House debates

Thursday, 5 March 2020


Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020; Second Reading

10:27 am

Photo of Julie CollinsJulie Collins (Franklin, Australian Labor Party, Shadow Minister for Ageing and Seniors) Share this | | Hansard source

As we heard from the Minister for Defence Personnel and Minister for Veterans' Affairs, the purpose of the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020 is to change home-care subsidies that are paid to providers from being paid in advance to being paid in arrears. In the lead-up to introducing this legislation I understand that the Minister for Aged Care and Senior Australians sought the advice of the Aged Care Financing Authority in relation to this legislation.

According to the Aged Care Financing Authority report presented to the government, this marks the beginning of three phases of reform to home-care payment arrangements. Essentially, we're moving from paying home-care providers in advance to ending up with a system like the NDIS, where home-care providers are paid a fee for service for the older Australians that they are caring for. I understand the first phase is set to commence in June 2020 and will trigger a change to the way providers are paid.

The second stage will involve legislation that will enable the government to deal with the unspent home-care package funds, which are currently very substantial. The second phase would commence in April 2021, and providers would only be paid the subsidy for the goods and services they actually provide to the consumer rather than receiving the full monthly subsidy amount for the recipient. Any unspent package funds would then be held by the department, not by the service provider, as is currently the case. The third phase would also commence in April 2021, and subsidy payments to providers for a consumer would be reduced by a proportion of the unspent package funds held by the provider for that recipient. I understand that this proportion is yet to be determined.

Labor do not want to hold up this bill, but we do have some concerns about the bill. We do want it to go through the parliament. I want to take this opportunity to put some of our concerns on the record around these changes. I hope and trust that the government has done its due diligence in relation to the concerns that I will raise. I do not want to see any adverse impact on providers. I do not want to see any impact on services that older Australians receive in their homes. I do not want to see any increase in home-care fees and charges to older Australians because of these changes.

Indeed, as acknowledged in the Aged Care Financing Authority report and the explanatory memorandum, some of the submissions suggested the new payment arrangements would be a risk to the viability of some providers. Many submissions referenced small providers and those particularly operating in rural and remote locations, suggesting that the risk to ongoing viability of these providers would be heightened as a result of the change in payment arrangements. Submissions from smaller providers asked that they be given special consideration and receive support to ameliorate the costs to them of the change in payment arrangements. The change from advance to arrears payments is set to commence from June 2020. Some of the service providers said this was an extremely tight turnaround for them. There is an increase in financial risk for some of the smaller service providers, who might not have adequate cash flow to deal with the payment changes. As is suggested in the Aged Care Financing Authority report, some service providers might have to revert to finding other financing arrangements, including loans or equity injections. Those home-care providers currently losing money will face significant difficulties changing over to an arrears payment arrangement. Some service providers have said that, as a result of cash flow pressures from these changes, they might be reluctant to take on new consumers during the transition phase. Service providers are also concerned that if the new payment arrangement increases administration costs then these costs will be passed on to consumers, which would in turn reduce the level of services that they are able to receive under a package.

The government has not yet detailed the savings associated with the change in these payment arrangements, which are expected to be somewhere in the vicinity of $250 million to $350 million, or what the funds will be used for. With the Royal Commission into Aged Care Quality and Safety to hand down its final report in November, there will be an immense amount of change before the aged-care sector. I would expect that the royal commission might also make a range of recommendations around the Home Care Packages Program that might include ideas about what to do with the unspent funds that have become part of the evidence presented in the hearings. As I indicated, the amount of unspent funds has increased substantially. In fact, it was $539 million as at June 2018 to a current pool of unspent funds of, I understand, around $750 million currently held by providers. ACFA states that this is an increase of approximately $200 million in the last 12 months. According to aged-care accountants StewartBrown, the average unspent funds per client is currently estimated to be $7,000. Given the evidence provided in the Aged Care Financing Authority report, some have put forward their concerns about the increased risk to the financial viability of service providers. As I said, the savings element of the reform is still not clear.

There are questions about why this legislative change is being made now when the royal commission isn't handing down its final report until November 2020. Of course, we have seen this government go off and say, 'We can't do this because of the royal commission and we can't do this because of the royal commission, but we are going to do this one thing and we're going to do this one thing.' It seems to be a very piecemeal approach to reform: every now and then we get some legislation or some sort of announcement to make it look like something is happening. This bill essentially just changes the home-care payment arrangement from advanced to arrears. It is the further changes down the track and, as I said, the possible impact on regional and rural providers that are our concern. The last bill the government introduced was the new commissioner functions bill. I stood in this place at the time and said that I thought it was a missed opportunity and that the government could have and should have strengthened the Aged Care Quality and Safety Commission. It could have been given some powers to arbitrate or to make some more decisive decisions, but of course the government has not yet decided to do that.

Interestingly, the government often says that it can't do things because of the royal commission. Essentially, it hides behind the royal commission. It says: 'No, we're not doing anything until the report'. But, extraordinarily, we did see, just before Christmas, the government make a decision to privatise the aged-care assessment teams. The government made the decision two days before Christmas and popped it up on its website. Then, after two months of everybody saying, 'This is not a good idea; why don't you wait for the royal commission report, as you keep using it as an excuse for everything,' we finally saw the government backflip on it just last week. On Thursday evening the minister said in estimates that he signed a briefing note to change his decision—'the previous minister's decision' was what he actually said—to privatise the aged-care assessment teams because of pressure from the state and territory governments.

Unfortunately, today we saw more confusion between the state and territory governments in relation to the aged-care facility in New South Wales that has been confirmed to have COVID-19 and currently has residents in isolation and staff who have been quarantined. It is very concerning that we still have some disagreements between the states and the territories in relation to how we're managing COVID-19. I look forward to getting a briefing from the government sometime later today about exactly how this is being handled.

Last month marked the third anniversary of the government's Home Care Packages Program coming to a national priority queue. We saw the priority queue grow from the very first announcement, from 88,000 older Australians waiting for home care to now, where we have around 120,000 older Australians waiting for home care. We've seen from the government various announcements—and I will give them some credit here—to try to do something about that. But, as I've said repeatedly and particularly when the Royal Commission handed down its interim report, to do 5,000 packages when you've got 120,000 older Australians waiting for home care is a mere drop in the ocean. This is crying out for very serious major reform. My big concern is the fact that the government keeps putting everything off to the royal commission and does this ad hoc, piecemeal, higgledy-piggledy reform—do this little bit here and this little bit there, say they can't do this for the royal commission but will wait for that for the royal commission.

There doesn't seem to be a clear strategy for aged-care reform. That is the problem. I sincerely hope that, when the government finally gets the recommendations from the aged-care royal commission, which is due in November of this year, they actually have a strategy on how to deal with the reforms, that they actually have a planned agenda on what reform they're going to do in what order and how they're going to do it. We cannot afford, when the aged care system is in such crisis, when we're having serious issues where we now have COVID-19 in one of the facilities, to keep doing this piecemeal, ad hoc reform. Government needs to do better.

I know they're very good at marketing over there and we've got Prime Minister Scotty, who thinks he's very clever about all this, but this is actually about old people getting services. This is people in their 90s, people's parents, aunts, uncles, relatives, brothers and sisters who are crying out for help and this government doesn't appear to be listening. This government appears to think that a bit of smoke and mirrors from time to time, a little bit of assisting 5,000 when you've got 120,000 people waiting, is good enough. It's not good enough, and I will continue to stand up in this place and hold the government accountable when it's not good enough.

We've also seen some issues with the Productivity Commission report this year about the waiting times. Because there are 120,000 people waiting on this list, we of course had the government's own Productivity Commission say that the waiting time for the high level home care packages is almost three years. Once you're approved by the Aged Care Assessment Team, you get told you need services immediately, and there is a three-year wait for this high-level care package. The report, interestingly, also revealed that older Australians are waiting longer to get into residential aged care.

We have seen the government do some things in regards to transparency on some of the home care fees; however, we're still getting reports from people all over the country about rising costs. People are concerned about administration fees, about exit fees and about other fees that they're being charged, and that is limiting the hours and the amount of care that people are able to receive. Former minister Wyatt said he would have a look at this and that he was going to do something about this, but again there doesn't appear to be any action from the government on that. We do need to hear from the government about whether or not it is going to do something about these fees and the concerns that I'm sure they are getting. If we're getting them from all over the country, they must be.

It is incredible to think that the government can do things like change the payment system, make a decision to privatise assessments but make a decision again not to privatise them, but there is no plan for reform. We still don't have mapped out 'This is what an aged-care system in Australia should look like, this is how we're going to get there and we're going to do it over this time period.' Where is the government on this? What we've seen instead over seven years is four ministers. We have seen billions of dollars ripped out of the system. We've seen a little bit of money put back in but nowhere near enough when you're talking about 120,000 people still waiting for home care. We don't have a clear plan from this government. They need to do better.

Our second reading amendment I am going to move reflects our concern about the government's inaction over the past few years. Therefore, I move:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House notes the Government's piecemeal approach to aged care reform".

Photo of Rob MitchellRob Mitchell (McEwen, Australian Labor Party) Share this | | Hansard source

Is the amendment seconded?

Photo of Ed HusicEd Husic (Chifley, Australian Labor Party) Share this | | Hansard source

I second the amendment and I reserve my right to speak at a later time.

10:40 am

Photo of Angie BellAngie Bell (Moncrieff, Liberal National Party) Share this | | Hansard source

I'm pleased to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. Improving aged-care for senior Australians continues to be a key priority for the government, and we are making government to improve the sector. We're delivering record investment across the aged-care system, from $13.3 billion in 2012-13, growing to $21.4 billion in 2019-20 and up to an estimated $25.4 billion in 2022-23. That's an increase of over $5 billion in extra support for older Australians over the forward estimates. The government remains committed to supporting senior Australians to live in their own homes longer.

The Gold Coast's idyllic weather, proximity to beaches and amenities makes it a prime location to retire. My electorate of Moncrieff is amongst the highest in the number of senior Australians who call the central Gold Coast home. This means that we also have many senior residents who want to stay in their homes longer and are in need of care from their loved ones or are making the transition to aged care. In the year to September 2019, almost 30 per cent more seniors across the nation had access to a home-care package. Since the 2018-19 budget, the Morrison government has invested in 44,000 new home-care packages, at a cost of $2.7 billion.

This bill amends the way that home-care providers are paid the government subsidy. While I'm at it, providers shouldn't be spending people's money before they have delivered their services. StewartBrown found that at least 89 per cent of providers had sufficient liquid assets. Further, providers have access to a business advisory service. The government will be monitoring providers closely and responding if needed. I think that answers some of the questions that the member for Franklin had. Providers currently receive the monthly subsidy for a home-care recipient in advance, using an estimate based— (Quorum formed)

Providers currently receive the monthly subsidy for a home care recipient in advance using an estimate based on previous months. The provider then lodges a claim after the end of the month, at which time a reconciliation occurs. Underpayments of subsidy are then rectified immediately, while overpayments are withheld from future payments. This means that idle money often sits in providers' bank accounts, and this has created a rising level of unspent home care funds.

