Wednesday, 24 October 2018
Health and Ageing Committee; Report
As a member of the Standing Committee on Health, Aged Care and Sport, I rise today to speak on the report on the inquiry into the quality of care in aged care facilities in Australia of October 2018. This inquiry was long overdue and, for many on the committee, it re-enforced what we already knew. Within the aged care sector, there exist myriad problems. We already knew this; the public already knew this—which begs the question as to why it has taken the government so long to take any action.
From the outset, I wish to make it clear that I support the government's decision to hold a royal commission into the sector. For some time, we in the Labor Party have acknowledged and championed action to address the state of crisis that the sector is in. We need a royal commission to thoroughly investigate and uncover the structural problems that we know occur in the aged care sector.
Call me a cynic, but I can't help but wonder why the committee and its findings weren't considered by the government before it announced its royal commission and terms of reference. I would have thought this report, which has just been handed down, would have been instrumental in setting the terms of reference for the royal commission. Policy on the run appears to be the norm for those opposite. I hold sincere fears that the government will delay taking any action to address the aged care problems until after the findings of the royal commission are handed down. We cannot afford for the government to neglect their responsibilities any longer. The crisis needs to start being fixed now—right now. Any delayed action to address this national crisis in the immediate future will prove the government hypocritical. They didn't wait for this report to be handed down before announcing a royal commission, so they needn't wait for the commission's findings to take the necessary steps to address problems that are occurring today, every day, in residential aged care and also in home care for those who are aged.
Through my experience on the inquiry, I would think the coalition's years of cuts to the aged care sector need to be front and centre. You wouldn't know it when they speak. They are always quick to blame their issues on governments past, but the reality is that the Abbott-Turnbull-Morrison government have been in power for five years—five years. Think of all that Gough Whitlam achieved in a period of less than three years. The next time Scott Morrison and his mates try to blame their issues on a long-gone Labor government, we will speak out. The reality is that the Liberal-National government have cut billions of dollars from the aged care sector since coming to power. You can't fix aged care by cutting from it. Some responsibility for this crisis falls on the shoulders of those presently in power through their poor governance. The man with his hand on the tiller, Prime Minister Scott Morrison himself, shares a great deal of responsibility. He himself signed off on a $1.2 billion cut to aged care in his very first budget as Treasurer.
However, I want to take this opportunity to thank all those on this committee for their work in delivering this bipartisan report and specifically acknowledge the work of the committee secretariat, who have worked tirelessly, travelled extensively and delivered what is essentially a terrific report that underlines the problems that exist. In particular, I'd also like to thank the chair of the committee, the member for North Sydney, and the deputy chair, the member for Hindmarsh, for their tireless efforts in delivering this bipartisan report.
The report's recommendations that will improve transparency in complaints and complaint resolution, enhance access to medical practitioners in aged-care facilities, provide simplified ratings systems for facilities, guarantee access to a registered nurse in all facilities and establish unannounced audits of aged-care facilities, I believe, are of the utmost importance. We have heard some pretty harrowing evidence of late about aged care, both through this inquiry and through investigative journalism. We know Australia's population is ageing, and the demand for the provision of aged-care services is only going to increase in the coming years. We owe it to our older Australians, who have contributed to our society and, indeed, helped to build our nation in many ways, to ensure issues in our aged-care sector are addressed. From my vantage point, the inquiry demonstrated there are models of care that work extremely well, where people's needs are met medically, socially and environmentally, relationships are fostered, and families' individual situations are understood. However, best practice management is not available to all.
Other recommendations this committee made through this report include those which will contribute to an improved aged-care system in the future through the development of national guidelines. The individual needs of the patient must be considered first and foremost in addressing the level of care that's provided in aged-care facilities. To those who read the report, it's evident the committee is recommending a shift in focus for this inquiry, with a consumer-orientated approach deemed necessary. This may sound obvious to most Australians, but if we know anything from this developing crisis, it's clear the needs of the elderly, the real consumers, have not been made a priority.
As the chair of the standing committee, the member for North Sydney, Mr Trent Zimmerman, said in his foreword of this report:
Providing high quality residential care to older Australians is an obligation we have as a society and a parliament.
