House debates

Wednesday, 11 September 2019


Aged Care Amendment (Movement of Provisionally Allocated Places) Bill 2019; Second Reading

10:30 am

Photo of Zali SteggallZali Steggall (Warringah, Independent) Share this | | Hansard source

I rise to speak on the Aged Care Amendment (Movement of Provisionally Allocated Places) Bill 2019. I commend the government on allowing approved providers of residential aged care to move provisionally allocated residential aged-care places from one region to another within a state or territory and for allowing approved providers to operationalise a residential aged-care place more quickly. This will allow the more efficient allocation of resources.

In Warringah, 15.7 per cent of the total population is aged over 65 years, and this will significantly increase as 55.1 per cent of the population will be 65 and over by 2036. The complex needs of an ageing population will impose an increasing demand on healthcare services. The elderly deserve respectful, affordable, accessible and safe aged-care options. Warringah residents want aged care that promotes independence and wellbeing with choices so people can stay at home longer while being healthy and connected, and more options for a suitable mix of home help and medical support. And, if residential care is the right choice for them, it must be safe and secure and appropriately resourced to support wellbeing.

While the royal commission is revealing some shocking problems in the sector, in our aged-care system there are other challenges as well. There are almost 130,000 Australians in the home care priority queue with many waiting more than a year for assistance. Once funding is granted, home care providers are taking a large amount of the funding in administration costs and profit. Families face a lack of accountability, little information on provider performance, and hidden charges and exit fees. In residential care, many find a lack of registered nurses and other needed care, which contributes to more residents ending up in hospital emergency departments. Residents also find aged care isolating and to the detriment of their mental health, and when they try and reach out they discover a lack of access to mental health services.

That is why I am calling on the government to provide more flexible Medicare funding for home help, telehealth and medical support, provide more information on providers to support informed choices, implement the recommendations of the aged care royal commission when they come to hand, support wellness programs to reduce loneliness and improve mental health, and increase funding for dementia care.

While this bill will allow the more efficient allocation of provisional places, we must also discuss not just access to placements for our elderly but the quality of care our elderly receive when in our aged-care system. We know that properly staffed homes are essential to welfare, but people do not know if homes are adequately staffed before they send their parents or relatives to residency. That is why I also support the member for Mayo's private member's bill, which is the Aged Care Amendment (Staffing Ratio Disclosure) Bill 2019. This bill will require providers to disclose their carer-to-patient ratio. Older Australians deserve our support and our every effort on their behalf to improve their quality of care.

10:34 am

Photo of Tony ZappiaTony Zappia (Makin, Australian Labor Party) Share this | | Hansard source

This bill, the Aged Care Amendment (Movement of Provisionally Allocated Places) Bill 2019, allows for the movement of provisional bed places from one region to another within a state or a territory. It is a sensible proposal. However, the legislation relates to a critical social issue confronting Australia. I refer to the services available to older Australians and the care provided to them—services that are too often difficult to access and care that on too many occasions, in too many places, has failed elderly Australians. The failures and the public's reaction to them have resulted in the royal commission into aged care that is now under way. Only last month another case of a residential care failure was exposed at a state-run facility in South Australia's Riverland. Simultaneously, more aged-care facilities are now failing to meet their accreditation standards.

I'm not surprised to hear those stories. As a member of the Standing Committee on Health, Aged Care and Sport, which inquired into the aged-care sector and reported back in October last year, I heard firsthand from residents, family members, workers, service providers, health professionals and operators of those facilities about what was needed. It was not only some facility operators that failed in their duty of care to residents, but also the government departments that were responsible for the oversight and accreditation of facilities. The government has taken some steps towards improving the inspection and accreditation process, but it needs to do much more and it needs to do much more now. It does not need to wait until the royal commission has concluded in order to address matters that are well known and that would immediately make a difference to residential care. The 14 recommendations of the House of Representatives committee's report would be a good start. The committee met with people from right around the country. As I said earlier, it heard from all stakeholders in the sector. The recommendations have been before the government for nearly a year. Most of those recommendations are properly thought through, commonsense recommendations that would immediately make a difference to the type of care that is available. The government could act on them right now.

