House debates

Tuesday, 2 February 2021


Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020; Second Reading

12:23 pm

Photo of Clare O'NeilClare O'Neil (Hotham, Australian Labor Party, Shadow Minister for Senior Australians and Aged Care Services) Share this | | Hansard source

Thank you so much, Speaker, for the opportunity to make a statement on behalf of the Australian Labor Party in this second reading debate on the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020 that is before the House. It's very unfortunate that we're dealing with this bill far, far later than we should be. The government has taken much too long to respond to serious incident abuses that have been happening in our aged-care system. The bill that's before us will implement the recommendations for a scheme that were put before the government more than three years ago by the Australian Law Reform Commission. Soon after that, the Carnell-Paterson review, commissioned by the government following the Oakden nursing home tragedy, also recommended introducing the scheme—back in 2017. Here it is—an issue as critical as how a nursing home manages a sexual or physical assault on a vulnerable elderly person, and it has taken the government years to take action. As I'll explain, the bill that's before us is deficient in some very profound ways, including the fact that it actually leaves the majority of users of our aged-care system completely out of this scheme.

The way in which the government has dealt with this issue—this lumbering, delayed, lack of urgent prioritisation—is unfortunately emblematic of what we see of the government's entire approach to the aged-care crisis which confronts our country. It is obvious to every Australian that changes need to be made to this system. We have a royal commission's report titled Neglectthis is how obvious the problems in this system are—and yet we see that time and time again these reports are given to the government, and it takes them years to do anything, if at all. In fact, when the Prime Minister was Treasurer of this country, we saw him try not to solve the problems in aged care but to cut $1.7 billion out of this system in crisis. We see again that when the government attempts to make changes it does so in a slow fashion, in a way that shows that this is not an urgent priority for the Morrison government and in a way that, frankly, introduces a sub-standard system like the one we'll be debating today.

I make these points because it's really important for Australians to see the pattern that's in place here. We've got a royal commission on foot which tells us that this system is profoundly failing hundreds of thousands of users of the aged-care system, profoundly failing millions of people who will in future use that system, and we have a government that just drags its feet when it comes to reform and to appropriately fixing the problems that are discussed here.

Neglect is the title of the royal commission's report into aged care. That doesn't just describe the way in which the aged-care system operates; it describes the way in which the government has dealt with this critical area of policy for its almost eight years in office, and it needs to be held to account for that. Ultimately, I see the government's handling of this issue and so many others as its own form of cruelty.

Let me talk a little bit about the specifics of this bill, because it's an area that I think hasn't seen the kind of light and transparency that I think it deserves. So I want to talk a little bit about the problem that's trying to be solved. The scheme that's before us is trying to bring more transparency into the issue of serious incidents that occur in aged care. Serious incidents in aged care are actually very common, and we saw reported assaults, for example, in aged care have gone up every year in recent years and reached 5,233 in 2018-19. So let's think about the cohort of Australians that we're talking about here against whom these serious assaults or incidents are occurring—the most vulnerable, the most frail and, in many ways, the most important Australians that this parliament gathers in this chamber to protect, and yet we are seeing routine incidents that are not being properly reported and which people are not being held accountable for because of the failures of this parliament.

The bill does make some important changes—of course, changes that Labor greatly supports. The bill will require providers of aged-care facilities to manage incidents and to take reasonable steps to prevent them in the first place, and that's going to include requiring aged-care homes, for example, to put in place organisation-wide systems that will manage and report incidents of abuse and neglect.

The bill will require approved providers of residential care in residential aged care to report all serious incidents to the Aged Care Quality and Safety Commissioner. A wider range of incidents will now be reportable, including unreasonable use of force, unlawful or inappropriate sexual contact, psychological or emotional abuse, unexpected death, stealing or financial coercion by a staff member, neglect, inappropriate physical or chemical restraint and unexplained absence of care. The scheme is going to remove an exemption that exists at the moment for reporting assaults where the alleged perpetrator is another residential aged-care victim with a cognitive or mental impairment and the victim is another care recipient, obviously another important piece of reform. The bill will strengthen protections for people working in aged care who disclose incidents of abuse and neglect in the system. The bill will improve oversight of these new changes, expanding the powers of the Aged Care Quality and Safety Commission, and there are some other aspects that are more administrative that support the scheme.

You can hear from the things I'm describing here that these are important changes. I think the question that most Australians would have when hearing this list of things is: why in God's name aren't these things already law in this country? How can we have a system where people can be sexually assaulted in aged care where there's no real transparency and appropriate reporting of that to the people who run the aged-care system? How can we have a system where you can be the victim of a physical assault, for example, and where, because the perpetrator of the assault is another aged-care resident with a cognitive disability, that doesn't get reported?