We require understanding of the increasingly complex medical and social needs of older people in residential aged care. Many of the problems we saw and stories we heard related to lack of understanding, poor governance, lack of transparency, under-resourcing and poor communication. As a doctor, I found it quite distressing to hear evidence that frail aged people are not receiving the best medical and nursing care that we can provide at the end of people's lives. In particular, difficulties getting adequate pain relief, difficulty accessing palliative care, problems accessing general practitioners and specialists as well as paramedical services need to be resolved urgently if best practice care is to be provided.
We know that high-quality evidence based care can be provided, but this requires (1) adequate funding. (2) adequate staffing levels, (3) adequate training of staff, (4) a patient focus, and, most importantly, (5) transparency. I'd like to echo the remarks of my friend and colleague the member for Hindmarsh, Mr Steve Georganas:
… 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.
This report is a sound place for the government to start, but I must stress they must start today and they must provide better quality care for older Australians who are in the twilight of their lives. This will benefit us all and is a requirement of a just and caring society.
It's always a pleasure to get the opportunity to speak in front of you, Deputy Speaker Laundy. Today I rise once again to add my voice to the countless voices of my community who are demanding that governments take action seriously to the threats to our population through lack of access to quality, affordable aged care. It's always good to follow my friend Dr Freelander, the member for Macarthur, who is very well versed and knowledgeable in this area. His expertise is something we are lucky to have on this side of the House.
The report highlights what so many in our communities are shouting from the rooftops: we don't have enough places to provide care, and we don't have enough carers to do the task with dignity and respect that our ageing friends and family deserve. It was only last week in the House that I was speaking on behalf of thousands of concerned residents who lent their voices to the Doreen Seniors Club petition 'Spotlight on Aged Care', which was calling on governments to establish an aged-care facility in Mernda or Doreen to meet the needs of the growing north. This is one of the fastest-growing regions in Australia.
The urgent need for increased access and service can be seen in full view. We know it, our communities know it. The only ones who don't seem to understand these issues, and haven't for years, are governments. Time and time again, on this side of the House, we've asked the government to address the fact that the aged-care system is in a state of crisis. With that in mind, I take this opportunity to once again address this issue that is critical to our community. I seek leave to table a petition signed by 2,000 local residents of Doreen and Mernda and surrounding areas. The petition calls on governments to take action in our local community and make the necessary investment to bring critical aged care to our community.
I thank the intelligent members of the government for letting this through, because it's vitally important that we address all calls from the community, because that inquiry is just not enough. Reports like this one that we are discussing here today are important. But what's needed, as the member for Macarthur said, is real action and a real plan. There have been several inquiries over the years into problems in the aged-care sector, which the government has simply refused to act on. We know from this report, and from the stories we hear from local residents, that the quality standards and reporting system just aren't working. There aren't enough aged-care workers, and they aren't given the right pay or respect or support they need.
Despite what the Abbott-Turnbull-Morrison government might have you believe, you don't fix aged care by cutting funding. The opposition leader and the shadow minister for aging and mental health have already written to the Prime Minister, urging him to broaden the terms of reference of the recently announced royal commission to include a range of issues that at this point seem to be totally ignored. Billions of dollars have been cut from aged care in the last five years under the Liberal-National Party government. The current Prime Minister cut almost $2 billion in his first year as Treasurer, and we wonder why there's a crisis! There are 108,000 people on the Home Care Package waiting list; 88,000 of those have critical high needs, many living with dementia. Those 108,000 Australians deserve some answers, they deserve respect and they deserve dignity.
We should judge ourselves as a nation by how we treat our elderly and, right now, it's fair to say we are failing the basic test. How can we call ourselves a fair and generous country if we can't give elderly Australians the love, the care and the comfort in their sunset years that they deserve? With the ever-revolving cabinet door—three ministers in five years—and billions of dollars cut, the government has ignored dozens of its own reports and reviews of what's needed to fix the problem. Only after a shocking report on Four Corners did we see any movement. These reviews and reports have been allowed to collect dust instead of being acted upon. It shouldn't take bad press to get some action. We shouldn't wait for the minister to say, 'Look, if it lands on my desk, I might have a look at it, but otherwise let it go.' We shouldn't only care about ageing citizens when they are in desperate crisis.
