House debates

Wednesday, 17 October 2018

Bills

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

12:40 pm

Photo of Tony ZappiaTony Zappia (Makin, Australian Labor Party, Shadow Assistant Minister for Medicare) Share this | | Hansard source

I speak in support of the amendment moved by the member for Franklin in respect to the Aged Care Quality and Safety Commission Bill 2018. Australia's aged-care system is in crisis. Over the last two decades or so there have been around 20 inquiries that in some way relate to Australia's aged-care system. We've just concluded another inquiry by the parliament through the Standing Committee on Health, Aged Care and Sport. That inquiry, whilst concluded, now goes into its next phase, which is to look at the issues of staffing in the sector. We've also seen in recent years several media reports relating to the failures of the aged-care system. We also know that complaints in the sector are increasing. In 2017-18 the number of complaints received by the Aged Care Complaints Commissioner rose to 4,315.

Finally, we now have a royal commission called by the government. I welcome that royal commission. Whilst I am disappointed that the terms of reference do not include inquiring into retirement villages, I nevertheless welcome the royal commission and look forward to its findings. Let me be absolutely clear. The royal commission should be no excuse to defer action or funding on matters of concern that have already been raised, that are known and that need to be urgently addressed. Nor do I believe the royal commission should simply be used by the government as an excuse to put off decisions until after the next federal election.

The royal commission, whilst based in South Australia, should also not be a distraction from the widespread concerns raised in respect to the aged-care sector simply by focusing its attention on what happened at Oakden, which was in South Australia. Oakden, of course, deserves condemnation. But it's had its own ICAC investigation from within that state. It's also been the subject of a Senate inquiry of this parliament. And the facility is now closed. Oakden was not an isolated case. It is clear from the people I've spoken to, the evidence that I've heard and the revelations to date that the abuse and poor care of elderly people in residential aged-care facilities is widespread. That's both from within for-profit centres and not-for-profit centres.

Let me also make it clear that the Makk and McLeay wards in Oakden, the two most heavily criticised, were inspected and licensed by the federal government's health department. This was through the work of the quality assurance agency that, over many years, carried out inspections of that facility. These inspections were carried out over the very years that the abuse was occurring and where complaints were continuously being made. Indeed, between 1 January 2012 and 13 June 2017 there were 64 visits made by the quality assurance agency to that centre. Some 54 were made in 2017, when the centre was in its dying stages.

So there were numerous visits by that agency over the years, and it was only when the public spotlight was shone on Oakden that the agency started to find flaws with the facility. Indeed, from my recollection, there were about a third of the conditions that were not met in the final inspection. I fail to understand how at a time that the spotlight was being shone, and when there was likely to be greater effort made to comply with the conditions, that the agency suddenly found 15 conditions that were not being met when in all the previous years there were no such findings.

The existing regulatory oversight of our aged-care sector has badly failed Australians, and the government has finally faced up to the reality, through this legislation, that change is required. I hope that this legislation brings about the improvements that we all want to see. I support the legislation, but only time will tell just how effective it's going to be because there are two other important changes that are urgently required if this legislation is going to make the difference that we hope it will. Firstly, there needs to be a culture change across the whole sector, from the regulatory agencies right through to the operators of these facilities. Secondly, there needs to be additional funding, and considerable additional funding in some cases. Without it, I can't see how we're going to make the improvements that the community is calling for.

Every day around 200,000 people are being cared for in an aged-care facility somewhere across Australia. In the course of a year, about 240,000 people will have passed through these facilities. Around 85,000 people are currently in receipt of a home care package, and those numbers are rising—121,418 people are currently on the national prioritisation queue, waiting for a package. We know that those figures continue to rise and, indeed, the real concern is that the government's commitment to providing those packages is not even keeping up with the number of people that each week come onto the waiting list. In the last decade, 33,667 new residential aged-care places were added to the system. Over the next decade, it's expected that around 83,500 will very likely also be added.