I make it absolutely clear that there are good and bad operators in the sector, as there are in all industry sectors. I regularly visit aged-care facilities in my electorate. Overwhelmingly they provide a very high standard of care. Only last Friday I visited the Estia aged-care centre at Hope Valley. Last week was Royal Adelaide Show week, so staff at the Estia centre brought the show spirit to the residents with a fantastic display of show stalls and entertainment within the facility itself. The staff at the centre went to extraordinary lengths to organise the in-house event, and I commend them for their efforts. I take this opportunity also to express my gratitude to the aged-care workers and other health professionals and service providers who work in facilities throughout Australia for the incredibly important work that they all do. It is work that many others would not do: caring for older people, many of whom who have no ability to care for themselves and who need assistance with everything they require in their everyday life. Yet the staff in these aged-care centres do their work day in and day out, often under time pressures because of the number of residents they need to care for or the level of care that those residents need.

My understanding is that over 50 per cent of residents in an aged-care facility across the country have dementia. Workers need special skills in order to support residents with dementia. It's also my understanding that by mid-century about a million Australians will be suffering from some form of dementia, so the demand is getting greater all the time. Those aged-care workers need more recognition. It is time that we gave them the recognition they deserve, gave them the support they deserve and remunerated them at a level that reflects the important work they do. They too have patiently been asking for too long to be treated with the respect that they need in order to carry out the work they do to provide the dignity to the residents that they care for that those residents also deserve.

In 2016-17, the last year for which figures were available when the House committee prepared its report, 240,000 Australians received permanent residential care in about 2,670 facilities across the country. At any given time there are around 200,000 people being cared for in an aged-care facility. This legislation provides flexibility for the aged-care beds that are available within those centres and within the states and territories, as I said from the outset. However, we could and should be doing a lot more. We know that people prefer to remain in their own home if they can access the home care that they need as well. Accessing home care packages under the Morrison government is becoming farcical. As other speakers on this side of the House have made absolutely clear, there are about 129,000 people waiting for a package or the appropriate package for which they have been assessed. Nearly 76,000 of those people have no package at all, and the 53,000 with a lower-level package are desperately waiting for a higher-level package. And the waiting list is getting longer.

Whilst the government claims that they are putting extra funding into the aged-care package system, the reality is that the extra funding is not even keeping up with demand. My understanding is that we have currently around 93,000 Australians in receipt of an aged-care package. Simultaneously, we have 129,000 people on the waiting list and, of those, nearly 76,000 have no package at all. So that tells me that there are more people on the waiting list than packages that are actually available. It also tells me that those people that are on the waiting list are very likely only ever to get a package when one of the 93,000 people in receipt of a package right now either passes away or goes into a residential aged-care facility. In other words, they will only get a package when someone else relinquishes theirs. It is not good enough to have a system that is dependent on one person relinquishing a package so that somebody else can access it.

As the member for Franklin, sitting at the table right now, pointed out in her own remarks, people are actually dying whilst they wait to get a package. I understand that some 16,000 have passed away or been admitted to residential care facilities. Some 14,000 have had to do that because they couldn't wait any longer and they desperately needed support. It wasn't available in their own home, so they had to move into a residential care facility.

Whilst I'm speaking about home care, I also take this opportunity to acknowledge the thousands of volunteers around Australia who provide Meals on Wheels to older people living in their own homes. Last week I attended the annual general meeting of the Modbury branch of Meals on Wheels in Adelaide. That branch has now delivered, since its inception around 30 years ago, nearly a million meals to people in the community that I represent. Currently, they deliver about 30,000 meals a year. It's a service that enables people to stay in their own home, and I believe it's a cost-effective service because the meals are delivered by volunteers. Meals on Wheels Australia, I know, is pleading for extra federal government funding to enable them to continue to provide the services they do at an affordable cost to those residents who would like to stay in their own home, and I believe this government should also look to supporting Meals on Wheels with greater funding so that they can actually do that. It is a simple way of actually helping people do exactly what they want to do, and that is stay in their own home for as long as they can.

