House debates

Monday, 18 February 2019


Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018; Second Reading

1:04 pm

Photo of Kerryn PhelpsKerryn Phelps (Wentworth, Independent) Share this | | Hansard source

A royal commission into aged-care services must not put the brakes on making urgent reforms in the sector, including greater transparency around staffing ratios. My son Carl is in aged-care worker and doctors in our general practice provide GP services to aged-care facilities, so I have some insight into the difficulties faced by people trying to provide care for elderly residents, many of whom have significant age related disabilities, including various degrees of dementia, and are on multiple medications. We need to act quickly to address our community's very real concerns about understaffing and the low, sometimes nonexistent, number of registered nurses in our aged-care facilities as well as poor training and retention rates for aged-care workers.

The Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018 will force residential aged-care facilities to provide their staff-to-resident ratios every three months for publication. This will at least give people a more informed choice about which facility they choose for themselves or for their family members. At present there is no regulation around minimum acceptable levels of staff in residential aged-care facilities, just that providers must maintain an adequate number of appropriately skilled staff to ensure that the care needs of care recipients are met.

In my electorate of Wentworth, all eight aged-care facilities visited by the New South Wales Nurses' and Midwives Association in 2018 failed to provide an acceptable level of nurse care per resident. This audit of just eight facilities revealed an average ratio of one registered nurse to 74 residents on night shift, which is not what families expect or residents deserve. These are vulnerable people needing around-the-clock care. This is just a snapshot of what is happening in aged-care facilities across the country. This data highlights how widespread the staffing issues are in aged care, even in the most affluent suburbs. The poorest ratio uncovered was just one registered nurse to 116 residents. Examples of missed care as a result of understaffing include missed medications, increased falls, limited time to complete hygiene care and the inability to mobilise residents as often as needed. Unless we have ratios, it will be a matter of profit over person.

Last year, the six biggest for-profit aged-care providers received over the $2.17 billion in taxpayer subsidies, which accounted for around 70 per cent of their revenue. Currently there is no requirement for providers to report how government money is spent or a guarantee that it be tied to care. This is a sector whose providers profit over $1 billion a year and receive healthy government subsidies, large resident deposits and fortnightly part-pension payments yet it still has no guaranteed staffing or reporting requirements. Even when argued on pragmatic and detached economic grounds, reducing the information gap between the residents and their families and providers will lead to a more efficient, competitive market upon which competing residential aged-care services can more easily attract people through the greater quality of their service.

The Australian Medical Association has continually called for a regulated, registered nurse-to-resident ratio which adapts to the individual care needs of residents and ensures that nurses are available 24 hours a day. According to the AMA, there's been a decline in the proportion of full-time equivalent registered nurses and enrolled nurses in the residential care workforce and an increase in the proportion of personal care attendants. This trend goes against the increasing chronic, complex medical care needs of residents. AMA president Dr Tony Bartone notes that there are not enough registered nurses with aged-care experience to provide the clinical governance, oversight and leadership required in these facilities, leading to poor clinical care, inadequate communication and a lack of knowledge about individual residents. Personal care attendants cannot duplicate the work of registered nurses. Even then, personal care needs must be considered as a quality of life issue for elderly people with high dependency needs. I'm told that personal care attendants may have only 20 minutes per day to attend to all the resident's personal care needs, including showering, toilet, hair and dental hygiene.

With an ageing population and an aged-care reform moving to ensure older people can stay in their home for as long as appropriate, it's likely that the clinical attention required by those in residential facilities will become more intense. The government must, as a matter of urgency, ensure that the health and aged-care systems and their workforces are prepared for this. I wholeheartedly support the member for Mayo's legislation as an important first step in addressing community concerns about staffing ratios in our nursing homes.

1:09 pm

Photo of Susan LambSusan Lamb (Longman, Australian Labor Party) Share this | | Hansard source

I'm fortunate to represent a community in which many Australian seniors call home. Not only am I lucky enough to be invited to things like trivia days, trivia nights, morning teas and ceremonies that are held at my local retirement villages, nursing homes and aged care facilities; but I also get the opportunity to speak with and hear from those great people who built our nation. Let me tell you, Deputy Speaker, they can often spin quite a yarn when they talk about their lives! These are people who have worked hard their whole life, and they have the wisdom and life experience to show for it. And it's why we, as those who follow them, have a duty to support Australia's seniors and ensure they have access to adequate aged care.

I'm supportive of a number of the elements of the member for Mayo's private member's bill, the Aged Care Amendment (Staffing Ratio Disclosure) Bill 2018. I'll always be supportive of any measure that goes towards improving transparency for older Australians, their families and their carers—those people seeking aged care services. This could be with regard to transparency around staffing numbers. It could be with regard to the number of complaints a facility receives. It could be with regard to information on accreditation failures or the measures that service providers have put in place to deal with accreditation issues. I hope that transparency for customers is a key focus of the royal commission into aged care. Labor has been calling for this royal commission for some time, but the government decided instead to play politics, likening it to committing elder abuse. It's a positive to see that the government is now finally listening to Labor and the people of Australia and has changed its mind.

It's no secret that Australia has an ageing population; it's no secret at all. The number of people aged over 85 is rapidly increasing compared to our younger age groups, and it's predicted to double by 2032. This means we will need to see a tripling of the aged care workforce in the next 30 years to be able to provide a high standard of living and care for this growing proportion of older Australians. This will only happen, though, when the government looks forward and cooperates with the aged care providers, the unions and, of course, the training organisations to ensure that we have an adequately skilled, an adequately funded and an adequately equipped aged care workforce to care for that rapidly ageing population.

But the government's track record doesn't bode well for the long-term future. We have endured three Prime Ministers in the last few years and together those three Prime Ministers have presided over shameful cuts to this sector. They have ignored important reports, they have failed to drive reforms and they have allowed the blowout of home care package waitlists to occur. This is a government that is too busy fighting each other for the top job to look after Australia's seniors. Currently sitting on the government's desk are more than a dozen reviews, with recommendations on aged care that still have not been implemented.

I haven't been quiet on this—and I can tell you, Deputy Speaker, I'm not going to be quiet on this—and, in fact, neither have the good people in my community. From the health professionals and doctors to the daughters and sons of our seniors, they haven't been quiet on this either. So, together with Labor, we have been putting pressure on the government for some time now, and it seems that they are starting to realise that this isn't just an issue for older Australians; it's also a bit of a political problem for them and it could cost them their jobs. So it's good to see that they're starting to act, although, we can question the motivation.

After five years and billions of dollars in cuts, including a $1.2 billion cut by the Prime Minister when he was Treasurer, it comes as a great relief now to see some action being taken. With the government calling on a royal commission into aged care, it appears that they're now scrambling to respond to the many issues that they have allowed to pile up and pile up—issues that should have been dealt with months and months and years ago. There is significant work to be done. There's an election coming up in a few months, and I suspect there will be an answer to those delays. (Time expired)

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

The time allotted for the debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.

Sitting suspended from 13 : 14 to 16 : 00