice and to provide them with the support to live independently in their homes for as long as possible. These reforms were accompanied by a funding package of $3.7 billion over five years.

Sadly for the elderly of this nation, just three month after those historic Labor reforms were legislated, the Abbott government was elected. Since then, the coalition government has shown almost a complete lack of commitment to Australia's aged-care system. They've cut billions from the aged-care system and they've ignored dozens of reviews and reports, including hundreds of recommendations that were all about improving the aged-care sector.

Aged-care policy is not something that can be kicked down the road. It's in crisis already and every demographer—and anyone who goes out in their community—knows that it is only going to get worse in the years to come. There are around 1.3 million Australians currently receiving some form of aged care. There are around 400,000 nurses and carers administering the care to these Australians. By 2056, just 38 years away, the aged-care workforce will need to triple. One in four Australians will require aged care by 2056. That's around 3½ million older Australians. We need to get this mess fixed now.

So I support the Royal Commission into Aged Care Quality and Safety. The horrors of abuse we have seen documented on Four Corners and elsewhere really are a national shame. Sadly, these are not just one-off incidents. We know that abuse is occurring widely and is still happening today.

When the Minister for Senior Australians and Aged Care announced the royal commission, he asked members of parliament to engage with their communities and report what issues should be included in the terms of reference for the royal commission. Unfortunately, he only gave us a very short time frame—in fact, just one weekend—but I emailed my constituents on the Friday afternoon and asked them to report back to me on the Monday.

I was overwhelmed with the response just in that one weekend. Many Moreton constituents told me of their own experiences with their loved ones in aged-care facilities, and this was heart-wrenching information. The same issues came out in emails and phone calls and letters over and over again: staffing levels; the qualifications of staff; the standard of care; appropriate care for those living with dementia; the provision of medical care in residential aged care; the needs of the culturally and linguistically diverse residents; the affordability of aged care and funding arrangements; the transparency of provider performance and regular inspections of residential facilities; information about the choices available in aged care; and responsiveness to the allocation of home care packages and transitions between levels of aged care.

This is a sector in deep crisis. A royal commission is welcome, but older Australians deserve this crisis to be fixed, not just recognised. The Morrison government needs to do its job and look after older Australians who need to access aged care. The Prime Minister has a particular responsibility because he was responsible for those deep cuts into this sector. The waitlist for home care packages has now blown out to 121,000. These are older Australians who want to stay in their own homes, thus saving money—people like my father. They are capable of staying in their home with some support, but the longer they stay on the waiting list without the support they need, the more likely it is that they will need residential aged care. Many older Australians are waiting more than two years for the home care package they've been approved for. This is disgraceful.

It is with great reluctance by the government that these figures were even revealed at all. The release of each set of data has been delayed by months. The most recent data was released under cover of—guess what?—the grand final weekend. It was released late on the Friday afternoon right before the NRL and AFL grand finals kicked off. Labor has written to the Prime Minister and the Minister for Senior Australians and Aged Care, calling on the government to do more to fix this crisis in the home care package waiting list.

Sadly, there is a significant, growing crisis inside the aged-care sector, and that concerns dementia. Dementia is the second-leading cause of death for Australians, but for women it is actually the leading cause of death. Dementia is not a normal part of growing old. It is an insidious, terminal illness that impacts on and eventually takes the lives of more and more Australians each year. This is an urgent issue, one that has a serious impact on the aged-care sector.

Labor fully understands how urgent the issue is. At the last election, Labor made a commitment to raise awareness of the growing dementia crisis and build community capacity towards a dementia-friendly nation. We must continue to invest in research to find a cure, but, until we have that cure, we need to do more to make our communities livable places for people with dementia. We need to make sure that government gives families and carers of people living with dementia the support they need and that aged-care providers are giving their residents who are living with dementia the care and the dignity that all older Australians deserve.

It is not good enough that older Australians are continuing to endure the suffering that we've seen on our TV screens, on that Four Corners program and in other programs. Older Australians living in residential aged-care facilities include some of the most frail and vulnerable in our community. Many are unable to communicate to raise the alarm if their care is not as it should be. They often literally have no voice—and please note that correct use of the word 'literally'. We often hear the phrase, 'It's your word against theirs,' but, for our most vulnerable in aged care, many have no words. When there are unexplained bruises or other injuries, the families have no choice but to accept the explanation given by the aged-care provider, even when that explanation just does not sit right.