This old way of funding differs to how the Australian government ordinarily pays for programs and services such as the NDIS. The bill will amend the legislation so that a provider will not receive a payment in advance but will be paid the monthly subsidy for a home care recipient upon lodgement of a claim with Services Australia after the end of each month. To be clear, this will not impact on the amount of subsidy available to a care recipient under their home care package. This is an important step towards addressing stakeholder concerns regarding unspent funds and aligning home care payment arrangements with other government services.

The opposition has publicly agreed that these unspent funds should be supporting the home care system rather than sitting idle. The member for Franklin raised this in the House on 23 November 2019, and so we look forward to her support to ensure this important legislation is passed.

At the last election, Labor had no plan for senior Australians. Instead, they planned for $387 billion in new taxes, including their retirees tax, which would have—

10:47 am

Photo of Madeleine KingMadeleine King (Brand, Australian Labor Party, Shadow Minister for Trade) Share this | | Hansard source

I move:

That the Member be no longer heard.

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

The question is the member be no further heard.

10:55 am

Photo of Angie BellAngie Bell (Moncrieff, Liberal National Party) Share this | | Hansard source

They don't want to hear about their $387 billion worth of extra taxes that Labor had, so they shut me down. They closed me down because they don't want to hear about the mistakes that they were about to make. (Time expired)

Photo of Mike FreelanderMike Freelander (Macarthur, Australian Labor Party) Share this | | Hansard source

I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. I want to take this opportunity at the outset to express my complete and utter dismay at this coalition government's handling of aged care. My frustration and disapproval of the government's handling of this crisis—and it is a crisis—is shared by many residents in Macarthur and across the country. It may well be that the chickens are coming home to roost. I have been contacted by numerous local residents who have suffered due to the government's blatant mismanagement of the aged care sector in recent years. I have been contacted by residents who are elderly and suffering and who can barely stand for more than couple of minutes at a time, who are not receiving the support that they are owed by this reactionary government. I have been contacted by sons and daughters and grandchildren who inform me of some of the truly horrific living standards suffered by their loved ones. I have been contacted by concerned neighbours who take it upon themselves to advocate for those who are voiceless and are being left behind by the Liberal-National government. Each and every case I hear is harrowing. People in my community are suffering needlessly owing to the government's blatant failures in aged care.

This is not a problem that's been going on for one year or two years. It's being going on for the life of the Abbott/Turnbull/Morrison government over six years. We have spoken a number of times in this place about the state of aged care under the stewardship of this reactionary government. The sector has been in crisis for a long time. We have had inquiries, we now have a royal commission, and we have a government that has lacked any leadership to tackle this crisis with due diligence. My heart goes out to the many people who are not receiving the assistance they deserve and to the families and loved ones who advocate so selflessly for justice. We can do better and we must do better.

The government has presided over a growing problem with aged care packages. When I first came into this place, this had been pointed out to the government then. Nothing has happened. Unfortunately the aged care packages being offered to older Australians are going undelivered in many cases, and people are suffering from a growing trend of disadvantages and delays in this sector. I thank my colleague the member for Franklin, Julie Collins MP, for her tireless advocacy in this field. She well knows the difficulty that those in aged care are suffering. I note also the advocacy of the member for Macquarie, who brought forward a motion in the House this week on this very issue.

For many older Australians, be they home owners or tenants, their home is much more than bricks and mortar. It is a catalogue of memories and experiences that have been shared over decades with friends and family in the wider community. There appears to be a belief held by some that once you get to a certain age you're expected to pack up and move into residential aged care. This neglects the many elderly Australians who want to stay in their own homes, and it removes from them part of who they are. Many elderly Australians are more than happy to remain in their homes with the assistance of the much-needed but much-delayed aged and home care packages. For instance, the most recent census found that 95 per cent of Australians aged over 65 lived in their own home.

I would like to highlight another aspect of this matter: the implications that this issue has on other sectors within our economy and society. This includes the cost of family members taking time off work to assist elderly relatives, with a Deloitte Access Economics report finding this type of informal care assistance to be valued at $60.3 billion per annum—a huge sum that shows the sheer amount of unpaid work that's being provided by families and friends to those who need it most. The report, published in 2015, also found that these same family-and-friend services will outstrip the current supply of formal packages within the next 10 years, leaving us with five years to try to correct the problem. Another area that has and will continue to be affected is our hospitals, with applicants ending up in hospital beds for long periods receiving care for injuries and illnesses sustained that could have been avoided had their home care packages been delivered.

Tragically, the Royal Commission into Aged Care, Quality and Safety heard that approximately 44 people a day died in 2018 after they had received approval for a package that was not delivered. These packages were never utilised as they were never delivered to the people who were most in need. This is a very sad state of affairs—and, for the most part, it is an avoidable tragedy, had the government made support more accessible and reliable. I strongly agree with the royal commission, who noted that these deaths are totally unacceptable. These are people requiring high-level, in home aged-care support, who never got it—who died without getting it. This is a tragedy for our nation.

Additionally, figures published in the royal commission's interim report noted that those approved for the highest level packages, levels 3 and 4, had the longest wait periods, with estimations of between nine and 12 months in the period ending 30 June 2018 and over 12 months in the period ending June 2019. These are people who have had formal ACAT assessments and were assessed as being in urgent need of support and as having severe problems, such as mobility issues, continence issues, feeding issues and respiratory issues—a whole range of severe problems—who were not provided with support at the time in their life when they really most needed it. We are failing these people, and it is a tragedy. Two very important facts stand out here. Firstly, the government have failed to improve wait times for applicants in spite of the constant times that we have reminded the government of this. Secondly, those needing the most crucial of services face the longest wait times, often suffering in pain and distress because of the health issues they have.

I hate using this phrase, but we hear it all the time from those opposite—if you have a go, you get a go. Well, these people have had a go. They've worked all their lives and they've done their best for this country, and we are failing them. It's a phrase that's been all too often used by this Prime Minister to describe the ups and downs that Australians can experience, particularly the ups if they work for it. I encourage you, Prime Minister, to look at the long list of applicants for high-level aged-care packages, their detailed application forms and their current circumstances, and to realise that elderly Australians have for decades contributed to this nation and yet we are failing them. It is time for them to get a fair go and receive their packages. I call on the Prime Minister and the Minister for Aged Care to fix our country's broken aged-care system. It's unacceptable that older Australians are having to wait months, if not years, to receive the home care packages that they deserve. This should not be a political football. Labor is prepared to work constructively with the government to get the recommendations of the royal commission off report pages and into pragmatic policy work and the delivering of services.

We have before us today a bill that the government is attempting to introduce as it pursued the shocking plans to privatise aged-care assessment services—even before the Royal Commission into Aged Care Quality and Safety is allowed to hand down its final report. It's good that we've been able to at least temporarily stop the government trying to privatise the ACAT assessments, but it is shocking to me that the government would try and go ahead with this in the face of the disaster that they have in aged care.

We've just marked the third anniversary since the government handed down their Increasing Choice in Home Care reforms. One has to wonder about the significance of this occasion, given the fact that these reforms have done nothing to address the growing home care package waiting list. More than 100,000 Australians are still waiting to receive the home care package that they've been approved for. I think if anyone has had contact with elderly Australians in this situation, you would realise the terrible health issues that they are sometimes suffering from—incontinence, breathing difficulties, heart failure, swallowing difficulties, nutritional difficulties. They are terrible, terrible issues. That's 100,000 elderly mums and dads, grandmothers and grandfathers, aunts and uncles who are being sorely let down by this government.

We drill into our children, and have done so for generations, the notion that we ought to respect our elders. We are taught from a young age to care for our elderly population—to treat our elders with compassion and love and, above all, with respect. This is not happening under this government. It appears that this government missed out on this lesson in ethics and civics throughout their upbringing. They are presently letting down over 100,000 older Australian who have helped build this country and who have contributed to our society throughout their lifetimes.

The government's failure in this arena is unforgivable to me. This is not a crisis that sprang out of nowhere. This was a growing issue that Labor had been attempting to work with the government on for years—certainly for far longer than I have been in this parliament. Yet all we've had are empty slogans and no action. This is something that our elderly will look back on with growing concern, particularly as we face health crises in this country. Those opposite cannot deny their complacency. They have attempted to shirk all responsibility to older Australians for years and arguably only sprang into gear following an expose on Four Corners.

I use the word 'sprang' lightly, as this government is still yet to deliver substantive change to the living standards for countless older Australians. It's unacceptable, and we would do well to put pressure on this government to urgently address the crisis which has occurred under their watch. It appears that those opposite only act or show up for the job when their marketing message is at risk. That's all they've delivered to aged care: marketing messages. There has been no substantive change. We must continue to show the government the consequences and the true human cost of their inaction and to keep the pressure on when news cameras cease covering the royal commission.

I think the royal commission's interim report title, Neglect, says it all. Older Australians have not only been sorely let down by the Abbott-Turnbull-Morrison government but been treated with contempt and been neglected all together. It appeared to me that the government was initially going to use the royal commission as a mechanism to delay any action to address the aged care crisis plaguing Australia. They were dragged kicking and screaming to hold the royal commission after ignoring the problems in the sector for far too long, as was the case with the banking royal commission. Then it appeared they would delay taking urgent steps to begin addressing the crises, awaiting the commission's findings.

However, Neglect, the Commission's interim report, put forward three recommendations that require the government's urgent action. They were: ensure older Australians are getting the care at home when they need it most; end the overreliance of chemical restraints in aged care; and stop the unacceptable number of young people entering residential aged care. Those are three recommendations which paint a scathing picture about the government's inability to address problems in the aged-care system. Shockingly, even after receiving such a scathing and public report card from the royal commission, the coalition government's response remains woefully inadequate.

Those opposite, through their marketing prowess, would have us believe that they are taking the necessary steps to address the aged care crisis. For all of their spin, the facts remain, and the government's results are pathetic at best. In response to the royal commission's interim report, we have an extra 10,000 home care packages. For all of their valiant efforts to respond to the commission's interim findings, the government is still presiding over a system in which over 100,000 older Australians remain waiting for their approved aged care packages.