The problem, however, is not just that there are more people coming into the aged-care system; with respect to residential aged-care facilities, they enter aged care at an older and more vulnerable age. Over the last decade, those people who were in these residential aged-care facilities and were in what would be referred to as the 'no-care or low-care' classification represented about 45 per cent of people. Today, that figure is down to 15 per cent. Conversely, the people who were considered to have high-care needs 10 years ago were about 28 per cent of the population of those facilities. Today, that figure has gone up to 58 per cent. So we've seen a very clear change in the type of people in these facilities and in their needs. And with greater needs, of course, comes greater cost and greater support required.

Not surprisingly, the industry now claims that some 43 per cent of their facilities are either operating at a loss or are struggling financially. The funding is inadequate because of funding cuts by this government, including the dementia supplement cap that was made some years ago. This government's failure to properly index funding has resulted in a real effect, where billions of dollars have been cut from this sector. This is what the Aged Care Guild said about financial viability in a letter that it sent only last month:

Current funding for aged care services in Australia is inadequate and needs to be addressed. According to independent data from StewartBrown, Chartered Accountants and provider of the most comprehensive financial data across the aged care sector – has calculated that care funding for residential care falls short of cost by $7.30 per day, per resident. The Guild is concerned that the disparity of over $558 million per year of care funding will - without redress – lead to further failures in the system and put senior Australians at risk.

It goes on:

Operating costs for aged care providers are currently growing at an industry average of 5.2 per cent per annum, while average care funding will grow by only 1.2 per cent for 2018-19. This is on the back of zero growth in care funding for 2017-18. This is unsustainable and is forcing providers to either reduce services, close or sell their operation, or continue operating whilst financially hampered and risk non-compliance with quality of care standards. In fact, 43 per cent of providers are currently operating at a loss and the remaining 57 per cent are forecasting similar outcomes over the next twelve months.

That letter sums up the state of the industry right now. Whilst I accept that it's a letter from the industry and obviously they've got an interest in their remarks, the reality is that it also reflects the conversations that I have had with so many of the centre operators and with other people currently within the sector and, indeed, the experiences of what we're seeing within these facilities.

The issue is even more critical with respect to regional and rural locations, where residential aged-care facilities are not only critical; in many cases they might be the closest place that an older person can be taken to. They don't have a choice, in many of the regional and remote areas, as to where an older person can be cared for when they can't remain in their own home, and so those facilities are absolutely critical to those communities. And I know that for many of the regional and rural centres the financial viability is even tougher. Residential aged-care facilities are also important for those communities because in many cases they add immensely to the local economy and job creation within those communities. If they fail, not only is the care that they provide then not available to those communities in the future, but it directly affects the whole township because of the jobs that are lost.

What we have seen in recent years throughout the sector is that the financial pressures are resulting in cost cutting, which in turn results in fewer staff, poorer levels of care, lower food quality and less access to allied health and other social programs that were previously provided. The expectations being placed on staff within those facilities are unrealistic. Some of the stories that I have heard from people who've come to see me about it make me very concerned about how staff could possibly provide the care that is required by residents in those facilities, given the work pressures they are put under.

The other concern that arises from all of that is that it is a false saving for government. What is happening today is that because there is inadequate staff in many centres, when a resident becomes unwell, rather than calling in a doctor or having a registered nurse on site who might be able to attend to the needs of that person, they are immediately being taken to the local public hospital. That in turn puts pressure on the local public hospital—and our hospitals, as we all know, have their own pressures to contend with—to provide a service which could have be provided within the residential aged-care facility, had the facility been properly staffed. I know that is happening because, again, I have spoken directly with people in the emergency sections of public hospitals around the country.

