Monday, 22 October 2018
Standing Committee on Health, Aged Care and Sport; Report
On behalf of the Standing Committee on Health, Aged Care and Sport, I present the committee's Report on the inquiry into the quality of care in aged care facilities in Australia, together with the minutes of proceedings.
Report made a parliamentary paper in accordance with standing order 39(e).
Providing high-quality residential care to older Australians is an obligation we have as a society and as a parliament.
It is both a debt we must pay to those generations who have done so much to build our prosperous nation and also, fundamentally, a basic human right.
Australia's residential aged care provides a home to nearly 240,000 Australians. Many are providing aged care which is delivered to a high standard and does provide older Australians with a safe environment to age with dignity and the care they need.
Yet there are also many who have not had such a positive experience. In the worst cases, older Australians—our mums and dads—have been the subject of abuse and mistreatment.
Australia's residential aged-care facilities have come under increased scrutiny as high-profile reports of mistreatment have come to light and have been investigated.
Shocking failures in the provision of care at facilities such as Oakden, in South Australia, have rightly led to a re-evaluation of how the aged-care sector is regulated.
When regulatory authorities are giving a certification to a place subsequently found to be so wretchedly wanting, we know something has gone severely wrong.
While perhaps the worst example, Oakden cannot be seen as an isolated event. Investigative reporting such as that undertaken by Four Corners recently has highlighted other serious examples of mistreatment. This parliamentary inquiry has received submissions from residents and family members often outlining what can only be described as harrowing experiences. This is simply not acceptable in a nation like Australia.
This parliamentary inquiry has followed a number of government-initiated reviews, all of which have made important contributions. More recently, the seriousness of concern about mistreatment in the aged-care sector has led the government to establish a royal commission.
The committee has welcomed this announcement and the continued focus on quality and safety in aged care. At the same time, the Australian government has been implementing a number of major reforms flowing from the work of earlier inquiries.
While it is too early to examine whether these sectoral reforms will be effective, the committee considers that they are a positive change and will lead to a stronger and more responsive residential aged-care sector.
As Australia's population lives longer, demand for aged-care services will inevitably grow. By 2056, it is estimated that 22 per cent of the population will be made up of older Australians. At the same time, rates of dementia, for example, are expected to increase to around one million people across the nation.
The need for a streamlined, responsive residential aged-care system is clear, and recent and upcoming reforms will help the evolving aged-care system in Australia.
The committee have considered these reforms but believe there is more that can be done to improve our aged-care system and that we shouldn't wait for the royal commission to deliver its own findings. Our 14 recommendations that we've tabled today include such matters as:
I want to thank the many organisations and individuals who made submissions to this inquiry. I also thank my fellow committee members, who have worked together to deliver a bipartisan report, and I particularly acknowledge in the chamber my deputy chair, the member for Hindmarsh.
The committee is also indebted to the work of the committee staff, who have provided such professional support to our deliberations.
Ensuring Australians are provided with residential aged care they can trust must be a priority for the Australian government and all of us as parliamentarians.
As all of us age, we should do so confident that, if we need residential aged care, the final chapters of our lives can be lived with dignity.
And as children, we so desperately want to ensure that our parents are afforded the same love, care and support that they have bestowed upon us.
As a nation, it is a test of our commitment to both those who are vulnerable and those on whose shoulders Australia has been built. We need to ensure that the aged-care system is meeting their needs.
Our hope is that this report will provide additional impetus to ensuring that all of these goals are achieved.
I rise today in my capacity as the Deputy Chair of the Standing Committee on Health, Aged Care and Sport to second the motion. Can I thank the member for North Sydney, the chairman of our committee, for initially presenting the report on the inquiry into the quality of care in residential aged-care facilities in Australia to the House today. I sincerely hope that this report will be taken seriously and urgently, not only by the government but also by all those who are reading it and caring for our older Australians. I would also like to thank the chairman and all the other members for their commitment to a bipartisan approach to this report. We did so in a bipartisan way because of the seriousness of this inquiry.
We've heard in this place over the last few weeks when we've been debating aged-care bills that older Australians deserve better, and they do deserve better. They deserve better from governments, from agencies, from aged-care facilities and from all who are involved with our older Australians. They deserve better from all of us. As I said, we heard the chair say just now that, of course, they're the people who have worked and built this country for us to enjoy. They deserve better from a system that has failed them, as we've seen from different reports on Four Corners and the Oakden saga in South Australia, which, of course, has brought upon us a royal commission, and rightly so.
As the chairman explained previously, the committee has put forward a number of serious recommendations that need to be considered and ultimately addressed. Australians are living longer. There could be close to 8.7 million older people living in Australia by 2056. That'll be over one in five of the total population. With that number, dementia rates are expected to increase to around one million by 2056—one million people with dementia, let alone the others that require to be cared for.
We've seen failures in the system in many states around Australia, and we all expect that the royal commission will uncover more. We heard many witnesses present to our inquiry with a number of stories. The number of aged-care complaints, we heard in the report, has increased 23 per cent, with the Aged Care Complaints Commissioner dealing with most of the concerns. In dealing with this inquiry what really struck me—and, I'm sure, all the other committee members and our chair—was the number of reports made and the subsequent lack of follow-through on resolutions that actually deal with the complaints. In 2017-18, there were 4,315 complaints relating to residential aged care made to the commissioner. Around 66 per cent of those were made by a family member. Of the complaints made, only a fraction were resolved. We discovered a number of issues that were raised regarding the complaint handling process. We heard evidence from people who complained about time-frame issues, capacity issues, cost barriers, communication issues and fear of reprisal for staff, residents, their carers and their families.
When the committee travelled to Melbourne, we asked a question to one of the witnesses about complaints: 'How many complaints were received and finalised in a reasonable time frame?' It was revealed that, out of the 4,713 residential home-care complaints, there were only 52 visits to the facilities. Of those complaints, 92 per cent were resolved in early resolution. But I worry about the eight per cent that were not. Some of those cases took over 180 days—and some even longer than that. It is easy to see why people in the system feel they are not taken seriously when a complaint is made. This was evident throughout the inquiry.
I won't go over again the things the member for North Sydney has already said, but we need to get smarter about this. We need to care for our older people. We heard these things in our inquiry. One of the things that needs to be addressed immediately is that we need to ensure that residential aged-care facilities provide for a minimum of one registered nurse to be on site at all times and specifically monitor and report on standards of care, including complaints and findings of elder abuse. In closing, I would like to thank the committee staff, who made the arrangements for everything, and my fellow committee members and our chair. Special thanks go to Stephanie Mikac and Carissa Skinner for their very hard work.