Disgracefully, for all of their spin, the government has still not delivered any funding since December 2017. There's a lot of talk, but very little action. The coalition has merely brought forward funding from other years, or else funded packages through a reduction in residential aged-care places. They are literally taking money from one part of an already struggling and failing system and placing it in another part to paint a more rosy picture for the general population. The government has harped on for too long about their long sought after budget surplus. Effectively, they are stubbornly refusing to put the necessary funding into a system in desperate need of a boost. A hundred thousand Australians are presently waiting for a package that the government has told them they are entitled to, because the government is stubbornly delaying spending money. This is what it comes down to. A budget surplus, we all agree, isn't a bad thing. But when the very social fabric and values that underpin our society are sacrificed to achieve this goal, one has to question the government's judgement and its motives. At what cost must they continue to promulgate a false narrative? (Time expired)

11:10 am

Photo of Terry YoungTerry Young (Longman, Liberal National Party) Share this | | Hansard source

I rise in support of the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. Working for your whole life in order to provide for your family takes commitment, dedication, drive, patience and passion—not to mention strength to face the challenges, tests and trials you will encounter in life along the way. Building up that nest egg, setting yourself up for life after work and ensuring that your children and grandchildren have the things that you never had takes time and effort. The dedication of that tradie who's just hung up his hat for the last time after many years of loyally providing for his family deserves to be reward. That single mother who has worked for years to embark on her career, put her kids through school and provide for her family deserves to be rewarded. Like many senior Australians have done before, and will do in the years to come, my parents wanted the best life possible for me. For that, I thank them. This amazing level of dedication and commitment deserves to be recognised and rewarded, not disregarded. This important legislation not only amends both the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997, but will ensure that the needs of our senior Australians are met, that they will get the support they need and that their years of hard work will not be forgotten or be in vain.

Our senior Australians have worked hard for their entire lives, and many are still finding themselves working in order to bring in income for themselves and their families. They have paid their taxes and done their fair share. The Morrison government sees that clearly and prides itself on giving back to our hardworking senior Australians and making them a top priority, so that they can comfortably retire to enjoy all the wonderful perks that life has to offer, such as travelling, attending shows or sporting events and, most importantly, spending time with their kids and grandkids, because they deserve it, they truly do.

We have more than 27,000 senior Australians living in the electorate of Longman as of today, and I am committed to delivering for every single one of them. I'm a man on a mission: to improve their lives and ensure that they can access the support and aged-care packages that they need in order to live a happy, healthy and comfortable life. One great thing that the Morrison government has done to improve the life of Longman senior residents is to increase the age pension by $117.80 for singles per fortnight and by $177.40 per couples per fortnight, benefitting the 21,433 aged pensioners that live in Longman. The Morrison government will continue to increase pension payments.

(Quorum formed) The Morrison government will continue to increase pension payments for the aged pensioners in Longman in March and September each year. This announcement by the Morrison government's welcomed by many pensioners within the community of Longman.

Not only as a government but also as a nation we must continue to support and respect our older Australians. Why? Because retirement brings its own set of challenges as well as a more relaxed life with time to yourself, your children and your grandchildren. It can also lead to loneliness and social isolation for a lot of senior Australians, who should be enjoying retirement. This is why it's important to take care of the senior members of your family, to make sure that they are happy and not drifting into social isolation. Take the time to visit them, drop in for a cup of tea and some biscuits, or walk next door and say hello to your elderly neighbour. Sometimes these moments, these brief chats, are enough to make their week, pull them out of isolation, get them out of bed in the morning and put a smile on their face. It can also encourage them to get involved in the community, such as signing up to be a member of a local club or even volunteering with a community group. Longman has great community groups, filled with great volunteers, who do a lot for the senior Australians who live in the community.

Meals on Wheels is one of those. This service provides great benefits to the elderly, not only with a hot, nutritious meal but sometimes the only person an elderly resident will see all day, or even all week, is a friendly volunteer from Meals on Wheels ready to deliver their food and have a quick chat. This makes their day, and it's something they look forward to.

We want our older Australians to live longer, healthier and more fulfilling lives by giving them a choice about how and where they want to live, giving them more aged-care options and the capacity to live independently for as long as possible. This is why the Morrison government has been actively working for our older Australians every single day. This is why the Prime Minister announced the royal commission into the aged-care sector, in order to look at the quality of care provided in residential and home aged care to senior Australians. We are committed to providing older Australians with access to care that supports their dignity. We want to ensure that the quality of life of residents of aged-care homes and consumers of home care packages, who are socially isolated or lonely, are improved.

Some senior Australians may choose to travel Australia in their caravan once they retire, or may flock to places like Bribie Island in Longman, the electorate I serve, to retire in style by the sea. But we are finding that more and more senior Australians are choosing—you

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

I interrupt the member for Longman. The member for Chifley is seeking the call.

11:19 am

Photo of Ed HusicEd Husic (Chifley, Australian Labor Party) Share this | | Hansard source

I move:

That the speaker be no longer heard.

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

The question is that the member be no further heard.

11:28 am

Photo of Matt ThistlethwaiteMatt Thistlethwaite (Kingsford Smith, Australian Labor Party, Shadow Assistant Minister for Financial Services) Share this | | Hansard source

I'm speaking in support of the amendment. There are several concerns that we have about the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. Although we don't wish to hold the bill's progress up through the parliament, we are going to put forward some concerns. The concerns relate to the royal commission and the fact that the royal commission still hasn't completed its work. The government here is bringing forward this particular piece of legislation despite the fact that the final report of the royal commission won't be handed down until November.

The Royal Commission into Aged Care Quality and Safety will hand down its final report in November. There has been an immense amount of change regarding the sector over recent years. The royal commission may make a range of recommendations around home-care packages and their programs, and it may include what to do with unspent funds that have been part of the evidence presented in the hearings. Given the evidence provided in aged-care financing and the authority's report, some have put forward their concerns about increased risk to the financial viability of some service providers.

Why make legislative changes now when the Royal Commission into Aged Care Quality and Safety won't even hand down its report until November 2020? We know that this government is renowned for its piecemeal reform. Last month marked the third anniversary of the government's increasing choice in home care reforms, and three years on the question is being asked: what's been achieved from these reforms and older Australians choosing to receive aged-care services in their own homes? These reforms have done nothing at all to address the growing waiting list for care packages. There are still more than 100,000 older Australians waiting for an approved aged-care package. Sadly, almost 30,000 have died over the past two years waiting for that approved aged-care package.

My office received a call last year from a 93-year-old constituent who was complaining that, despite the fact that she had no direct relatives in the local vicinity that could care for her and she was living on her own in quite a large residence, she had still been waiting over 12 months for the approval of her aged-care package. And that is not uncommon, unfortunately, under this government and their approach to aged-care packages. That's why many older Australians, who've worked all of their lives and paid their taxes, are so frustrated with this government when it comes to aged care packages.

The government did release an additional 10,000 spots in their last budget, but the sad thing about that was that the funding wasn't additional funding. It came from earmarked funding already within the budget, and it says everything about this government's approach to budgeting and the way they mislead the Australian public about providing funds and additional services for people and how they're funding them. Around 25,000 older Australians entered residential aged care prematurely over the past two years because they couldn't get access to approved home care packages. With an ageing population, this is a problem that is growing in Australia and it's something that all of us, as local members of parliament, are experiencing in our interactions with constituents: the frustration that elderly Australians are facing with the government's system of not supporting and not providing adequate response times in respect to applications for in-home aged-care packages. That's putting pressure on the residential aged-care sector, and with an ageing population it's only getting worse.

The waitlist times under this government have blown out. Older Australians waiting for high-level packages are waiting almost three years to get care that they have been approved for. The median waiting time for older Australians going into residential aged care has grown from more a month when the Liberals and Nationals took office to now over 100 days. It's grown exponentially under their watch, and the Productivity Commission report on government services, released in January this year, revealed that older Australians waiting for high-level home care packages are waiting almost three years to get the care that they've been approved for. The report also revealed that older Australians are waiting longer to enter residential aged care. The government has made improvements to the transparency of home care fees; however, home care recipients are still raising concerns about the rising cost of administrative and daily fees that are deducted from their packages, therefore impacting the amount of care hours that they can access.

Then there's, of course, the royal commission. The findings that have been uncovered under the royal commission's auspices have been quite shocking. The royal commission handed down an interim report on 31 October last year, and that report was titled Neglectone word. The commissioners put forward three recommendations that required urgent action. The first was to ensure that older Australians are getting the care at home that they most need. Second was about the over-reliance on chemical restraints in aged care throughout Australia. The third recommendation was to stop the unacceptable number of young people entering residential aged care.

I must say that it's heartbreaking to see a young person, particularly a young person with a disability in their 30s or 40s, lingering in an aged-care facility, where they certainly don't belong. In a wealthy nation like Australia, with the living standards we enjoy, that should be something we avoid at all costs. Again that is an important recommendation of the royal commission that we hope the government will deal with.

The government's response to the interim report has been woefully inadequate, especially in relation to addressing the home-care packages waiting list. The commissioners recommended urgent action to address the home-care packages waiting list, but the government has put only 5,500 home-care packages into the system since 1 December last year. This is simply inadequate when 100,000 older Australians are waiting for their approved home-care package.

Another example of the Morrison government's piecemeal reform was the attempt to privatise the very successful aged-care assessment teams, the ACAT services. This is one element of the aged-care system in Australia that actually works very well and which there has been very little complaint about. But this government, like many Liberal governments throughout the country, saw an opportunity to privatise another essential service. It wanted to try to make bucks out of contracting out this essential service. Thankfully, at COAG last week the government was forced into an embarrassing retreat on this plan to privatise the assessment of aged-care services. The government confirmed that it has abandoned the current tender process after its plan was panned by state and territory governments, aged-care experts and even its own members of parliament.

Labor has proudly stood up for these assessment teams; for the rights of older Australians, who deserve the best aged-care services; and particularly for the government commitment to those aged-care services in the future. The Morrison government must now give a clear assurance that this important work will continue to be done by experienced and well-qualified assessors in conjunction with the states and territories. That's what older Australians want when they're accessing aged-care services and that's what they deserve. Labor will keep fighting to ensure that those important services are maintained and are properly resourced with well-trained staff by the Australian government.

The Morrison government's privatisation plan was ill-conceived from the beginning. In January the aged-care royal commissioners issued an extraordinary public correction in response to the minister for aged care's false assertion that they supported the plan to privatise aged-care assessments. That was a disgraceful misuse and manipulation of the royal commissioners. It's quite extraordinary for royal commissioners to go out of their way and issue such a statement. I think it highlights just how misleading this government has been when it comes to aged-care services. It goes to what we've seen around the sports rorts and the lack of leadership that came from this government in the management of the bushfire crisis throughout the country in recent times. They do all they can to avoid scrutiny and all they can to avoid providing the truth and facts to the Australian public. That was highlighted by the royal commissioners' response and their claims about being misrepresented by the aged-care minister through those comments.

Just last week the government's plan to outsource the assessment of aged-care services was rubbished by one of its own federal MPs in a speech in this parliament. Thankfully, that member of parliament stood up and had their voice heard when it came to providing support for those important assessment teams.

This government's piecemeal and mismanaged reform before the final report of the royal commission in November again is an example of the government asleep at the wheel. Basically it hasn't got a plan, particularly when it comes to aged-care services in the longer term.