In addition to all of that, we now know that even the doctors are not wanting to go to residential aged-care facilities as they did in the past. One in ten doctors surveyed have stopped going to aged-care facilities altogether in the past five years. We know that one in three GPs have now said that they will phase out or scale down their visits to aged-care facilities over the next ten years. They won't go there, because the compensation, the money they get under the MBS from the government for visits to aged-care facilities, is simply inadequate for the time that they spend at those facilities. It does not adequately compensate them. So, again, if we don't have doctors visiting residents within the facilities, of course they'll end up in the public hospitals, which in turn comes at a much greater cost to the public. So it's actually a no-win situation to cut back on funding to the residential aged-care facilities if ultimately we are going to end up sending them to the public hospitals.

The last point I want to make is this—and I think this is a critical matter. There was a 13-year study by Professor Joe Ibrahim, who found that one in six deaths that occur in residential aged-care facilities was preventable—one in six. That in itself should have rung alarm bells for government and said something is wrong and we need to act and act urgently. If we can prevent those deaths then we should be doing so. The only reasons they were not prevented were, again, the financial pressures and the staffing shortages within those centres. I look forward to the outcome of the royal commission findings.

12:55 pm

Photo of Milton DickMilton Dick (Oxley, Australian Labor Party) Share this | | Hansard source

There's been much debate from both sides of the House on this important legislation, the Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018. Whilst Labor will be supporting these bills, it would have been better if I were speaking in this place with both major parties on a bipartisan unity ticket on the issue of giving our eldest Australians the care they deserve. Unfortunately, this is not the case. The government's actions on this national crisis could be considered somewhat too little too late. There are around 1.3 million Australians who are currently receiving some form of aged care, which is provided by around 400,000 nurses and carers. By 2056 it's projected the aged-care workforce will need to triple, with an additional one million workers required to deliver services. We ensure that our aged-care system is properly funded and prioritised to benefit not only our current eldest Australians but for future generations to come.

When our parents and grandparents begin the next phase in their life with aged care, we should know for certain that they are comfortable, they are cared for and they are safe. Last month on Four Corners we saw, as we've heard in this debate so far, the horrors that are facing millions of elderly Australians in aged care. They were deeply disturbing and completely unacceptable. In my opinion, it is indeed a national shame that these types of behaviour have been left unchecked. But I want to be really clear that this is not new information. The Morrison government has known about these types of injustices for years but have paid lip service rather than deliver any sort of decisive action to fix it. For example, we've heard from the previous speaker about the Oakden nursing home in Australia early last year. In response to Oakden, we know there was a Senate inquiry. This Senate inquiry report triggered the government to commission the Review of National Aged Care Quality Regulatory Processes, better known as the Carnell-Paterson review, which was handed to the then Turnbull government on 23 October 2017, almost exactly one year ago.

In fact, as the shadow minister and the member for Franklin stated yesterday, the government has had on its desk more than one dozen reports into Australia's aged-care system. One, of course, is the Carnell-Paterson report into Oakden, but, to date, only one of the 10 recommendations has been partially implemented with legislation in this place at the moment. There are a range of other recommendations that need to be implemented that we are still waiting for. We've had the David Tune report into aged-care services in Australia, for which the government has responded to 18 of 38 recommendations. Another 20 are yet to be dealt with. Despite all of this, when the Leader of the Opposition said in April this year that Australia's aged-care industry was a 'national crisis', members of the government refused to pay any attention and just continued with lip-service. The so-called Minister for Senior Australians and Aged Care even had the audacity to say that this statement was 'verging on the abuse of elder Australians'. It just goes to show how much the government sticks its head in the sand and refuses to acknowledge how bad the crisis has actually become.

These are some of the nation's most vulnerable people, who, rather than receiving the care they need and deserve, are instead being exploited and taken advantage of. Australians are right to be appalled by the shocking stories we've seen and by the crisis in our nation's aged-care system, particularly the standard of care delivered in some nursing homes. The aged-care providers must take responsibility for this but so too should the Prime Minister and the government. The lack of response in relation to any reform fits a disturbing pattern of cover-ups and inaction on aged care from successive Liberal governments. It is deeply disappointing. There are dozens of reviews and reports on aged care that have been ignored by the government.