We also know the roles of nurses and personal care workers in looking after of our older Australians are absolutely critical, and will become increasingly important as demand continues to grow. Labor also understand the important roles other health professionals such as GPs, occupational therapists, physiotherapists and dietitians play when you look at a holistic approach to the wellbeing of our older Australians. The number of people aged 85 years is rapidly increasing when comparing it with younger age groups; it is projected to double by 2032. What we are going to need is a tripling of the aged-care workforce in the next 30 years to provide a standard of living and care for this growing proportion of older Australians. Where is the plan to address the shortfall? It's nowhere. Where's the focus on quality training and retraining in the aged-care space? It's gone with the wind.
Reports show us that the predicted aged-care workforce will need to increase from around 366,000 people to around one million people by 2050. So what did the government do? After the 2013 election they dumped Labor's $1.5 billion workforce compact and supplement. That totally undid the groundwork for a comprehensive aged-care workforce development strategy to address those issues of training, staffing levels and an ageing workforce.
It wasn't until almost five years later that the government finally addressed some of these issues with the Aged Care Workforce Strategy Taskforce in the 2017-18 budget—a day late and a dollar short. We know that, in order to address the shortfalls in aged care and to meet the growing demand, the government must work with unions and aged-care providers to implement a clear strategy. I mean an actual strategy—one that considers issues such as the proposal for 24-hour registered nurse coverage at residential aged-care facilities.
Whether it is aged-care providers, workers or consumers, the message up till now has been frustratingly consistent. It has been one of reaction or inaction. The Abbott-Turnbull-Morrison government can and should get proactive to ensure that we have an adequately skilled and equipped aged-care workforce to care for our population as they age. While the chaotic and divided Liberals have fought amongst themselves the care of older Australians has been neglected.
My analysis of the aged-care sector was clearly outlined in my contribution to the Aged Care Quality and Safety Commission Bill 2018 debate in this place last week. The sector is in crisis. It has been for some time. The victims of the crisis are mainly the vulnerable elderly, although they do include some of the staff who work within the sector as well. The government has now announced a royal commission, which Labor supports. However, I repeat what I said last week: the royal commission should not be an excuse to delay changes that are needed immediately about matters that are well-known and have been for some time.
This report of the House of Representatives Standing Committee on Health, Aged Care and Sport is one of many over recent years that have focused on the aged-care sector. Many of the other reports came to similar conclusions as this committee report did. Indeed, the Australian Law Reform Commission report of only a couple of years ago addressed many of the matters that the committee addressed and came to similar conclusions on many of those matters as the House standing committee did.
We have reached a point where we see that this sector, which has been exposed for its shortfalls and deficiencies over many years, continues to deteriorate rather than improve. We have reached a point where there are inadequate staffing levels, fewer allied health professional visits, less social activity within centres, deteriorating food quality, GPs cutting back or cutting out their residential aged-care facility visits, long waiting lists for home care packages, too much of the home care package funding being chewed up in administrative costs and other problems within the sector. All of those matters are known and have been known for some time. What I see from this government is simply more talk about the problems and more promises to do things in the future but no real change taking place right now.
Even today we have announcements about increased unannounced visits to aged-care facilities in the future—beginning some time next year. The reality is that those matters could be addressed right now and should be addressed right now. They don't require legislative changes. They could simply be administrative changes that the government implements. Those matters are well known. I have often asked the question: why did we not introduce unannounced visits in years gone by? Why was there a need to announce the visits in the first place? Regardless of whether we increased the number of visits, the fact that the visits were taking place with an announcement being made in advance seemed to me to defeat their very purpose. Again, the government claims that it will respond and act in that matter—but when?
In the course of the inquiry the committee heard considerable evidence. There were some 123 submissions, many of them confidential because they were made by people that work within and had very personal insight about the industry or by family members who, equally, had personal experience of how the facilities were operating. For fear either for their future employment within the centre or of retribution against the family member that was in those facilities they didn't want their submissions to be made public. I suspect that was simply the tip of the iceberg with respect to the number of people that would have loved to have come forward and talked about their experience within this sector but for one reason or another chose not to.
We have a royal commission now. One of my other concerns about the royal commission is that the government will effectively sideline the committee's report and defer any meaningful response until the royal commission findings are in. My understanding is that will be some 18 months to two years away, which effectively means that, again, matters that need to be dealt with immediately will simply be pushed into the future and, in this particular case, beyond the next federal election. I say to the government: if the royal commission is being called for no better motive than to defer action then I believe that the public will simply not wear it. I think it would be fair to say, certainly from the numerous people I've spoken to about this matter, that the public are looking for a response right here and now.