There have been four different ministers since this government was elected to office, and there's been no consistency of approach in this portfolio. I've mentioned the over 100,000 Australians that are on the waiting list for in-care packages, and the piecemeal approach to providing funding—providing some in one budget and cutting funding for aged-care services in another. There's no consistency. There's no plan. Just like their management of the economy, there is no plan for aged-care services in this country, and Australians are suffering.

After ripping billions of dollars out of the aged-care system initially, they've lurched from one crisis to another. The money that was ripped out in those earlier budgets of the Abbott and Turnbull governments—money that was ripped out when the Prime Minister was the Treasurer, I might add—are now seeing many Australians missing out on the care that they deserve. This government must do a better job to ensure that older Australians get the quality care and services that they deserve right now, not at some stage into the future after the commission has reported.

(Quorum formed)

11:44 am

Photo of Chris HayesChris Hayes (Fowler, Australian Labor Party) Share this | | Hansard source

I would encourage colleagues opposite to stay after the quorum. This is a very interesting debate, particularly when we're talking about the most vulnerable Australians—those who actually need our assistance most. I would have thought that those opposite would have an interest in this matter. We should be clear from the outset that, firstly, as has been pointed out, we will support the passage of this bill, the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. However, in relation to the amendments that have been moved by the shadow minister, the member for Franklin, it is instructive to look at the government's record when it comes to administering aged care.

No-one in this place should be fooled into thinking that this government actually cares for the most vulnerable in our community. If you look at the record that they have been able to muster over the last seven years, you'll see that they haven't really shown much care or empathy for the most vulnerable Australians, those who are in need of aged care. The Abbott, Turnbull and Morrison governments have clearly been asleep at the wheel or have simply been negligent. We've had four ministers, billions of dollars ripped out of the aged-care system and one crisis after another. The government in its very poor way, quite frankly, has stumbled into addressing the findings of the royal commission into aged care. It has been instructive to see what the commission put in its initial findings.

Before I do that, I'd like to talk a little about what this bill seeks to do. It seeks to change the payment for home-care subsidy providers from being paid in advance to being paid in arrears. That doesn't seem much of a change. As a matter of fact, it does seem to be practical in many respects, but it is going to require some transitioning. Like many members, I have many providers that are very low cost, many of which run on a not-for-profit basis. The change in the payment system is something that they need to be able to accommodate properly. What I've been advised is that it's not just a simple task of changing a piece of legislation. The explanatory memorandum states that the bill will 'improve the way home-care providers are paid the government subsidy on behalf of home-care package holders and will bring these arrangements in line with contemporary business practices'. I think that's probably fair. However, the Aged Care Financing Authority, the ACFA, when they were consulted about the terms of this provision contained in the bill, highlighted a series of concerns. They said, 'The new payment arrangements would be a risk to the viability of some providers.' That's precisely the information we're getting at the coalface, in our electorates, from those providers that are not multinationals and are not major businesses but are providing significant services to some of the most vulnerable people in our community. Many of the stakeholders have raised issues, particularly drawing attention to the significant impacts that it would have on small providers and those operating in rural and remote locations.

The change from advance to arrears is to commence on 1 June 2020, which, you'd have to admit, is an extremely tight turnaround. I think that in itself is problematic as specified in this bill. There is an increased risk that some of the smaller service providers who do not have adequate cashflow will struggle not only to meet the time demand but to actually make the initial transition. As noted by ACFA, it may become necessary for service providers to resort to other financing arrangements, including loans and equity injections, to be able to accommodate the initial change. The change may also see some home-care providers become reluctant to take on new customers. That in itself would be problematic in that we do need to have greater provisioning of home-care services, otherwise we'll see a significant influx into residential aged care. What I'm trying to point out is that this is once again symptomatic of the government's piecemeal attitude to reform. This is no real reform; this is just making a minor change and being caught on the run.

Last month marked the third anniversary of this government's Increasing Choice in Home Care reforms—the third anniversary of that significant reform that they announced with much fanfare. But, three years on, we see that these reforms have done little to address the growing home care packages waiting lists. There are still more than 100,000 older Australians waiting for their approved home care packages—not waiting to go on a list or waiting to put an application in; waiting for the delivery of their approved packages. Sadly, almost 30,000 older Australians have died over the past two years waiting for their approved packages to be delivered and around 25,000 older Australians entered residential aged care prematurely. As I said before, for many people, if you can't get the services at home, the only alternative is to go into full-time residential aged care.

The median waiting time for older Australians going into residential care has also grown by over 100 days. It is no longer just one month; under the Liberal and Nationals, it has now grown to up to five months. So, after making that initial decision to actually set yourself up in aged care, you now have to wait some time. Bear in mind that the people we are talking about are some of the most vulnerable people in our community. The people going into aged care are ordinarily well into their eighties or older—and we need to support these people. These figures make it clear that the government's simply not doing enough to support older Australians.

The Productivity Commission's report on government services, released in January this year, sheds further light on the government's mismanagement. It notes that Australians waiting for high-level home care packages are waiting almost three years to get the care that they have been approved for. That's three long years for people in our communities, in our families, and in our electorates who are doing it very tough. These years that could go into improving the quality of their lives of elderly Australians. But, rather, because of the government's mismanagement, the exact opposite is happening.

Let's not forget the Royal Commission into Aged Care Quality and Safety interim report, which was handed down on 31 October last year. The interim report was interestingly titled, Neglect, and it highlighted three significant matters for this government to take urgent and immediate action to address: namely, ensuring that older Australians are getting the care at home when they need it; preventing the overreliance on chemical restraints in aged care; and, thirdly, ending the unacceptable number of young people entering residential care. The government's response to the interim report has been woeful, to say the least, especially in relation to addressing the issue of home care packages waiting lists. The commission also recommended urgent action to address home care waiting lists but, once again, what we have seen is that the government has a shortfall, putting only 5,500 home care packages into the system since December last year. That doesn't equate with more than 100,000 people, older Australians, who are currently on the waiting list. The 5,500 new packages are not really going to make a huge dint when there are 100,000 people still on the waiting list today.

My office regularly receives representations from members of my community on the issue of waiting times for approval of home care packages—and we've seen a spike in that over recent times. To highlight this, I would like to draw the attention of the House to the experience of one my constituents—and this woman has allowed me to name her. Nora David is 82 years old. Although she has been approved for a level 3 home care package, she has only been allocated a level 2 My Aged Care package. She was told that she would need to wait nine to 12 months for funding to be available for a level 3 package. With the current level 2 package, Nora has only 3½ hours of care per week. That 3½ hours is expected to meet all of her needs, including groceries, shopping, food preparation, cleaning, doctor appointments and purchasing medication, just to name a few. She goes on to say that, if she needs to visit a doctor, simply going to the surgery, taking her appointment and some wait time can basically take up her full 3½ hours, basically leaving this 82-year-old woman with no extra care for the remainder of the week.

One doctor's appointment takes out her shopping, takes out the purchase of her medication, takes out her cleaning and takes out all those things that care is supposed to be provided for. For an 82-year-old, someone who has actually been a long-term resident of this country, who has grown up here, worked and paid taxes—is that the way we really want to treat people? I remind the House that it was this Prime Minister, when he was Treasurer, who was the architect of cutting almost $2 billion out of aged care. With more than 22,000 Australians aged 65 or older in my electorate of Fowler alone, I've seen the impact of the government's continued neglect on older Australians in the aged-care system.

As parliamentarians, I think we all have a responsibility to ensure the quality of care for our elderly. We need to ensure that the sector works positively to look after their needs. If we can't spend enough time and resources looking after our elderly, doesn't that mean that we as their representatives and as parliamentarians have simply failed? At some stage I think we have to admit that. The government has to be strong enough to come out and not just make another budgetary adjustment, not just fudge around waiting times but be honest and say, 'We've failed.' I call on the government to reverse their continued cuts to the aged-care sector and look to address their broken promises. Heading towards the election, make no mistake about it, they had plenty of promises on what they were going to do about aged care, but have consistently failed to meet them.

Against this background, as I said, we'll be supporting the passage of the bill. But I think that with this situation we do need to see the government show that it has the courage of its commitment to meet its electoral promises and stand up and support Labor's call to look after the most vulnerable in our society and to look after those that we have an ongoing obligation to look after, older Australians.

(Quorum formed)

12:01 pm

Photo of Anthony AlbaneseAnthony Albanese (Grayndler, Australian Labor Party, Leader of the Opposition) Share this | | Hansard source

I'm pleased that so many members of the government have come to hear this address, because clearly they do not have an aged-care strategy, and clearly it's once again up to Labor to lead from opposition on the issue.

Frankly, there is an aged-care crisis in this country. I rise to speak in support of the amendment moved by the member for Franklin pointing out the lack of a government strategy when it comes to ageing Australians and the aged-care sector. When I look at older Australians, I see the generation that built this nation. I see the generation that built our economy and shaped our modern society—the generation that did the hard yards. They have shown aspiration at its most fundamental—aspiration not just for themselves in a selfish, individualist way. They have shown aspiration for a better life for their children, for their grandchildren, for their neighbours, for their community and, indeed, for their country. In them I see what I hope we all see: the strength and the spirit of modern Australia. And you see it everywhere you go, because, for so many Australians, the later years are an incredible opportunity. We are living longer. When people hit their 70s they were once seen as being towards the end of their life. But in so many cases today, due to medical breakthroughs, better nutrition and a range of factors, what we're finding is that people are living longer. What that represents is an incredible opportunity for those people to travel, to look after younger generations and to participate in society. Where would our civil institutions be without the contribution of older Australians? They're the ones who are keeping the clubs going. They're the ones who are there cooking on a Saturday anywhere in the country to raise two bucks from the snag sandwich to give to their local cricket club or netball club. They're the ones who, of course, got ripped off by this government's sports rorts scandal.

The fact is, though, that this situation also represents a challenge, because those older Australians are entitled to think that when they reach a stage in their life where they can no longer support themselves without assistance—whether in the home or in an aged-care facility—the contribution that they've made to this country will be paid back to them in the form of proper, adequate care which ensures that they have quality of life. And this is an issue not just for them, of course, but for their relatives. This is something that worries their kids and, indeed, their grandkids—that they're able to have a fulfilling retirement up until that point, but that, after that point as well, their later years continue to be good years. But for their part, this government—now there for seven years, three terms, with three prime ministers—the Abbott-Turnbull-Morrison government, has no strategy, no plan, to deal with the challenge and, indeed, to reap the benefits that are there also from an ageing population.