What is worse is that the Abbott-Turnbull-Morrison governments have shown a complete lack of commitment to Australia's aged-care system by cutting billions from it. I've been listening to what members of the government have been saying in this debate today and there's been one thing missing: an apology—members of the government getting on their feet and apologising for not taking action sooner. I'm not going to cut it in any way, shape or form that somehow the government have done the right thing here. They have been dragged kicking and screaming, just like any other issue they've got to deal with. And we've never heard the minister in this parliament get up and apologise for not taking action sooner. We've never had the minister walk to the dispatch box and actually outline the reasons why he didn't take action sooner.

The facts are very clear: when this Prime Minister was Treasurer, he cut $1.2 billion from aged care in his first budget. A cut in size has consequences, and we are seeing these consequences play out in reality today. This is nothing you can sweep under the carpet. The Prime Minister can't revel in the fact that we now have a royal commission when year after year it was his government, and every single member of the government, that voted to take away funding and that didn't take action on these issues seriously. Rather than dealing with this growing epidemic head-on, it is deeply concerning that the government have responded with cuts, not compassion. We know this is nothing new for the LNP in this country. This goes hand in hand with cuts to schools, cuts to TAFE, cuts to hospitals; the list goes on and on. Every member of the government should be ashamed of themselves. They should be embarrassed and they should get up in this chamber and apologise to older Australians.

It is sadly inevitable that standards in the care of older Australians have begun to slip under the weight of these cuts. You cannot cut $1.2 billion from the aged-care sector in this country without there being consequences. And then the government say, 'Oh, yes, it's all terrible. We are deeply concerned about older Australians.' What a load of rot and what a load of rubbish. If they were concerned about older Australians, why did every single member of the Abbott-Turnbull-Morrison governments cut funding to aged care? Stony silence, as always. It took the airing of the Four Corners report to have the Prime Minister jump into action. It was clear to see in that program that the current regulatory framework that should be protecting older Australians in care is not working. This is despite the Minister for Senior Australians and Aged Care saying the complete opposite.

Labor has repeatedly raised public concerns about the lack of transparency and the handling of reporting and complaints made against residential aged-care facilities. We know there are doctors, nurses, carers and health professionals who work hard to deliver care to older Australians each and every day. We recognise that every day around the country the majority of older Australians are treated with care and respect at residential aged-care facilities. But anyone who watched the Four Corners program would be genuinely moved by the stories told by staff and families about those not receiving this care, and it is clear they were let down. But of greater concern to their loved ones was that they did not get the care that they needed.

While Labor supports a royal commission into the abuse and cover-ups of the aged-care sector, millions of Australians simply deserve much more from this out-of-touch government, rather than waiting for the royal commission to finish before they start fixing the crisis. What we as a parliament need to make sure of and what the government need to make sure of is that we don't wait until the final report in 2020 before acting, because these issues are real and they are happening now, just like the massive blowout in the waiting list for appropriate home care packages. First it was 80,000, then it jumped to 108,000, and the most recent data tells us there are now 121,000 older Australians waiting for the approval of home care packages. This includes 95,000 older Australians waiting on this list with high-care needs, many with dementia, and around 56,000 older Australians who have no home care packages at all.

Our national aged-care system has become almost diabolical because of this government's cuts and neglect. There is no other way to look at it. These might sound like harsh words, but when you talk to healthcare professionals—and one of the first things I did when I was a candidate, before office, was to go and visit and meet with aged-care workers because I wanted to hear what a life in their shoes was, before I was elected. I've got a number of aged-care facilities in my electorate, and today I place on record the hard work and the dedication of those men and women who care for the most frail and vulnerable in my community. I salute them. I acknowledge the work that they do, and I pay them tribute in this parliament on behalf of the people that they care for. We recognise and thank them for the work that they do.