I understand that the royal commission into the aged care sector may be providing its interim report next month. I would hope that, as a result of that report, the government gets on with responding to the needs that have been outlined time and time again, through a series of different reports over recent years, as to what could and should be done to provide a better level of care to people in residential aged-care facilities. We also know that, currently, about 15 per cent of the Australian population is 65 years or older and that by mid-century that figure will be around 20 per cent. We have a system that is currently under stress, that is failing to meet the needs of older people and that is actually growing. It is growing at a rate at which, if something isn't done urgently, older people will be suffering even more than many of them already are.

My office is regularly contacted by people who have applied for an aged-care package, and they have been waiting patiently. In some of those cases I have spoken to people personally and I know their circumstances; they are genuine cases of people in real need, people that cannot wait any longer. These are not people trying to rort the system. These are people that would have preferred not to have had to even apply for a package, but they do so because it is the only way that they can remain in their own homes. Yet I see people waiting months and months before they get that support, along with other support that older Australians need through a whole range of other services that they also apply for.

If we know that the population in Australia is ageing; if we know, in many cases, what the problems are within the current system; if we know what the demands are; and if we know what most of the solutions are—and it requires more support and more funding from this government—then I believe the government has a moral obligation to act. It cannot continue to keep kicking the can down the road by saying, 'We will wait for the royal commission's report in October.' Even then, that won't be its final report; it'll probably be next year before we get the final report. When we get that, as we have seen with the banking royal commission, it might be one or two years before the government brings down its recommendations on how it's going to respond in this place to the royal commission's recommendations. That tells me that it will be years before older people in this country see some real change to the services that are needed. It will be years before the changes that will make a real difference to their lives are implemented by this government.

Reform is needed now. Funding is needed now. The aged-care system is already struggling, as the member for Franklin quite rightly pointed out in her address in this place when she moved her amendment. We need to act now. We need to do so because the older people of this country deserve to live out their last few years with the dignity and respect each and every one of us would want for ourselves or for our parents. I urge the government not to keep delaying what it knows needs to be done but to get on with the job of responding to the needs of the older Australians with the care and compassion that they deserve.

10:48 am

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for the National Disability Insurance Scheme) Share this | | Hansard source

I thank all members who have contributed to the debate on the Aged Care Amendment (Movement of Provisionally Allocated Places) Bill 2019. The Australian population is ageing, and senior Australians and their families deserve to have access to high-quality aged care and services when they need them. Integral to this is supporting approved providers to make residential aged-care places ready for use as quickly as possible.

Constructing aged-care homes is a difficult, time-consuming and expensive exercise. It is not uncommon for providers to finish aged-care homes with fewer rooms than originally intended due to either planning or construction issues. Where this is the case, the Aged Care Act 1997 needs to be flexible enough to allow these leftover places to be moved to another suitable location. Similarly, a provider may find a more suitable or affordable location for an aged-care home a few minutes drive from the planning region to which the places were originally allocated. Again, the act needs to be flexible enough to allow this.

The amendments within this bill seek to add flexibility to the act by allowing provisionally allocated residential aged-care places to be moved from one region to another where a provider can demonstrate that the movement is in the interests of aged-care consumers, there is a clear need for places in the new region and it is not detrimental to the region to which the provisionally allocated places are currently allocated. This change is in the best interests of all older Australians and the broader community. It will remove a potential barrier to the community in accessing residential aged care, thereby aligning with the government's commitment to ensuring delivery of high-quality aged care and services when and where they're needed. I commend the bill to the House.

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

The original question was that this bill be now read a second time. To this the honourable member for Franklin has moved as an amendment that all words after 'That' be omitted with a view to substituting other words. The immediate question is that the amendment moved by the member for Franklin be agreed to.