Current policy settings are simply inadequate. Australia's lifestyle has long been the envy of the world, but when it comes to supporting our ageing population, we fall far short of that reputation. Old age, of course, isn't synonymous with aged care, but for some older Australians it is necessary—but our aged-care system is broken. We need to look no further than the royal commission into aged care quality and safety where desperate families and exhausted under-resourced aged-care workers are telling their stories, and those stories, quite frankly, are horrific. The royal commission's interim report described Australia's aged-care system as 'cruel and harmful', 'shocking' and 'All too often, they are unsafe and seemingly uncaring.' They found that:

Many of the cases of deficiencies or outright failings in aged care were known to … the regulators before coming to public attention.

Just think about that. The regulators from the government knew that these problems were there but held on to that information without making it public, therefore, delaying the public response, which is demanding action from this government. We should not allow that to continue.

For too long, governments have turned a blind eye. There's been a lack of reform and investment in aged care, in both home care and residential aged care. For those Australians who can and want to stay in their homes, a home care package provides the support that they need. But there's more than 100,000 Australians on the waiting list for such a package.

Older Australians, waiting for their high-level package, are waiting almost three years to get the care that they've been approved for. Just think about this: they have an assessment and that assessment objectively determines that they need a level of care and they have to wait three years in order to get it. And in the last two years—and I think this is perhaps the most horrific figure from the interim report and from the other information that's out there—30,000 Australians, who have been approved for home care, literally have died waiting to get that care. That's 30,000 Australians in just two years. The median waiting time for older Australians going into residential aged care has grown by more than 100 days under this government. It was around about a month, now it's five months, under this government over the last seven years.

The royal commission heard stories of degradation, suffering, abuse, neglect and systemic failure. We heard that up to half of older Australians in residential aged care are malnourished. Think about what that means: they are literally starving in a wealthy country like ours. We heard that the major quality and safety issues are inadequate prevention and management of wounds, sometimes leading to septicaemia and death; and aged-care residents often sitting or lying in urine or faeces.

Part of the answer to this crisis must lie in giving support to our aged-care workforce, those we trust to care for our most vulnerable—our parents, our grandparents and eventually ourselves. Even the selfish individualists opposite, one would have thought, would have an incentive to actually improve the system that one day they may well rely upon. We all have a direct interest in ensuring this—a self-interest, if you like. So, if not motivated by anything else, like care of anyone else, I would have thought that maybe this could jolt them into action. But I see that government members have removed themselves from the speaking list on this legislation—

An opposition member: Nothing to say.

because they have nothing to say about the real issues confronting this nation. The fact is that there are too few aged-care workers, and they are paid too little. They've begged the government to do something. Labor is listening. Our aged-care workers need proper pay and proper training.

The aged-care workforce must also be able to provide culturally and linguistically appropriate care. The day before I gave my fourth vision statement in Brisbane, on respecting and valuing older Australians, I visited the electorate of Oxley with its member and with the Shadow Treasurer. Milton, Jim and I had a terrific event with Vietnamese seniors in that community. One of the things that happens with multicultural communities is that often as people get older they lose their second language; they go back to the language of their birth. That's why these are the sorts of issues that require support and respect. One of the things about these communities—including the Vietnamese community, but it is certainly not alone—is the way they respect and revere their elders. With the way that we're handling the ageing of the population in this country, we're not doing that. This government certainly is not doing that.

Issues like staffing numbers, qualifications, skills mix and experience all affect the ability of aged-care workers to provide safe quality care, and we should have a workforce strategy to make sure that those issues are dealt with. One of the things that we will do, as a priority task for Jobs and Skills Australia, which we will establish if we are successful at the next election, is task them with this particular sector of delivering.

In spite of all of the crisis that's there, as outlined in the interim report, what was the response of this government? The response of the government was to try to privatise the one bit of the system that's working: the aged-care assessment teams. It put them out for profit, because there's a real profit to be made in that area. I mean, naturally, it fits with the market, going in and working out whether someone needs aged care and what level of care they need. It's just extraordinary! It was due to the pressure of the community, the unions involved in the sector, the shadow minister—I must say—and the work that we, on this side of the House, had unashamedly done in putting a focus on the ageing of the population that the government last week had to back down on its recommendations to privatise ACAT. It must now act on the royal commission recommendations. We need something much better than this legislation that does nothing to change the fundamentals there.

As I announced in Brisbane, we in contrast will develop a positive ageing strategy, outlining a plan to help Australians in their final years of paid work to build the nest egg that will let them retire when and how they want. That's one of the reasons we support increasing the superannuation guarantee to 12 per cent. It's not about welfare; it's about giving people a quality of life at the same time as providing the nation with the national asset that superannuation represents. We want to make sure that when Australians do retire they have access to quality health care. We want to make sure that they have a roof over their head. We want to make sure they have access to quality aged care when the need arises.

There are a whole lot of creative areas that you could look at. I encourage people to have a look at the ABC show Old People's Home for 4 Year Olds. There are benefits from getting our very youngest people with our oldest people. They learn off each other and it lifts the health care. They had experts, nurses and doctors explain why the stimulation reduces heart disease and a whole range of health issues for those older Australians. This government is so complacent, obsessed with advertising and marketing and too busy downloading false documents, allegedly, from computers that it is not capable of actually addressing the big challenge.

Labor know that there is more we can and should be doing for older Australians. Our older years should be good years. We will continue to put forward constructive ideas to the government. If not supported, we will hold them to account. We will be presenting a positive vision for ageing to the nation in two years time, when the election is held.

12:16 pm

Photo of Joanne RyanJoanne Ryan (Lalor, Australian Labor Party) Share this | | Hansard source

Deputy Speaker Mitchell, I appreciate you giving a few moments for my colleagues to leave the chamber after listening to the significant contribution by the Leader of the Opposition, the member for Grayndler, on Labor's thinking, optimism and positivity around what could and should be happening in this country in our aged-care sector and the care for our older Australians. I stand here very pleased to support the amendment moved by the shadow minister for ageing and seniors to the second reading of the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. We won't decline to give the bill a second reading, but we note the government's piecemeal approach to aged care. I stand here while my mum is at home. Hopefully, she is watching on the telly. Mum, g'day; how are you? She is 92. For me everything in the aged-care space is not only about the people I represent but also about the person closest to my heart besides my own children, and that is my mum. At 92 my mother is still independent. She still lives in her own unit and completely looks after herself, but she does have some home-care package support.

The government's approach to aged care and home-care packages in my time here has been absolutely piecemeal. I am struck today that we are here talking about legislation in this space while the royal commission is occurring. The royal commission has made an interim report and yet this legislation does not address any aspect of that interim report. Like when we were speaking on education yesterday, it again feels that, really, we are here talking about money bills and not actually talking about aged care. This legislation has scant implications for any kind of improvement in the aged-care system. I think that's a crying shame and that the government should be called out, and that's what we're standing here doing.

I note the legislation does a few things. The first phase is set to commence in June this year and will trigger a change to the way providers are paid. Rather than providers of home-care packages being paid upfront so people can access those funds and the care that comes with them, this legislation will mean that they will get paid in arrears. I note that this really means that money—and we're struggling to get an accurate figure, but we think between $250 million and $350 million—will not come out of government coffers and go to providers for aged care but would be held back until the new financial year.

I'm sorry if I sound cynical. I apologise to the House if my suspicious mind puts me in a different space from everybody else, but it seems pretty clear to me that this legislation, particularly the part of the legislation in front of us, is a budget saving measure by this government, given the other two factors in this legislation don't commence until 2021. There doesn't appear to be a rush to do those. But we're for standing here today because this government wants to save potentially $250 million to $350 million in this year's budget. This is about protecting an early crow on the surplus rather than protecting our elderly and ensuring that they're getting quality aged-care and quality home-care packages. I can't stress this enough. You only have to look at the facts.

I think that the number of Australians waiting for home-care packages is now out to 120,000 people. As we heard the member for Grayndler say so recently, we've gone from a one-month wait to a five-month wait to get into an aged-care facility, and we're now waiting up to three years for people to get to the level of the home-care package that they've been assessed for. We know that people are being encouraged by those opposite, 'If you can't get the higher levels just take the lower level and get yourself on the waiting list,' which is now out to three years. We know what the outcomes of this are. The outcomes are that people are dying before they get into aged care. The outcomes are that people are dying while waiting for home care packages. There is not an Australian, not one person in this country, who thinks that's okay except those opposite, who after six years still have no fix for this and who seem to be completely ignorant of their drip feeding of this information. They hold it back, waiting three months to tell us what the lists say now.

We know from the interim report of the royal commission that half of older Australians are malnourished. We know that the name of the interim report is 'Negligent'. We know that this government was planning to privatise the assessment processes for the aged care packages, what we call ACAT, the aged care assessment teams. They pulled back from that, but only because of pushback from states and a campaign run by the opposition around what that plan would actually mean. The campaign said, 'You want to privatise the one thing that's working while you ignore all the other problems in the system.' We know that this government has now had four ministers in six years and that all of those ministers have been responsible for billions of dollars of cuts in the sector. We're in the middle of a royal commission where some of the worst things are having a light shone on them. So they've been asleep at the wheel for six years—four different ministers, billions of dollars ripped out—and they have lurched from one crisis to another.

We're in the chamber today talking about a piece of legislation that contains a critical point that is a budget saving for this government, and we're doing this while in every question time we have 10 questions about coronavirus. Who is most susceptible to coronavirus? The elderly! So we're going to not put $250 million into the system, into home-care packages where people may be isolated and may be unaware that they're carrying the virus and what that means for them and their respiratory system. It is an absolute shame.

What does the holding back of these funds really mean? Let's have a look at it. Most Australians this will have very little impact from it. They'll be very aware that this is a budget measure. They'll be unaware of what is going on in this House today. But I'll tell you who will find out: it is people getting home-care packages in regional and remote areas, where the providers are most likely to be operating on the margins and are most likely to find themselves with an incredible cash shortfall that might mean they close their doors, which might mean that someone doesn't arrive to assist my mum next week. That's what might happen if we let this go through today. That's what we're up against. It is people in country areas, where the providers are most likely to be in this circumstance and may not take on new clients because of this cash shortfall that's going to be thrust upon them so quickly and with such little planning time, who will be affected. We've had that feedback from the peak bodies. So three years may become three years and three months. Who cares? It doesn't matter. The legislation in front of us today is an absolute indictment of this government.

We know that in January the aged-care royal commission had to issue an extraordinary public correction in response to the false assertion of the Minister for Aged Care and Senior Australians that they supported the plan to privatise aged-care assessments. This government should be in here apologising for their behaviour around the potential privatisation of ACAT. The minister actually claimed that the aged-care royal commissioners supported the privatisation of the ACAT system, a system that's working perfectly fine and that, in fact, the states say is working very well. In Senate question time in early February the minister admitted he hadn't even read the interim report of the royal commission. No wonder older Australians are suffering at the hands of this government, when they can't be bothered even reading the interim report from the royal commission, a royal commission that was called in response to television footage of things that were happening in some aged-care facilities that horrified and mortified Australians around the country.