The committee came forward with some 13 recommendations. There are other matters that perhaps could have been dealt with, but I think the 13 recommendations are appropriate and in most cases should not be ignored and should be supported by the government now—and not wait for the findings of the royal commission. I won't speak about all of them; I want to talk about just half a dozen. The first is recommendation 2, which talks about penalties. To date the penalties imposed on providers of aged-care services that have breached their obligations is generally to have their accreditation or their licence to operate suspended for a period of time until they rectify the problems. To my mind no other types of penalties have ever been imposed. I believe the issue of penalties needs to be reviewed. The penalties imposed where serious breaches occur should be more than just a suspension and a 'please explain' letter from the department but, rather, a real penalty.
The second is with respect to the comment I made earlier about GPs not visiting centres as much as they used to and many others now saying that they will cut out or cut back on their visits in the future. That is an issue that goes to the heart of the Medicare Benefits Schedule payments the GPs receive, and that matter needs to be reviewed. If it's not and GPs don't visit people within these facilities then it is not good for the resident and it is not good for the public health system, because the resident ultimately ends up in a public hospital.
The third is the unannounced visits which I spoke about earlier. In my view unannounced visits are a no-brainer, but in addition to visits being unannounced, they need to also take place in the out-of-business-hours time periods: after 5 pm, on weekends and perhaps even on public holidays. My understanding from the feedback I've received is that's where most of the problems are likely to occur, and most of the criticisms made arise from the care provided during those out-of-hours times.
The other matter of real concern to the committee is the use of restrictive practices, whether it's the use of medication or other more direct restraint methods. I can accept in some cases the need to do that but in all cases where restrictive practices are used, two conditions should apply. Firstly, there should be the approval of a medical professional before a restrictive practice is used. Secondly, the family or carer of the person should be notified.
Lastly, I go to the issue of the My Aged Care website, where it ought to clearly highlight the complaints that have been received by a particular facility so that the public, which has the right to know, know how that facility stacks up in comparison to the others. I'm aware that the committee's inquiry will continue with respect to staff ratios. That's a very important matter. I look forward to the evidence and to the report of that inquiry when it's presented to parliament.
I'd like to thank the committee and secretariat for their work in producing what is a comprehensive review of the issues that are currently facing the sector and the challenges we are going to face into the future. Aged-care reform is a complex problem but it is a problem we must not ignore in this parliament. We must consider the financial impacts, the changing healthcare needs and, of course, the emotional cost on our loved ones. I know in my own electorate of Mayo that we have some wonderful homes which go above and beyond to care for their residents. But I also hear, day after day, from concerned constituents sharing their own stories of abuse and neglect. Indeed, since launching my private member's bill, I hear from people across the nation. Notwithstanding the scale of reform that is required, I'm confident we can harness the support evident on both sides of this chamber today to meet the inevitable demand for aged-care places, not with fluster but a carefully-prepared plan to manage the needs of our elderly loved ones.
Before I turn to the report itself, I note the appointment today of Ms Janet Anderson as Commissioner of the Aged Care, Quality and Safety Commission. A primary role of quality regulation is consumer protection. We know from recent examples in the media that this is a heavy responsibility and it will restore trust and confidence in the industry, and that's what we need. This report makes clear there is not going to be a simple pathway forward for reform. How can there be when aged-care needs are complex, the funding arrangements are complex and the health needs of our ageing population are changing? We know people are moving into aged-care homes when they are older, when they are more frail. We also have a shrinking workforce for our ageing population and so how will we, as a nation, ensure that the growing demand for services is met with an aged-care workforce and the right people to do the work?
While the reform required may be extensive, I believe the best way forward is to follow the recommendations of the report as well as the many reports and reviews previously completed and adopted. And we need to adopt a consumer-focused approach to aged care. This is perhaps best identified in the proposed charter of aged-care rights. I appreciate that the earlier charter received some criticisms during the inquiry, both for its legalistic language and for the fact that neither staff nor residents were aware of the document itself. But I believe there is some merit in such a document and I want to spend some time exploring the draft charter. Firstly, the charter is written in simple English rather than legalese, and I think this is very important.