They could make a complaint to the Aged Care Complaints Commission. Many of those have been made—more than 5,000 last year. But, as I will come to in a minute, those complaints often go nowhere. Imagine the fear of those vulnerable, frail residents—not able to move, not able to raise any alarm at all and day after day subjected to treatment that no Australian should be subjected to. We must ensure there are safeguards in place for these Australians to protect them from harm.

I must stress that the overwhelming majority of carers in the aged-care sector are great, or good. They are hardworking and caring professionals. We're not talking about the majority; it's just the occasional rogue. But, sadly, sometimes there are not enough of the best-hearted people. There are not enough staff, or not enough trained staff, to properly care for the needs of those dependent on their care.

The Australian Medical Association's submission to the Senate Community Affairs Legislation Committee said that the current system has failed older Australians—strong words from the AMA. They said that the current:

… lack of coordination and information-sharing can result in the inexcusable, continuous neglect of older people …

The AMA quoted the 2017 Review of the Commonwealth's aged care quality regulatory processes, that said in its report:

Serious complaints about medication mismanagement and unexplained bruising on a resident at Oakden were raised with the Principal Community Visitor in June 2016 and then with Northern Adelaide Local Health Network (NALHN). This led the CEO of the NALHN to request South Australia's Chief Psychiatrist to undertake an extensive review of clinical care within the Oakden facility in December 2016 and appoint a senior nurse manager on 9 January 2017 to oversee the delivery of clinical care. Inexplicably, the Commonwealth aged care quality regulators were not advised of these issues and instead found out about them through a media report on 18 January 2017.

The Aged Care Complaints Commissioner communicates fewer than 15 per cent of complaints received by it to the Australian Aged Care Quality Agency—15 per cent! That cannot be right! The AMA continued:

There is no overarching regulatory body for the whole aged care sector. This be confusing for aged care providers and consumers, as well as create inefficiencies and a lack of communication between the existing regulatory bodies.

So this bill will create an Aged Care Quality and Safety Commission which will be led by a statutory-appointed Aged Care Quality and Safety Commissioner. The commissioner will be appointed for a term of five years.

The task of the commission is to help restore the confidence of aged-care consumers in the delivery of aged-care services. There will be a single point of contact for aged-care consumers and providers of aged care in relation to quality of care and regulation. The commission will be responsible for accreditation, assessment and monitoring of and complaints-handling for aged-care services and Commonwealth funded aged-care services. All areas of aged care will be included: residential aged care, home care, flexible care services, the Commonwealth Home Support Program and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. The functions and operation of existing authorities will be transferred into the new commission. Members of the existing Aged Care Quality Advisory Council will continue for their current term of appointment as new members of the Aged Care Quality and Safety Advisory Council.

As I said at the start, Labor supports these bills, and I support these bills, because these bills will create this new statutory commission. However, I remain concerned about the time it has taken this government—in their 6th year of governing; I guess we can call it governing!—to introduce this legislation, and they've had this recommendation for almost a year. There were 5,779 complaints about aged-care services submitted to the current Aged Care Complaints Commissioner in just the last 12 months. That was an increase of 23 per cent on the previous year. So there is much work to be done to improve the lives of older Australians. As a nation, we should judge ourselves by how we treat our elderly—this generation that has done so much for us. We can't call ourselves a fair and generous country until we give all elderly Australians the love, care and respect that they deserve.

4:54 pm

Photo of Emma HusarEmma Husar (Lindsay, Australian Labor Party) Share this | | Hansard source

It's always good to follow the member for Moreton in his passionate speech, particularly about aged care, and it's great to have so many Labor people up here speaking on this important issue. It's something that we need to all consider, given that we're all ageing and we're all going to get there at some point—some sooner than others, as I note especially when I stand in this chamber with those around me now.

We need to do better in the aged-care sector. Currently 1.3 million Australians are receiving some form of aged care, provided by about 400,000 dedicated nurses and carers. I must say that the reports we've seen on Four Corners don't reflect all of the great work that is being done by some of those hardworking and dedicated aged carers. Given that we're all ageing and we'll all be there at some point, in order to keep up with the monumental demand, which is going to increase exponentially by 2056, the aged-care workforce needs to triple to adequately deliver services. Older Australian will make up around one in four of the population. There are over 14,000 age pensioners living in my electorate of Lindsay. Not all of them receive aged care, but it is fair to say that at some point they will. We need to establish this new Aged Care Quality and Safety Commission and we need do it now—no more stalling, no more waiting.