I don't want to put too fine a point on it, but it seems to me that this government—if we do the compare and contrast and look at the sports grants fiasco—is very good at putting money out the door when it's for its own jobs, but, let's face it, now they're going to pull back money from home-care packages for elderly Australians in a piece of trickery—again, to save face. Let's get this clear, this is to save face. This is so that the Treasurer doesn't have to come in here and say they're not going to get a surplus. That's what this is about. It's absolutely disappointing. I will be absolutely ensuring that members in my community understand what this is about.

The providers are going to be put under pressure because of this piece of legislation and because of the rush of this piece of legislation. There are some things in this legislation that need to go through, the things that are set to happen from April 2021. Providers will only be paid the subsidy for the goods and services they actually provide to the consumer, rather than receiving the full monthly subsidy amount of the receipt. There are some areas there that may well have merit, but again we're doing this in the middle of a royal commission. We can't do anything about increasing the number of home-care packages, because we are in the middle of a royal commission. We can't do anything about the quality of our aged-care services, because we're in the middle of a royal commission. But there is this little thing that we could get through the parliament that would mean a budgetary save, or pushing down the road payments to providers of home-care packages into the next financial year. Although we don't want to hold up the bill going through the parliament, we have to get into this place and stand up one after the other to make sure that Australians understand what is going on here. We have to draw this to the House's attention, to ensure that those members opposite understand what it is they're going to walk in and vote for and understand what it is that they've put in front of this House today.

The change from advanced to arrears will commence in June 2020. It's an extraordinarily tight turnaround for service providers. There's an increase in financial risk for some smaller service providers, who may not have adequate cashflow to deal with the payment changes. There are some service providers who may have to revert to finding other financing arrangements, including loans or equity injections. Those home-care providers currently losing money will face significant difficulties changing over to an arrears payment arrangement. Service providers are also concerned whether the new payment arrangements increase administrative costs. Of course, we're all concerned about this, because we know that we have a waiting list of 120,000 people for aged-care packages and we've got many who are on home-care packages but are not on the appropriate levels and are waiting to go onto those appropriate levels. The ramifications of any strain we're putting onto the providers through this system are going to play out on elderly Australians who are still living in their homes and are dependent upon these services.

The Royal Commission into Aged Care Quality and Safety is to hand down its final report in November. There will be an immense amount of change before the aged-care sector. Right now, in a critical area, the home care packages area, this legislation is asking for changes in their financial arrangements—not in their provision-of-care arrangements; not in reviewing to ensure that the people that they're employing are being remunerated appropriately for the work they're doing; and not in ensuring that, with the services they're providing, there is a feedback loop and that the people they're caring for are having their plans and their packages appropriately managed. This legislation is not about improving service to the elderly. This legislation is purely about funding. It's an absolute shame that, when we know that half of our elderly Australians in aged-care facilities are malnourished, we don't have figures on the nutritional state of people relying on home care packages. We don't have those figures, because those people are not in the facilities. But it seems to me, and it seems to my colleagues in this place, that this government could spend a lot more time focused on improving the care for our elderly Australians and a lot less time worrying about their bottom line and a lot less time juggling money around—and a lot more time focused on the things that Australians care about. They don't care about your surplus, but they do care about their mothers and their fathers.

12:31 pm

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

There is nothing more important than older people having the security that they can be looked after in their later years. I see huge amounts of anxiety amongst them when they look ahead and wonder: 'Will I be able to afford the care that I need? Will my partner—my husband or my wife—afford the care that they need?' Children are concerned about it. I'm certainly in that category of people who have older parents. I have a mother turning 80 shortly and a father turning 90. It's certainly something that we as a family talk about. I can see how they respond when they see some of the stories coming out of the royal commission—the stories of neglect, of people not having sufficient food, and of the quality of that food. When I visit aged-care facilities, those conversations do take place with me. (Quorum formed) I'm very pleased to be able to speak on this and to support everything that the member for Grayndler and the member for Lalor said earlier.

12:36 pm

Photo of Ged KearneyGed Kearney (Cooper, Australian Labor Party, Shadow Assistant Minister for Skills) Share this | | Hansard source

I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No.1) Bill 2020. As the member for Franklin has pointed out, there are some serious concerns with this. The purpose of the bill is to change the payment of the home care subsidy to approved providers from being paid in advance to being paid in arrears. It will move payments for home care packages to the same model as the NDIS provider payment works. This could see increased risks to the financial viability of some service providers, especially for smaller rural and regional service providers who don't have adequate cashflow to deal with payment changes. I know there are lots of concerns in the NDIS sector that payments are often very late. I have one NDIS provider in my electorate who is still waiting on up to $270,000 in payments for invoices issued. Labor will move to have this bill referred to a Senate committee so that these issues can be worked through.

More broadly, as the member for Franklin has moved in her second reading amendment, this government is failing to provide the genuine, wholesale industry reform that the aged care sector so desperately needs. We have heard from many of the previous speakers that just last week the government was forced to backflip on a plan to privatise the aged care assessment teams. It was a plan that nobody asked for and nobody wanted. It was the only part of the aged care system which isn't broken. You have to ask yourself what the motivation was for wanting to privatise it in the first place. There were some serious suggestions that the government saw this as an opportunity to put downward pressure on home care package waiting lists, where we know that some 110,000 people currently sit and are waiting. It was an opportunity, some say, to actually move the assessment guidelines to make some people less eligible for packages or for higher packages et cetera. It would have seen 1,000 workers sacked from the ACAT teams. One thousand workers could have lost their jobs.

The states didn't want this plan. Embarrassingly for the minister, the states and territories pushed back. The New South Wales health minister himself said that it was ill-advised. The unions raised their voices and campaigned against this, knowing that it was bad for the aged care sector. I want to thank the unions who all worked so hard and campaigned against this. The community spoke out in their thousands about their concerns about seeing the ACAT privatised. The royal commission was forced, embarrassingly, into a position to deny that it recommended it, when the government tried to suggest that it did.

Whilst we're on the royal commission, the interim report from the commission was scathing in its criticism of government inaction on aged care, describing the industry as a sad and shocking system that diminishes Australia as a nation. This is a third term government who constantly throw their hands in the air, seemingly baffled by the problems in aged care and unaware of the countless reports which provide solutions that are sitting still on the minister's desk.

One thing they could do right now is improve transparency and accountability of taxpayers' money. At every opportunity, this government shields dodgy aged-care providers from greater transparency and accountability of what they spend taxpayer funds on. Last year, Labor worked with the Senate crossbench to try to secure changes that would have driven accountability and transparency in the system, a vitally necessary reform. The amendments would have forced providers to publicly confirm how tax dollars are spent—how much money goes to the cost of care, such as food and food supplements, continence aids, staff, mobility aids et cetera. This information is vital for families and residents who are making one of the hardest decisions of their lives, where to entrust the care of their loved ones.

Aged-care facilities receive 70 to 80 per cent of their funding from the taxpayer, yet for so many of them there is very little information on how this money is spent, especially in the for-profit sector. Time and time again in the royal commission hearings we've heard stories from families and loved ones about being kept in the dark, a total lack of transparency and vital information that could give families assurances about the safety and wellbeing of their elderly family members. The interim report of the royal commission makes particular note of the lack of fundamental transparency across the sector. Did the government do anything about this? No. Without accountability and transparency, there is a risk that any new funding will not drive what the community is desperate for—quality care.

Just this week, we heard of yet another aged-care facility failing every industry standard. Tenison residential aged care was found by the Aged Care Quality and Safety Commission to pose 'an immediate and severe risk to the safety' of patients. The facility at Swansea is run by Southern Cross Care (NSW & ACT). It is a not-for-profit provider. Residents there were sleeping on towels and were left in soiled continence pads. The commission reported that the care provision did not maintain consumer dignity regarding continence, that there was a serious lack of resources and the facility did not have effective systems to respond to abuse and neglect of its residents. Distressingly, the report said there continues to be a reliance on chemical restraint, often in the absence of informed consent. This facility, as I said, is a not-for-profit facility. It received $1.5 million in government subsidies for 32 aged-care places in 2019. That's $47,000 per resident. We know this, and I know that there are going to be questions asked about the viability of some of our facilities, but we know this because, as a not-for-profit, it does actually present us, the community, with an annual report where it states where its money is spent. But we know that for many, particularly the for-profits, it is not declared so clearly. Without tighter accountability, we can't ensure that providers, especially for-profit providers, will simply not siphon off vital dollars to go elsewhere—the Cayman Islands maybe, or just to excessively line their pockets.

Many aged-care facilities do the right thing—I know that—on both sides, for-profit and the not-for-profit sector. I have great providers in my electorate whom I visit often, and they do their very, very best to provide quality care. I want to give a call out to all of the sector who do the best they can, to the workers who care so beautifully for the elderly with really limited resources. But the government and the people deserve to know where taxpayers' funds are spent.

The government has to get this right and ensure that aged-care funding is adequate to meet the needs of our ageing population and that it is linked to care. The Leader of the Opposition made the very pertinent point that it is in all of our interests to make sure we get this right. That means proper residential care, home care packages and adequate funding for rural and residential aged-care facilities, who are a special case—because of the challenges of remoteness they struggle to stay afloat.

The other key issue this government refuses to tackle is workforce. At a recent hearing at the royal commission focused on workforce, Counsel Assisting Peter Rozen QC slammed the Morrison government's inaction in fixing Australia's broken system, declaring that it's 'time to stop kicking the can down the road'. Counsel assisting made recommendations for the commission to consider for its final report on workforce issues, including minimum staffing numbers, appropriate skill mix, better pay, and better training and conditions for the aged-care workforce. The commission also heard recommendations that would increase the transparency and accountability of aged-care funding, making providers publish staffing numbers and skills mix. Counsel said 'the time is now' for real action, criticising the government for ignoring previous reports and recommendations handed to them as blueprints to fix the workforce issues.

These issues have been the subject of numerous inquiries and recommendations over the last two decades. Peter Rozen QC drew specific attention to John Pollaers's aged-care workforce strategy, which was delivered to the government more than a year ago. In evidence to the royal commission, Professor Pollaers considered the government's inaction in implementing the workforce strategy as 'profoundly disappointing'. The royal commission's interim report said:

Workloads are heavy. Pay and conditions are poor, signalling that working in aged care is not a valued occupation. Innovation is stymied. Education and training are patchy and there is no defined career path for staff. Leadership is lacking. Major change is necessary to deliver the certainty and working environment that staff need to deliver great quality care.

Labor has been saying for a long time that fixing the workforce issues that plague the aged-care system is crucial to delivering quality care in aged-care facilities. In Anthony Albanese's vision statement on ageing, he declared:

Part of the answer to this crisis must lie in our aged care workforce. Those we trust to care for our most vulnerable, our parents, our grandparents, eventually ourselves.

There are too few aged-care workers, and they are paid too little. They have begged the Government to do something.

Labor is listening.

Our aged care workers need proper pay and proper training.