The most recent home care package data was delayed by more than a month and released under the cover of the AFL and NRL grand finals weekend. What a cop-out. They are a government who are so ashamed of what they have delivered for elderly Australians that they will do anything to hide from it. As the list grows longer and longer, fresh stories emerge daily of older Australians waiting for care. It's simply unacceptable. The government will tell you that they are doing something about it. They are taking action to solve the crisis which has come at their own hands. How are they doing this? They are doing it by funding just 14,000 new in home care packages over four years. This is laughable. We know that the latest data on home care packages reveals that the waitlist has grown by a further 13,000 in just three months. This is not a solution; this is a slap in the face to older Australians, who continue to wait six months, 12 months or even two years for appropriate care.

When you break it down, the 14,000 places announced by the government equate to just 23 places per electorate per year. That's 23 in my electorate and 23 in the electorates of the member for Macquarie, the member for Wills, the member for Burt and the member for Lingiari. We say that's unacceptable. I want members of the government in the chamber today to answer this question—through you, Mr Deputy Speaker. Do they think that's acceptable? Do they think that offering just 23 places in their electorate is somehow a job well done? It's not. It's a joke. We know that. Outside of this chamber, if the government wasn't so busy destroying itself, blowing itself up, fighting amongst itself, voting for white supremacy motions in the Senate and making all of the administrative errors that seem to happen day after day, which is an excuse for a government, it should actually take this issue seriously.

This is all in stark contrast to this side of the House. Bill Shorten, the Leader of the Opposition, announced in his budget reply speech earlier this year that under Labor:

… tackling dementia and delivering better aged care will be a national priority backed by real resources …

This is backed up by the letter that the Leader of the Opposition and the shadow minister wrote to the Prime Minister last month to state Labor's support for the royal commission but at the same time to question whether the scope is broad enough to capture the full picture of what is happening to our oldest Australians. As I said, while the royal commission is a step in the right direction, it will not examine the impacts of reduced funding through the Aged Care Funding Instrument or the inadequacies of short- and long-term funding of the aged-care sector.

Labor also remains committed to establishing a royal commission into violence towards and abuse of people with disability. It's inevitable that the Royal Commission into Aged Care Quality and Safety will consider issues that relate to people with a disability who reside in aged-care facilities, whose stories and experiences should also be taken into consideration for future development.

On this side of the House, we know what it takes to deliver real quality aged care to elderly Australians, because, unlike those opposite, we actually get out into the community and speak with older Australians, their families, their carers and the staff who work in aged-care facilities. I've held a number of visits into the residential facilities in my electorate and was delighted to host the shadow minister for ageing, the member for Franklin, who did just this, in my electorate. We visited a number of aged-care facilities and retirement locations in my electorate: a great new location in Springfield; Sinnamon Village, a terrific village; and a new nursing home facility at Jindalee. We heard from residents and staff about the enormous pressure and strains that those in aged care are under, particularly seniors who are relying on government support. That's what real action to improve our aged-care system looks like: getting out into the community and listening to stories of older Australians firsthand.

My mother resides in a residential aged-care facility. I want the best support and care for her. She lives in a place called Bolton Clarke, formerly known as Carrington Retirement Village, in the suburb of Parkinson in Brisbane. Today, with the time I have remaining, I want to acknowledge the carers, the nurses, all the ancillary support staff, the OTs, the extra support and the diversional therapy staff—all the great and wonderful men and women who turn up day in and day out to look after my mother and her neighbours in the village she lives in. They do a wonderful job. They talk to me about the pressures that they are under. When I say, 'What do you want government to do?' they simply say, 'We want respect and we want resources.'

Now, we've got an opportunity to work in a bipartisan manner around aged care in Australia. It's time the Morrison government heard the message. More needs to be done. We cannot simply wait for the findings of the royal commission. We've got to take issues seriously. Stop cutting funds to aged care in Australia. Start listening to those in the sector, because my loved ones and all other loved ones in Australia deserve nothing less.