Given the government dumped Labor's $1.5 billion workforce compact and supplement after the 2013 election, we have consistently called for the development of a comprehensive aged-care workforce development strategy to address the issues of training and staffing levels on an ageing workforce. The government finally addressed workforce issues by announcing $1.9 million for an aged-care workforce taskforce in the 2017-18 budget; however, when the government made the membership of its task force public six months later, it failed, ironically, to include any representatives from the aged-care workforce.

The government's long-term inaction in the aged-care sector means devastating things for everyday Australians. The quality standards and reporting systems are not working, as was very adequately outlined by the member for Moreton. Aged-care workers are under immense pressure to cope with the increasing amount of work and the same—in some cases less—pay, respect and support. I've had representations in my electorate from aged-care workers who are not given adequate breaks; they're not given adequate training; and they're not given adequate conditions to work in under the pressure that they do, lovingly and caringly providing assistance and support to older Australians.

The government, however, thinks that funding just 14,000 new home care packages is enough to deal with the backlog that we have seen grow to 108,000 people currently waiting in the last six months, including 88,000 people with high needs, many living with dementia. Around 54,000 Australians are receiving no packages at all. I watched my great-uncle suffer with dementia. It's not a pleasant disease to watch somebody die from. It's not a pleasant thing to watch them lose all their functions and their ability to be alive, slowly and painfully. We need aged-care workers who are adequately trained and also a government who is willing to openly and transparently provide that support.

The average wait time for somebody at the moment for a level 3 and 4 package is still more than 12 months. I can't imagine watching what my great-uncle went through and then saying that we've got to wait another three or four or 12 months. I don't know what our family would have done. We are also awaiting key data, including a state and territory breakdown of the home care package wait list. Australians who rely on these services also deserve to know when the government's budget, which announced the 14,000 places, will be released and delivered.

It is now clear, though, that the government and the minister have failed to curb the growing home care package wait list and have done nothing whatsoever to reduce this aged-care crisis that has occurred under their watch. The Liberal government shouldn't be waiting for the royal commission to finish before starting to make an effort to fix this national crisis. I note that in May, when Bill Shorten said to this parliament that there was a crisis in the aged-care sector, the government called it the equivalent of committing elder abuse. It is good that they are now actually starting to listen and pay attention. It's a shame that it took Four Corners to reveal that, but that's another reason why we need a good ABC, I guess.

More than two months after this minister for aged care received the Aged Care Workforce Strategy Taskforce's report A matter of care, the Liberal government finally released their strategy. On the other side they seem to be a government of blue skies and rainbows and unicorns. It would seem that they're planning on driving this reform in the sector without having to provide any additional funding whatsoever to implement the strategy. The strategy needs to consider issues such as the proposal for 24-hour registered nurse coverage at residential aged-care facilities as well as the important role of professionals such as GPs, occupational therapists, physiotherapists and dietitians and the impact that the allied healthcare profession can have on older Australians. I acknowledge the chair of this report, John Pollaers, for his important work, and I implore the government to take on the strategy seriously and implement it now without any further delay.

It was only in May this year that the government was refusing to acknowledge that our aged-care system was in a state of national crisis, a crisis that has been caused by endless cuts to this sector. After six years and three prime ministers, those opposite still can't get it right. In his first year as Treasurer, the now Prime Minister, Scott Morrison, cut almost $2 billion from the aged-care sector. Despite this track record, I hope that he makes good and takes this crisis seriously. We've seen report after report and review after review ignored, just collecting dust on the shelves of all of us who have copies of them in our offices, without the government showing any desire or ability to fix the problems. The government's inaction, denial and cruel cuts have manifested in not even being able to fill three vacancies on its advisory council, which is quite concerning given the level of responsibility that the advisory council has. We only have to look at the budget and no further to understand that those opposite have never, and will never, put the best interests of older Australians front and centre. We see that not just in the aged-care crisis but also in their cutting the energy supplement and cutting back Medicare services for older Australians. This government is completely out of touch when it comes to older Australians. It will never put them front and centre, this generation of people who have worked hard to give us the standard of living that we all enjoy now.