The aged care workforce must also be able to provide culturally and linguistically appropriate care.

Staffing numbers, qualifications, skills mix and experience, all affect the ability of aged care workers to provide safe, quality care.

Under a Labor Government, solving this will be one of the priority tasks for Jobs and Skills Australia.

The impetus to get this right is huge and is something which the wonderful aged-care unions have been raising for years. In order to meet ever-increasing demand for aged-care services and support, the workforce will need to more than triple by 2050. By 2050 we will need to have more than one million Australians working in aged care. This represents a workforce growth rate of about two per cent annually to meet future demand. We must have a quality workforce which sees aged-care workers getting the respect and dignity they deserve.

Aged care is not babysitting. It is not a lifestyle choice. As a nurse, I know that elderly residents have complex health needs, like dementia, that require very specifically well-skilled workers. I want to say a big thank you to all the incredibly hardworking nurses and carers, many of whom must also look after young people in nursing homes. A tragedy of monumental proportions, this is as also mentioned by the royal commission. This government has thrown a few dollars into this issue—a bandaid, really—which will go nowhere in addressing the independent housing needs of these young people.

I will never forget the time when former Prime Minister Turnbull said that aged-care workers could always aspire to 'a better job'. I was livid. I leapt to my feet in this place to defend those workers and their unions. Their aspirations are to be able to give better care to the elderly, the people whose lives have been entrusted to them. They hope for better staffing, better resources and better pay, but not one of the people working in that sector has ever come to me and said they want 'a better job'. They love their jobs. They are dedicated. They get intrinsic rewards from ensuring dignity and quality of life. They aspire to make their residents' lives as comfortable and meaningful as possible and they aspire to ensure that their residents have, at the end of their lives, a dignified death. That is the type of aspiration that the then member for Wentworth and his colleagues perhaps did not understand.

I know what funding cuts mean. I know what it's like to be a carer or a nurse and not be able to deliver the care that you want to because there aren't the resources allowing you to do your job, because there's limited access to training and skills acquisition, and because the workloads are impossible. I know what it's like to try to feed four or five patients at once, or to have to decide between doing a wound dressing or taking a resident for a much-needed walk as physiotherapy. It's heartbreaking to have to make those decisions every day.

Finally, last year one of my constituents, Lily Coy, was interviewed by Channel Nine, recounting an experience that hundreds of thousands of older Australians have experienced. She said that she found herself begging for a home care package. She wasn't coping. She couldn't walk from the table to the sink. She was having to demand the assistance she was entitled to—having to beg for the assistance she was entitled to. She said it was humiliating. She said:

We're not bits of paper. We're not numbers on a bit of paper.

Lily said she feels awful thinking about others who are still waiting for home care packages. She said:

It makes me feel so guilty and sad.

The government's announcement this week of 10,000 home care packages means there are still 110,000 older Australians assessed and waiting for theirs. Older Australians and their families remain frustrated, confused and let down by this government, which is so clearly out of touch. It has no idea of what it means to be hoping for help with an older loved one. It has no idea what it means to watch an elderly parent wait in vain for assistance at home. It seems to have no idea or care what it means for a family to struggle to provide that care themselves, juggling rosters at work, juggling care of their own children who need their care and attention. Families take risks, ultimately, because sometimes it just doesn't work out the way you want it to. You worry desperately because you can't get home in time, because an elderly loved one is home all alone for just that bit too long. The crisis is getting worse. It seems the government has no idea what it means to watch an elderly patient wait in vain for help. I'm not going to stand here and tell you the solution is simple. It isn't. (Time expired)

(Quorum formed)

12:54 pm

Photo of Steve GeorganasSteve Georganas (Adelaide, Australian Labor Party) Share this | | Hansard source

I too rise today to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. I've been listening to all the speeches that have been taking place here and I hear the concerns of a lot of members about our elderly citizens. I've said it many times in here: these are the people who have built our foundations and paid their taxes, and some have fought in wars to give us the opportunities that we have today to live in a free, democratic country. It's a place that still has opportunity and is a country that is sought after by everyone in the world. They want to come and live here because of the foundations that have been put in place by the generations before us. That's why it's important to ensure that, as governments, we do whatever the right thing is in ensuring that our elderly Australians are looked after.

I've got to say that there are many things that are currently not working in the system. As I heard the Leader of the Opposition say earlier, in some communities—in fact, in most communities—elderly people are revered. In the Vietnamese community, many Asian communities and even a lot of European communities, they are revered and respected. It is unheard of for many people in these ethnic groups that they would put their parents or grandparents in aged-care facilities or have others looking after them. They feel that it is their duty. It is important that we do look after them, whether or not we do it ourselves. Obviously in a country like Australia, where everyone works and we're struggling with balancing family, kids et cetera, we do find ourselves in a position where sometimes our elderly Australians have to be looked after by someone else, whether it be in a facility that cares for older people or in home care.

That takes me to the home care packages that have had bungle upon bungle continuously whilst this government has been in place. They've had over six years—we're in the third term of government—to sort this out. We hear that there are still over 100,000 people waiting for aged care packages to look after people in their homes. They are people who are needy, people who need a little bit of support. After all, they supported us for generations. The least that we can do is give them that little bit of help that gives them a bit of dignity in their life.

You've got a list of over 100,000 people waiting who, in fact, have been assessed. They have been assessed and given the okay for the package and then they have to wait to receive the package. We've heard stories of over two years and up to three years of waiting. In fact, from some figures that came out, in the last few years some 30,000 people who had been approved and had been waiting for packages had died. It's not uncommon in my electorate office to have people come to see me and say: 'Remember when we applied for this particular package and we got the okay from the ACAT assessment? We waited and waited.' They'd been in to see me again and, in that period, those people had passed away or deteriorated. That is unacceptable. It is totally unacceptable that people are waiting for such a long period to receive a bit of help and a bit of care. It's also unacceptable that we, as a government, are not doing anything about it. As a government, we're just sitting back and shrugging our shoulders. Measures have to be put in place to make sure that we shorten that list, that people get that care in the appropriate period of time that ensures their health doesn't deteriorate.

What happens is, when you apply for a package, usually it's at the point when you're deteriorating—perhaps a lot of families haven't thought about it; it's at the last minute—and then you're waiting for a few months to get the assessment. Once the assessment takes place, then you're ticked off as basically a yes or no, and then the period of waiting starts—of waiting to have that package put in place. If you don't get that package in a timely manner, your health will deteriorate at a much faster pace than if you had someone caring for you. This means that a lot of people are ending up in nursing homes or aged care facilities needlessly, costing the government many more dollars than they would have if they had been kept at home with the care that was required.

We need to ensure that people get the care that they require within their homes. Most people want to stay within their homes. There are a few that do want to go into residential aged care facilities, but the majority of people I talk to in my electorate say they want their loved ones to remain at home with a bit of assistance and a bit of care. It is totally inacceptable that 30,000 people died waiting to receive an aged care package for assistance at home.

When we look at this government and see what they have put in place, not much is there. Not much is happening. Their biggest item for older Australians had been to try and privatise the ACAT, being the most profitable side of aged care services. That is wrong. It is a government that has at its focus the privatisation of services. For example, when you look at Medicare, we know that many attempts have been made to chip away at the sides and to cut away and gradually privatise any service that provides a service for the public good. ACAT is a service for the public good and should not be privatised. I'm pleased that through the campaigning that was done on this side of the House we were able to prevent that and ensure that it doesn't get privatised. It is a special service, which provides the checks and balances to make sure that people are eligible for aged care packages or facilities.

That takes me to another area. In the royal commission we heard many horrendous stories. First we saw them on TV and reported in the media—people being undernourished; people not receiving the care that they required; everything from abuse to criminal acts that were visited on these people. What a horrendous thing, to think that it could be your grandparents or your parents in that situation when you're handing them over with the trust that the facility will do their best to look after a loved one, and then to discover that they are being abused or malnourished or they are not having the care that is required.

It took a lot of work and a lot of effort in this place to commit the government to a royal commission. We all remember that day when they finally did, when they realised they didn't have the numbers to gazump it. The Prime Minister came into this House and announced it. The horror stories that came out were horrendous. The Morrison government has to act on any findings that the royal commission comes out with. It is extremely important that they not only act on it, but ensure that they put in the legislation that's required to check, safeguard and ensure that our elderly have the services that are required for their old age.

Waiting times for a bed in a facility have blown out as well. They were around two to three weeks. They are now far greater. Usually when a family comes to our office seeking some sort of assistance because they can't find a bed, it is at crisis point. It is usually at a point where something's gone wrong. Their elderly mum or dad has had a fall, has broken their hip or leg or has some other ailment or illness, and has been taken to hospital, and it has been deemed that they cannot care for themselves back home. So there's a mad rush to try and work out where they will be able to take them into a facility that they trust and feel comfortable with; with the added burden of having to wait weeks and weeks to find a bed. In that period, those people stay in hospital, again costing state governments and the federal government millions of dollars more.

What they require in these facilities is quality health care, and, as I said, we're only going to get that through this government responding to and acting on the report of the royal commission that's taken place. It's no good coming in here and just make statements about the feel-good things, as we've seen this Prime Minister do more and more, and continuously, where marketing is the tool but there is no action. We need action on the royal commission's findings. We need this government to perform. But this is not like any other important area. This is important because it is about human beings that are our mothers, our fathers, our grandparents, our great-grandparents, and all of us want to know and have confidence that, when they are in a facility, they are being looked after. We need to ensure that the right work skills are there.

We heard the previous speaker, the member for Cooper, talk about the understaffing in a lot of these facilities, with stories of 30- or 40-bed facilities with only one care worker on the nightshift. All it takes is one emergency, and everyone else is left on the side and not cared for until that emergency's dealt with. That is something that came out of the royal commission, the staffing levels, as well as the pressure that's on those aged-care workers and, certainly, the work skills that are needed.

We need to train more people up. We need to ensure the training facilities that we have are up to scratch. We need to ensure that the people that go into this industry do it because they love the industry, but they also need to be remunerated correctly and properly. They need to be given a sense of dignity, as do the workers who look after our elderly, and the people that have looked after us our entire lives.

The No. 1 most important thing is for this government to act on the royal commission findings. No. 2 is to deal with the long waiting list, with over 100,000 Australians waiting for aged-care home packages—many dying whilst they are waiting—which is unacceptable. No. 3 is to ensure that our facilities are up to scratch and that checks and balances are put in place. I know that the government have moved on this. I commend them for it. But it's no good just putting legislation in place and having some form of institution that is a toothless tiger. We need to act upon these things. We need to be vigilant. We need to ensure that the Australian public have confidence that, when they are putting their loved ones into a facility or having outside people caring for them, the right thing is being done.