I have the right to be listened to and understood. I have the right to complain. I have the right to be informed about my care in the way that meets my needs.
The words may be simple but the message is clear and powerful: the rights of Australians do not cease upon entering a residential care facility. As the minister regularly states—and I agree with him wholeheartedly—this is their home; it's just a different home. I accept that the charter of rights is only as meaningful as we choose to make it, but I urge the government, the service providers and their staff and the families of older Australians to pay attention to those words. If we are going to make a meaningful improvement in the lives of older Australians then we need to review and reform with the words of the charter at the front of our minds.
One way we can make a real change, a consumer focused change, is to provide families and residents with as much information as possible so that they can make an informed decision. This is a major financial investment for families and often involves selling the family home to meet the significant costs of care entry. This is one of the reasons I have pursued my private members bill, which calls for disclosure of staffing levels in all aged-care homes. The bill is currently in the inquiry phrase, with a public hearing scheduled for this Friday to consider the merits of the bill and the measures it contains. I'd like to spend a few minutes on why, in light of what has been said in the report, my bill is an important step in developing a consumer driven aged-care sector and one that is arguably consistent with the report.
Recommendation 4 of the report calls for the government to do two things in relation to staffing matters: firstly, to ensure that there is always an enrolled nurse on staff at all times—I think the Australian community is in shock that there is not an enrolled nurse, and nor is there a requirement for a registered nurse to be on duty at all times—and, secondly, to monitor and report on the relationship between standards of care and staffing mixes to guide on staffing requirements. I accept that the quantity of staff does not automatically translate to quality, and there can be no denying that appropriate staffing levels, with an appropriate mix of skilled medical professionals, will guard against abuse and neglect. But the level of care, and the number of staff to provide the care, is a critical issue for older Australians. The absence of that data has been noted time and time again, and that is the purpose of the bill. I appreciate that the release of staffing data will not be the panacea that we are all desperately searching for, but it is a start. I believe it is an important start and a start that we must make.
The royal commission is a welcome development, but I will not allow it to be used for an excuse to delay or deter further reforms. The committee report takes great pains to set out the previous reviews and reports carried out by government, the Productivity Commission, the Law Reform Council and various academics and stakeholders. It proves that we have so many good pieces of evidence before us. We need to ensure that action is now. I look forward to the hearing on Friday, and I thank the committee for its work on the report that's before us today.
I too would like to thank the committee for its report and also the member for Mayo for her comments. Before entering this place, I was involved in the aged-care sector for a decade and a half, and I have to say I find criticisms of the aged-care sector in Australia at the moment quite surprising. The reason I say that is that in 2004, when I first started in the aged-care sector, the level of care that was available to older Australians was at a much, much lower level than it is now. It was in fact extremely and extraordinarily poor.
There reforms of both parties in this place—firstly, the member for Curtin, Julie Bishop, and the member for Menzies, Kevin Andrews—introduced significant and far-reaching reforms in the aged-care sector that had the impact of inviting and indeed encouraging enormous amounts of private-sector capital into the sector, which has done nothing but massively improve the level of care that our tribal elders currently enjoy. The most egregious examples of our tribal elders being abused at the hands of aged-care workers and aged-care providers come not from a private-sector firm or a not-for-profit firm but from an aged-care nursing home run by the South Australian government—the Oakden home. When after audit after audit threw up red flags about this home and its service, the South Australian government and the nurses working at that facility blocked any further investigations. You see, there is a difference between clinical care, pastoral care or other care that we want our tribal elders to have in their final years. Seeing this issue, this challenge, that we face through the prism of an industrial instrument, an industrial dispute—indeed, promoting the interests of a particular union—does not, I think, actually provide the people whom we are seeking to provide care for with any further comfort. The fact of the matter is that aged care homes do not need more nurses; they need more carers. Indeed, one of the previous speakers, one of the Labor speakers, said that it is allied health workers who are required in these homes now more than ever. The fact that we don't have nurses on call 24 hours at nursing homes is not a matter that any Australian should be concerned about—in fact, quite the opposite. What they should be concerned about is the coming deficit in carers that we will need for the baby boomer generation who are about to enter our nursing homes here in Australia.