1:10 pm

Photo of Susan TemplemanSusan Templeman (Macquarie, Australian Labor Party) Share this | | Hansard source

We support the establishment of a new single point of contact for aged-care consumers and providers of aged care that is focused on quality. The bringing together of the Aged Care Quality Agency and the Aged Care Complaints Commission functions was one of 10 recommendations from the Carnell-Paterson review. You have to wonder why it took so long for this one to be implemented.

The new commission's job is going to be about restoring confidence of aged-care consumers in the delivery of aged-care services, given how much public concern there has been in recent times. The new agency is going to look after accreditation, assessment, monitoring of and complaints-handling for aged-care services and Commonwealth funded aged-care services. It is a huge responsibility that it will carry. The aged-care services include 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 this is really looking out for the quality of care for every aspect of our aged-care system right across the country.

Normally these bills would be considered non-controversial—and in themselves they are—but aged care has become one of the crisis points for our community. In fact, I think my conclusion is that these bills are a missed opportunity for the government to give the new commissioner stronger arbitrary powers, given the level of public concern in relation to service providers. It's also timely that we put the government on notice that there must be no change to the cost-recovery process or the fees charged to ensure that there is ongoing support for smaller providers. The smaller independent providers are part of the mix of aged care in my community. Those and the larger not-for-profit providers are full of staff who are doing what they can within the constraints that they have. They provide the very best quality care that they can, but the constraints they face are enormous.

If we think about the current environment, around 1.3 million Australians are currently receiving some form of aged care, which is provided by around 400,000 nurses and carers. The number of people aged over 85 years is rapidly increasing compared to younger age groups, and it's predicted to double by 2032. It's projected that by 2056 the aged-care workforce will need to have tripled to deliver services for more than 3.5 million people, and older people will represent one in four Australians. That's not happening in isolation. That's happening as the workforce demands also rise for people looking after people with disabilities under the NDIS. Both these things are happening at the same time. In aged care, it's an increase from around 366,000 or up to 400,000 people currently working in the sector to around one million by 2050. That is huge growth by anyone's calculations. Public expenditure on aged care could double as a share of the economy by the 2050s. These are really important financial and social considerations that we have to make.

I want to take a moment to talk about three aged-care workers in my community who have for many years been arguing for workforce issues to be addressed. Nurses and Midwives Association member Jocelyn Hofman, Annette Peters and Shirley Ross-Shuley have been fierce advocates for improvement in aged-care nurse wages and conditions and for quotas, and I support them in that call. They know what they're talking about. They have experienced appalling situations of having to look after too many people, with not enough qualified staff.

I've also heard from HSU members about the pressures they face. Quite frankly, from the stories that have been shared with me by staff and by families of residents, we as a parliament have a lot of work to do to make sure that staff are able to do their jobs as effectively as possible and to spend time with patients so that they feel they are cared for, not just dealt with. That is our greatest challenge.

The role of nurses and personal care workers in the care of our older Australians is critical and will become increasingly important, yet the government has failed to act on any of the issues relating to workers in aged care. And that is despite the urgency of it. It's not like we've got a lot of time to hang around and think this one through in more detail. We've had many inquiries and many reports. We actually know many of the things that need to be done in this sector. It took more than two months for the Minister for Senior Australians and Aged Care to release the report of the Aged Care Workforce Strategy Taskforce, A matter of care, and there has been no commitment to any funding for the strategy. How the government expects to drive reform without committing to or delivering funding is anyone's guess.

Labor has called on the government to immediately implement the workforce strategy and to work with unions and aged-care providers on issues like the proposed 24-hour registered nurse coverage at residential aged-care facilities. Given that 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 issues of training, staffing levels and an ageing workforce. The government finally addressed some workforce issues by announcing $1.9 million for an aged-care workforce task force in the 2017-18 budget, but there was not a single representative of the aged-care workforce on the task force when the membership was made public. That gives you some insight into the government's commitment.