The government hasn't allocated a single dollar for Australia's aged-care system in this year's budget. Not only did it underdeliver, but the budget was also quite dishonest and underhanded in trying to say that it funded things which it didn't. Playing politics with the lives of old people is never fun. It's now evident, by the government's own admission, that the 2018-19 budget response of 14,000 home care packages over four years is woefully inadequate, given that the waiting list, as I said before, is up to 108,000. Disappointingly, the Abbott-Turnbull-Morrison—and-who's-next?—government has shown a complete lack of commitment to our older Australians by cutting billions from the aged-care system. It is often said in this place that you are judged by how you treat your most vulnerable people, and I think this is an appalling indictment and a sad reflection on those opposite. Funding only 14,000 new in-home aged-care packages over four years is cruel and made even worse by the fact that the funding is coming from within the aged-care budget, not from new money. Instead of focusing on the needs of older Australians, those opposite have been quite busy and quite successful at fighting themselves. If only they were as good at fighting for older Australians as they are at fighting themselves, I think we'd all be in a better position here. They've denied their duty of care.

In contrast, though, Labor has a strong track record when it comes to ageing reform. It was Labor that introduced the historic Living Longer Living Better reforms in 2012, and it will be Labor that will make ageing and dementia a national priority. Only a Labor government will fight to make sure that older Australians are getting their fair share. The government has created this aged-care crisis and ignored it for so long now that it's going to take a mammoth effort on our part to fix it when we're in government. It astounds me that this government can justify $80 billion in tax cuts for the big end of town, including $17 billion for the big-bank fat cats, while stripping away funding from our most vulnerable Australians. I think it's important to point out the anomalies in giving people a tax cut while older Australians with dementia and high needs are basically left to rot in a state of disarray. It's particularly cruel, though, after the government promised older Australians it would address the injustices in the aged-care sector. The government needs to apologise for constantly overpromising and underdelivering and for failing older Australians while giving away $80 billion in tax cuts. Those opposite must start to work collaboratively with unions and aged-care providers in order to compete with the growing demands and pressures being placed on the sector and to correct the injustices that have been done in the aged-care frame.

If this government fails to act, we will see not only the material impact on older Australians but also the mental impact of the stress and anxiety in the minds of older Australians who are left to fight for themselves and the families and carers who look after them voluntarily. This government has created the crisis, and it needs to come clean and fix it. Its failure to fix this crisis is an absolute reflection on how this government feels about older Australians.

5:05 pm

Photo of Gai BrodtmannGai Brodtmann (Canberra, Australian Labor Party, Shadow Assistant Minister for Cyber Security and Defence) Share this | | Hansard source

I'd like to start by noting that it's a relief to finally be here. It's a relief to see the Morrison government introduce the Aged Care Quality and Safety Commission Bill 2018 into the parliament, and better late than never. One year ago, almost to the day, the government was handed the Review of national aged care quality regulatory processes report, better known as the Carnell-Paterson review report. This review was the result of a Senate inquiry into aged care, after an investigation into the South Australian Oakden aged-care facility revealed abuse and neglect of elderly residents. This bill arises from one of the 10 recommendations from that Carnell-Paterson review. One year ago—again, I underscore this—this government received that review's report. And here we are talking about it today. Since they received the report of that review, it has been one year. It is only now that we are talking about this.

This bill is to establish a new Aged Care Quality and Safety Commission from 1 January next year. The new commission will be tasked with helping restore the confidence of aged-care consumers in light of recent public concern. It will address all four areas of aged-care services: residential aged-care services, home care services, flexible care services, the Commonwealth Home Support Program and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program.

We've seen the reports from the ABC and the fact that this government announced a royal commission just the night before the program actually went to air. Labor supports the royal commission into the abuse and the cover-ups in the aged-care sector, but we don't believe that we have to wait for a royal commission to finish before we start fixing the crisis that has been created by those opposite after years and years and years of cuts to the sector.

There are 108,000 people on the home care package waiting lists, including 88,000 people with high needs. This includes many people in my community. I want to share just one of their stories. These are not hypotheticals; these are stories of the real lived experiences of men and women who have contacted my office for help, after months of feeling helpless.

Margaret lives in Kambah and requires modifications to her bathroom to ensure it is safe for her to use. Margaret's occupational therapist has told her that these modifications are vital—they're absolutely essential for her to live happily and safely in her own home. Margaret was approved for a home care package and applied to a local service provider to have these modifications done 14 months ago. For over a year, she worked with the provider to get the modifications, including to get a handrail installed in her shower. After 12 months of back-and-forth, Margaret was told that the service provider was no longer able to help. After 12 months of communication, the light at the end of the tunnel had gone—it had vanished. She had to start the whole process again. So Margaret began to look for other service providers in the area that could provide the services that she had had approved. Unfortunately, there is only one, and this provider is already at capacity with home care packages and unable to accommodate Margaret. She has now been placed on a waiting list, and it could take up to 12 months for her issues to be addressed.