The other issues that have been brought up are around audits and why the audits are not all unannounced audits. The reason is that many of the audits, as part of their process, check the documentation that the nursing home keeps on the level of care that it is providing to residents. Why is this important? Because there are funding models between levels 1-10. That essentially ensures how much money each nursing home receives for each resident. If a resident is assessed as having a care level of level 10 then the nursing home receives a much higher level of subsidisation from the Australian taxpayer; at level 1, a lower level. Nursing homes are incentivised by their very nature to try and increase the amount of care that a resident is getting, regardless of whether they need it or not.
It was not possible and is still not possible for people to just turn up on a Saturday night and say, 'Can I see the documentation for what level of care a person has been receiving?' That is why we have announced audits. The unannounced audits, which we commenced under this government, have been massively increased and that's why we've seen a spike in rectification reports for nursing homes across Australia. The issue that we face is that when others come into this place and say, 'Despite the fact that the aged care sector is currently receiving and will continue to receive record funding now and into the future,' what they are talking about is that they want extra payments to go to people who are ripping off the system. They want to encourage nursing homes and nursing home providers to undertake a system whereby the Australian taxpayer is subsidising rip-offs. I cannot comprehend in any way, shape or form why we think that is a good way to treat fellow Australians, because, simply put, it isn't.
Of course, all of this is taking place in the prism of what is going on with home care packages. Those opposite talk about the waiting lists for home care packages, and they're right, but you have to understand or question the value of some of those home care packages. Are they audited? Not really. What sort of care are they providing? Many Australians would be surprised to find that the vast majority of home care packages are going on services that are not necessarily dedicated to care—things like cooking, cleaning and, indeed, gardening. I think we need to have a mature and sensible debate, which hopefully will occur in the royal commission, about whether this is the best allocation of our scarce resources as a nation in helping to care for people as they get older, because there is the other truth.
I doorknock, and I know the member for Oxley does a lot of doorknocking too. I'm sure he's had the experience of knocking at a five-bedroom house where there is currently one person, often very elderly, who has now found herself—or himself, in some rare instances—trapped in her home, socially isolated from a lot of the other people in her community and a lot of her family. In some instances, we may be inadvertently making their lives worse by encouraging them to stay in their own homes. I think these are the sorts of discussions a royal commission should have and needs to have.
So, when the member for Mayo comes in here and says that most Australians will be shocked to find out that there isn't a 24-hour nurse on in a nursing home, why would they be shocked? I think they would be more shocked to find out that we are not treating a nursing home as a home but rather as some offshoot of a hospital and that we are treating people in nursing homes as though they're just some sort of outpatient. No, this is, in most cases, their last home. They deserve to be treated with dignity. They deserve to be cared for. They deserve to be looked after. Part of that is, without doubt, clinical care. But it's a very small part of it. People who come into this place and say that we need to have nurse-to-resident ratios are missing the actual, crucial point of what nursing homes do in our society. I understand that people who say we should put much more money into home care packages think they're caring, but in some cases—and I don't know how many and, hopefully, the royal commission will get to the bottom of it—they're actually making the lives of the people who they think they're helping much, much worse.
If the member for Oxley had been listening—and I know he does a lot of doorknocking. He has met people in their homes who feel that they are being trapped in their own homes and they would welcome the opportunity to be placed—
Mr Dick interjecting—
Yes, Member for Oxley, I have heard of ageing in place. Have you? Do you know what ageing in place is? Do you even know what that phrase means? It means that, when a person goes into a retirement village, they have a continuum of care. It doesn't mean that we leave the person in their own home. I take it, from your silence, that we have finally found something that I know more about than you. So I'll just enjoy this moment while it lasts. The fact of the matter is—
Honourable members interjecting—
No, the member for Oxley's right: it's not a competition. All of us should come to this place, because all of us have a proud record to speak about when it comes to aged care because all of us, over many different governments, have made massive advances in the way that our tribal elders get looked after. But just simply providing more home care packages will actually make some people worse off. We think we're caring, but we're actually hurting them, and that's why a royal commission is important, because it's easy to pick on things and say, 'Look, let's just throw more nurses at nursing homes,' when, in fact, we need more carers, or, 'Let's just throw more home care packages at people,' when, in fact, we need better nursing homes. These are the issues that the royal commission, hopefully, will get to the bottom of. This is a serious issue, and both sides need to treat it as such.