There are many other health professionals, such as GPs, occupational therapists, physios and dietitians, who play a key role in the wellbeing of older Australians—those being cared for in the community and those being cared for in residential aged care. In speaking of supporting ageing Australians, I want to mention a wonderful Richmond GP, Dr Ravi, who has coordinated dementia workshops for the community. Along with Windsor GP Dr Rory Webb and a range of geriatricians and careworkers, as well as partners of people suffering dementia, he has offered hope to members of the community who are going through that very difficult situation in their own families or in their own lives. The workshops have also heightened awareness of the gaps that we have in supporting patients and their families, both at a local community level and more widely in the system. I congratulate Dr Ravi on the work that he does. He is a wonderful driver of change within our community.

Of course, some of the support that is needed is about home care. You know how desperate things are in a sector when someone who gets very little sleep because she works full-time in aged care and is also a full-time carer for her mum, who suffers dementia, makes the time to come to a community forum that you're running. When that person gives up the only moment of free time she has, you know that things are pretty dire. When the Medicare task force visited my electorate of Macquarie, focusing on aged care, we had a full house in Katoomba. There were people who'd gone through the process of helping an elderly family member—maybe a mum, maybe a partner—tackle the bureaucracy to get an aged-care home package. The room was full of people, and then on the phone we had input from Anthea Cox-Norman. Anthea is an aged-care nurse. She lives in Hobartville and she shared with us her experience in trying to get the appropriate level of home care for her mum. Anthea works nights and she cares for her mum during the day. I first started speaking with Anthea in March when she rang, concerned that, despite her mum being discharged from hospital in early January into her care, they'd been advised of a nine- to 12-month wait for an in-home care package. Anthea's mum, Flo, has needs that have been assessed as meeting level 4, the highest level of care. I visited Anthea and Flo last month and there was still no sign of her package.

Flo is a character and clearly loves attention, and, as many dementia sufferers do, she calls out constantly and she wants a response and expects a response. She needs constant attention and constant supervision. She can't be left for more than a few minutes alone in her bed. Anthea is doing an amazing job of staying calm in the face of exhaustion, but she's doing it on a level 2 package. Because of her skill, she acts as a second carer for her mum to have showers. She doesn't get respite. The package doesn't give Anthea a break; it just means it's possible to shower her mum a couple of times a week. It is really disgusting to see that people have to cope with this on their own. A day after I met with Anthea, we got news. Flo has been allocated another package, although it isn't the level 4 package she wanted; it is a level 3 package. It is still not going to meet her needs.

Sadly, Anthea is not alone. Kim, from South Windsor, wrote to me recently and said:

My parents are currently waiting...waiting...waiting.

She explained:

... unfortunately, my Mother-in-law never got her assistance and had to be placed in a nursing home instead.

Kim describes the trauma of her mother-in-law having to leave home, having most of her personal effects taken away from her, to go to a single hospital type room. She said that has done untold damage to her mental state and it's really broken her spirit. That's an insight into why it's so important that we support people to stay in their homes. Susan, from Blaxland, told me:

My 89 year old mother was approved for a home care package but there is a 12-month wait ... now we have had to remove her from her home with my dad and put we her into a nursing home ... fancy being separated after 62 years married ...

These people don't deserve this and the government can change it. It is not just sad, it is tragic.

One of the key issues that emerged is that so many people give up on the package that they deserve and the package that they are eligible for; they accept a lower package which provides them with a lower level of care and then they find themselves having to foot the bill for the gap. The cost of that extra care can be a real shock and financially devastating. Those are some of the issues about not just the quality of care but the speed with which care can be delivered to people. The other disappointment for me is the delay in the release of data by the minister. The March data took forever to come out. The latest data was also delayed until earlier in October. It now shows 121,418 people waiting for a package. Fifty-five thousand of them have the highest care needs. It is clear that the government and the minister have failed to curb the growing home-care package waitlist and have done nothing to address the aged-care crisis. It has occurred under their watch and they are responsible.