Since being put on the waiting list, Margaret has had a fall in her shower. She was hospitalised, and her occupational therapist told her once again that the modifications to her bathroom were essential and urgent. This situation is ongoing. Just today, Margaret told me that she is still waiting for a home care package. This is a member of my community who, as recently as this morning, couldn't shower in her own home without the burden of the risk of yet another injury. After a year of back-and-forth to get the package she is entitled to, she has been forced to sit around and wait again.

Last month, in question time, the minister for human services was asked why more and more older Australians were finding it hard to get their applications for the age pension approved. He was, unfortunately, unable to answer, instead inviting MPs with individual concerns to contact him. In 2017-18, the average wait time for Australians trying to access the age pension was 49 days. This is up from 36 days the year before.

In Canberra, it seems to be a different story. Several members of my community can only wish they fell into this timeframe. I recently heard from Peter and Jenny, who live in Banks, who told me that, after applying for the aged pension, they were forced to wait five months—that is, about 150 days—with no communication about the progress of their application. Every email they sent to the department was unanswered and at one stage they were waiting on hold to the Department of Human Services for 45 minutes, so I hope that the minister is listening. Jenny and Peter told me calling or emailing is just a waste of their time. Eventually, they were fed up and visited my office, just like Jan, who waited four months or 120 days for her age pension, and Noel who also waited five months or 150 days for his age pension. Frank and Sharon waited a total of 10 months or a whopping 300 days to receive their age pension.

I hope the minister is listening. Here's what Canberra has to say in response to the request that you just sent out in question time. Frank and Sharon had by far the longest wait time I have ever heard about. I have no doubt there are many more Canberrans experiencing these delays in home care packages and aged pensions and I encourage them to contact me. Canberrans, please call or email my office if you are experiencing unreasonable wait times and delays for the services that you are entitled to.

5:11 pm

Photo of Sussan LeySussan Ley (Farrer, Liberal Party, Assistant Minister for Regional Development and Territories) Share this | | Hansard source

In summing up for the Minister for Senior Australians and Aged Care, I want to acknowledge the contributions of all members on all sides of the parliament relating to this incredibly important issue. For any of us who have tuned in to some of the personal stories from so many colleagues, it has been quite heartbreaking. I commend the Minister for Senior Australians and Aged Care in particular for the lead role he has taken and is taking in actually turning so much of the anguish into action.

The Australian population is ageing and senior Australians and their families deserve to have confidence that they and their loved ones are being properly cared for. The Australian government has established a royal commission to look more broadly at the challenges facing the aged-care sector, particularly as Australia's population ages, including the quality of care provided in residential and home aged care. The royal commission is in addition to, not instead of, the action the government is already undertaking. The government remains committed to continuing its reforms to improve safety and quality in aged-care services. This includes the establishment of a new aged-care quality and safety commission announced in the 2018-19 budget. The Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018 are part of the Australian government's fundamental reforms of the aged-care system. The reforms contribute to the promotion of high-quality aged-care services that meet consumer needs and preferences, and create a competitive market-based system where consumers drive quality.

The new independent Aged Care Quality and Safety Commission will be a single point of contact for consumers and providers of aged care in relation to quality of care and regulation. The commission replaces the existing Australian Aged Care Quality Agency and Aged Care Complaints Commissioner and, from 1 January 2019, will be responsible for the accreditation, assessment, monitoring and complaints handling of aged-care providers and Commonwealth-funded aged-care services. The commission will also undertake consumer engagement and education of providers, consumers and the general public as part of its functions.

The work of the commission will be strengthened through a number of initiatives announced in the 2018-19 budget, which will be delivered progressively over two years. This includes the development of options for a serious-incident response scheme and measures to strengthen risk profiling of providers with the aim of preventing or responding quickly to failures of aged care.

The provisions of these bills have been referred to Senate Community Affairs Legislation Committee for inquiry and report. The government will consider the recommendations and findings of the committee in the context of reforms being introduced by these bills and, as appropriate, through broader aged-care quality reform. Once again, I thank members for their contributions on this very important debate.

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

The original question was that this 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. So the immediate question is that the amendment moved by the member for Franklin be agreed to.

5:24 pm

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

The question now is that this bill be read a second time.

Question agreed to.

Bill read a second time.