As I've said many times in this place—I don't think there's any other line that I've said more often, and I'm about to say it again—these are the people that have given us the opportunity to enjoy the fruits of this wonderful country. Through their foresight, through building the foundations of this nation and through their hard work, and their taxes through that hard work, and through many of them fighting in wars, they have ensured that the next generation of Australians—that's us—benefit from this nation. We need to give them a sense of dignity and happiness in their twilight years, and we want them to be comfortable and to know that their loved ones are doing the best for them—and that their government is doing the best for them. I cannot stress that enough. We may talk about a million other policies in this place, but we will be judged in the future on the way that we looked after our elderly. After all, they are human beings and the people who, as I said, have given their whole life for their children, for their grandchildren, and, in many cases, have brought up not only their children but also their grandchildren.

I hope the government take something away from the royal commission report, I hope that they act on the royal commission findings and I really hope that, in this place, there is more focus on this policy area than there has been in the last few years.

(Quorum formed)

1:12 pm

Photo of Emma McBrideEmma McBride (Dobell, Australian Labor Party, Shadow Assistant Minister for Mental Health) Share this | | Hansard source

I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020 and support the amendment by the member for Franklin. The purpose of this bill is to change the payment of home-care subsidy to approved providers from being paid in advance to being paid in arrears. This change is to commence in June of this year. The report from the Aged Care Financing Authority highlighted that this is the first phase of reform for home-care payment arrangements. Phase 2 and 3 are set to commence in April 2021, and are to ensure that the provider is only paid for the service they provide and that subsidy payments to providers would be reduced to a currently unknown portion of the unspent package funds held by the provider for that recipient.

As previous speakers have noted, while we will not oppose this bill we do have some concerns on its impact. The June 2020 time frame for shifting from advanced to arrears payments increases the risk to some smaller providers, who may not have adequate cashflow to cope with this change. As a result, these providers, some of whom will be in regional and remote areas, may be reluctant to take on new clients or be forced to reduce services to existing clients. In all their talk about service providers and consumers, the government seem to have lost sight of the people, of the older Australians, their loved ones and their carers, and their hopes to remain safely in their own homes.

The Royal Commission into Aged Care Quality and Safety will hand down its final report in November. It's interim report made unprecedented recommendations which this government should be acting on now. But what is the government doing? Instead of acting on the recommendations of the commissioners, it's making piecemeal changes which appear to be designed to just save some money or shifts costs. Like the proposal from the government to privatise the assessment of aged-care services, a change described as illogical by the New South Wales Liberal health minister, Brad Hazzard. The government said there were no plans to privatise ACAT, yet there was a tender process scheduled to take place in April 2021. If there were no plans to privatise ACAT, why have a tender process? I'm relieved the government finally came to its senses and withdrew the tender process, following strong opposition from the community, from the unions, from state health ministers, from Labor and from the sector.

It does make you question this government's priorities when, instead of acting on the commissioner's recommendations, it tries to fix the one part of the sector that isn't subject to adverse findings by the commission. The interim report of the royal commission handed down in October last year, a report titled Neglect, put forward three recommendations that required urgent action: first, to ensure older Australians are getting the care at home when they need it most; second, to end the overreliance on chemical restraints in aged care; and, thirdly, to stop the unacceptable number of young people entering residential aged care. The government's response to the interim report has been woefully inadequate, especially in relation to home care packages. The commissioner recommended urgent action to address the home care package waiting list. What has this government done in response? It released 5,000 home care packages before Christmas—5,000 home care packages when there are over 120,000 older Australians waiting for their approved home care package. Labor has consistently highlighted the serious consequences of delays in home care packages to the person, to their family and carers and to our community. The average waiting time for a home care package is five months, with many people, particularly those waiting for high-level packages, waiting for over a year. Sadly, we learnt that 30,000 older Australians have died while waiting for home care and that 25,000 older Australians have ended up in residential care sooner than they needed to. Everyone has been saddened by the aged-care quality and safety report—three volumes, titled Neglectthat sines a light on the state of aged care in this country.

The government must bear some responsibility for this crisis. It was the current Prime Minister who, as Treasurer, took around $1.2 billion from aged-care funding. And how has the government responded to the findings of the commission? By providing $500 million for an additional 10,000 home care packages, of which, as I mentioned, only 5,000 were available before Christmas last year. This doesn't even amount to half of what the Prime Minister cut from aged-care funding during his time as Treasurer. For many, the truth is that these packages are too few and too late, and they don't address the underlying systemic problems plaguing the aged-care system in Australia today. As I mentioned, there are currently over 120,000 Australians on waiting lists for home care packages that they have been approved for—people who have been referred by their GP, who've had an ACAT assessment and who need help and need it now. They are on waiting lists under this government.

On the Central Coast there are over 1,333 older Australians waiting for home care packages right now. These are people like Noel of Long Jetty. Noel was approved for a level 2 package six months ago, a package which would help him to stay safely and independently in his home. But he's still waiting, like so many hundreds of thousands of others. So he's paying out-of-pocket for the services that he needs to stay safely at home. As an age pensioner, this is something that he can't afford. Noel and his circumstances are not an isolated example. According to the 2016 Census, almost one in five people in my electorate of Dobell are aged over 65. This is higher than both the state and national average, yet there hasn't been a hearing of the Royal Commission into Aged Care Quality and Safety held on the Central Coast. I note that on 27 November last year there was a hearing held in Newcastle. People in my electorate, and across the Central Coast, deserve the opportunity to share their stories and to share their experiences close to home, independent of the experiences of people living in other parts of Australia.

In November last year, I hosted an aged-care forum in my electorate on the New South Wales Central Coast, along with the Deputy Leader of the Labor Party. We heard from families, carers, support workers and providers about the challenges and difficulties they have experienced. People spoke often of the difficulties they've had dealing with My Aged Care. My Aged Care is the telephone and internet based national aged-care system which is often a person's first point of contact with aged-care services—a system called by the commissioner 'frightening, confronting and confusing.' So how do people access home care packages or find out about residential aged care? How do they arrange their assessment with an ACAT team? Through a portal that many, particularly in their 80s and 90s, find frightening, confronting, and confusing. Maybe the government could start by addressing My Aged Care.

As a pharmacist, I'd like to turn to the disturbing use of chemical restraint that was exposed in the interim report. The report found:

widespread overprescribing, often without clear consent, of drugs which sedate residents, rendering them drowsy and unresponsive to visiting family and removing their ability to interact with people.

Over 33 per cent of the online submissions to the commission raised issues about medication management, and research presented a survey of 11,368 residents across 139 facilities that found 61 per cent of residents were administered psychotropic agents. Psychotropic medications affect the mind, emotions and behaviour of a person. They're medications that should be used according to clinical guidelines and with informed consent.

As part of its response to the report, the government announced $25.5 million to improve medication management and $10 million for additional dementia training for aged-care providers to reduce chemical restraint. The Pharmaceutical Society of Australia, the PSA, in their submission to the commission when referring to the use of psychotropic medicines said, 'level of inappropriate use in aged care generally required review and action.'

On 26 February, the PSA released its Medicine safety: Aged care report. The report found over 95 per cent of people living in aged-care facilities have at least one problem with their medicines, detected at the time of the medicine's review. Most have three problems. It found that 50 per cent of people with dementia are taking medicines with anticholinergic properties, which can worsen confusion and other symptoms of dementia. One-fifth of people living in aged care are on antipsychotics, and more than half use the medicine for too long.

The Society of Hospital Pharmacists released a public statement following the announcement which noted:

the fact remains most aged care facilities do not have a pharmacist on staff, despite research consistently finding beneficial outcomes from the provision of clinical pharmacy services.

While funding for medication management training is welcome, these figures once again show the government not properly addressing the problem or the recommendations of the interim report.

The royal commission recommended urgent action to stop the flow of younger people with a disability going into aged care and to speed up the process of getting those young people, who are already in aged care, out. The royal commission heard evidence that there are some 6,000 people under the age of 65 living in aged-care facilities. It's just not right that people in their 30s, 40s and 50s should be living in aged-care facilities. I call on the government to act urgently on this recommendation.

The bill updates the payment structures for home care providers, but what is the point if people can't access home care packages when they need them? What is the point if people don't understand how the find a provider online and if the process of finding and researching the right package needs support, which many older people sadly don't have or isn't available to them? What is the point if there is no provider in that area, so they can't stay close to home, be close to friends and family and the community they know and have lived in.

This bill makes changes to the payment arrangements for providers, but what older Australians and their families need is aged care they can trust, where they have confidence that their loved ones are safe and well-cared for. The interim report made recommendations which the government must act on now to stop the neglect of older Australians. Changing the payment arrangements may help the government's bottom line but won't improve the quality of care for older Australians.

I come to this House as a pharmacist, as someone who worked in mental health for much of my life and at our local hospital for 10 years before I came into this place but also as the daughter and the granddaughter of someone who lived with dementia. I made a promise to my mum that I would do everything that I could to make sure that people who care for others will be better supported, and this is what I intend to do. It is something that is important to everybody: everybody should have confidence that they can trust that the person that they love will be cared for, will receive a quality and standard of care that they would hope to receive for their parent or their grandparent or, in future, themselves.

This is urgent. The government must act now. There are unprecedented recommendations from the commissioners in the interim report, and the government must act on them with urgency to make sure that older Australians are treated with dignity, respect and have care that they can trust.

(Quorum formed)

1:27 pm

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

I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. In the limited time that I have, I also want to focus on the important second reading amendment that the shadow minister has moved regarding this critical issue for Australia. I know that all members of the House have been hearing the horrific stories of neglect and abuse. This is not confined to a partisan issue—to a Labor or Liberal issue. It is an issue affecting every single Australian. Quite frankly, that's why I am disappointed that the government have stopped speaking on this issue; that the government have given up either defending their poor record or wanting to put on record in this place the dire set of circumstances that we're seeing for aged care in this country.

Maybe the facts are too strong for the government, so they are either pretending they don't exist or they are in denial about how the aged-care sector is in crisis in this country. We know there are more than 100,000 Australians waiting for their approved care package. Sadly, 30,000 older Australians died over the past two years waiting for their approved home care package. It is just not good enough in a country like Australia to have that statistic. And I am shocked that not one member of the government will get up in the remainder of the debate today and actually talk about this issue. They may have their own reasons for doing that, but I think every single member of the government should be on their feet, discussing this issue and explaining what their plan is to deal with the aged-care crisis in this country, rather than just hoping that it will go away—hoping that some magic will happen to fix their neglect and their lack of funding to deal with the aged-care crisis in this country.

Wait times have blown out. People are dying on the list. The median wait time for older Australians going to residential aged care has grown by more than 100 days under the Liberals and Nationals—from just over a month to a five-month wait. What is the excuse for this? What is the justification for this? The silence from those opposite says it all.

Photo of John McVeighJohn McVeigh (Groom, Liberal Party) Share this | | Hansard source

The debate is interrupted in accordance with standing order 43. The debate will be resumed at a later hour.