I have an electorate with many retired and elderly people. In fact, people move to the Blue Mountains and parts of the Hawkesbury to retire and breathe our clean air after busy working lives. It's completely understandable that, as people age, they want to be able to do it in their home, their own space, for as long as they can. We should allow them to do that. What's clear is that the Liberals are just too busy fighting amongst themselves to actually focus on what matters. It doesn't just matter to people in my electorate; it matters to people in everybody's electorate. It's deeply disappointing that dozens of reviews and reports have all been ignored. There have also been the cuts to aged-care funding—billions of dollars from the aged-care system. In the last budget was the illusion that there was more money for home care packages, but that tiny amount was actually coming out of another pot of aged-care money. So let's stop trying to play clever games, and focus on what really matters. It's time the Liberals started doing much better on this critical policy area.

I just want to briefly mention the royal commission—which, obviously, we support, to expose the abuses and the cover-ups. But we can't wait for the royal commission to finish before we start fixing this issue. We've said for a long time that we know the things that can be done, but, with three ministers in five years and billions cut from budgets, the government is just standing still on this issue. We call it a national crisis. We don't do that lightly. We do that because of the contacts we have from people, every single day, asking for help to find out when their package will be delivered, or seeking support in trying to speed up the delivery of that package so that older Australians can be safely, and with quality care, looked after in their own homes.

1:25 pm

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

I'm very grateful to have been able to follow, in my speech on the Aged Care Quality and Safety Commission Bill 2018, the member for Macquarie—outstanding member that she is—and particularly on this subject, because it's the member for Macquarie who has rendered great service to my own mother, who has been in this situation and is in dire need of in-home support and care in what are the declining months of her life. I'm extremely grateful to the member for her personal intervention and assistance, and I know that that is the sort of support and service she has been rendering to all of her community. She has been a great adornment to this chamber, and we are very fortunate to have her. But it does highlight the very issues that she has been talking about. It's wonderful to see the great line-up of Labor members that have been vitally interested in this issue, showing the deep concern and commitment we have always had. I think the Australian community understands that and gives us credit for giving priority to issues like health and aged care.

When we were in government, we introduced the Living Longer Living Better policy, and that was embraced by the Australian community wholeheartedly. It is very evident that the Australian people want to be able to stay in their homes as long as they possibly can, and certainly that has been the situation with my mother.

The problem is that the initial introduction of that policy, not long before we left government, left work to be done—work we hoped would be done by a committed government, in a bipartisan way, that would take the intent of that policy and the lessons learned and see that that policy was delivered. But what we saw was exactly the opposite. The Aged Care Funding Instrument, which was an essential element of the Living Longer Living Better program, was cut savagely by Tony Abbott, the member for Warringah, and also the health minister under his government. And of course the current Prime Minister, as Treasurer, also axed about $2 billion from the system.

Now we're in this situation where, the statistics suggest, the waiting lists for these in-home care packages are exponentially rising and, I believe, are now around the 120,000 mark. What was the answer from the government to this escalating need and issue? It was to offer 3,000 new packages in the last budget—3,000, when we're up to about 120,000 on the waiting list at the moment. They've said, 'Yes, but it's 14,000 actually.' Well, it's 14,000 over the forward estimates, of four years, at which time they will be severely outpaced by the exponential growth of the waiting list. So this problem is not being addressed by the government, and the Australian people are crying out for it to be addressed.

We must provide the wherewithal for Australians to be able to live at home for as long as they possibly can. And that's what Labor will do.

This legislation was introduced to answer the recommendations that were handed down by the Carnell-Paterson review, to establish this Aged Care Quality and Safety Commission, which is something we would support as one step forward. But—as we have seen from so much of the information that has emerged into the public space recently—there is so much more in this sector that needs to be addressed. Certainly, on this side of the House, we have been banging that drum for a long time, highlighting the effects that these savage cuts to the system have been causing—

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

I thank the member. The debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour, when the member for Eden-Monaro can seek continuation.