The thing that enrages me about the changes that we're seeing—I'm happy that they're going through; I'm just frustrated that they weren't already part of our system—is the treatment of people in aged care. It is as though they have fewer rights and less dignity than every other Australian. Of course, that is completely contrary to Australian values. As I said, I'm pleased to see some of these changes, but why the hell are we having to have the debate now? Why wasn't this done urgently, when we knew all the way back in 2017 that this was the system that ought to have been in place?

I and Labor do have some critical concerns with some aspects of the bill. The main concern that we have about the bill is that it does not include serious incidents in home care. It's much more than an oversight because, as much of the parliament would know, the vast majority of the people who are consumers of aged care in Australia, who are citizens who are getting that support from services, are actually getting that support in their own homes. There are more than a million people in Australia today who are getting some type of home care through the aged-care system, and this bill offers them no additional protections and no additional transparency. Why would we make a big change like this to the aged-care reporting system for serious incidents and leave out the strong majority of people who are in the system?

It's not just Labor, of course, that has this concern. In the royal commission, the counsel assisting, in its final submission, asked that the government ensure that the new scheme that was going to be put in place include home care. That was a direct request from the royal commission. Yet here we are in this parliament passing a bill that will introduce a system that will protect fewer than a quarter of the people who are receiving aged-care services today. That we are failing to protect an additional million Australians in a way that we so easily could through this parliament just seems, again, like a negligent and silly mistake. So I want to call on the government today to look at this scheme and urgently assess how it could be applied properly in a home-care setting. Of course, there are serious incidents that are occurring in home-care settings. That's inevitable when you have a million people, and they're vulnerable people, who are receiving these services. As has been requested by the royal commission, we need to have a proper system in place to protect those critical Australians, and I'd like the government to put that in place.

I want to turn now to the second reading amendment which I'll move at the closure of my remarks. I just want to talk a little bit about the broader context for this debate. I know that the parliament and most people watching and listening will know that we have a royal commission on foot because the aged-care system in this country is in crisis. There are a quarter of a million vulnerable people in residential aged care who, we know, are living in a system that does not provide adequately for the needs of most of them. We, as a parliament, make choices about how we prioritise things and about how we prioritise funds. I just think it is absolutely bleeding obvious that we need to be doing more to ensure dignity in the later years of life of older Australians who have done so much for this country.

Reading this report is actually quite hard going. But I hope everyone in this parliament has read the report, because they would not be in any disagreement with me when I say that this system today is a national disgrace. Even reading the initial 12-page forward of this report is gut-wrenching. It is rage inducing that we have allowed a situation to transpire where people whom we say we care about are being treated so poorly by a system that is run entirely by the Morrison government.

The interim report describes horrific mistreatment of older people in aged care. Many of the people in this chamber will recall seeing images of maggots in open wounds. This royal commission report details older Australians who are lying for hours, sometimes days, in urine and faeces, because the aged-care provider has rationed continence pads. It details the fact that up to half of Australia's most frail people living in aged care are malnourished. They are malnourished in a system that the Australian taxpayer pays for. It describes how about 60 per cent of residents in aged care today are on psychotropic medication, but that medication is estimated to be justified in about 10 per cent of cases. For anyone who wants to read and better understand this system, it confirms that 4,000 notifications or allegations of suspected sexual abuse are reported each year, that 274,409 self-reported cases of substandard care were made, and that, indeed, in one year, 32,715 calls to the My Aged Care consumer hotline went unanswered. That's in one year. That is neglect. That's why this report is called Neglect.

The report confirms, too, that we have an aged-care workforce that has been profoundly let down by the Morrison government—an aged-care workforce which is undervalued, underpaid and not properly resourced to do some of the most important work in the community. I want to ask why you think it is that today you can earn more doing a shift in a supermarket than you can in caring for one of the most vulnerable people who live in our country. How can that be the case? Yet it is the case because for almost eight years the Morrison government have known about these problems and have commissioned report after report after report and have done nothing to fix the problems. Instead, they have made the situation profoundly worse by taking funding out of this incredibly stretched system.

Hearing these stories and digesting what has happened on the watch of the Morrison government is very difficult. It's really difficult to confront some of these issues. In the report the royal commissioners speak about the fact that a lot of people don't want to think about their own ageing, so it's hard to really engage with some of the difficulties that are talked about, but we have to because we cannot stand back when good people are being treated this way. Overwhelmingly, the victims of this horrible system are some of the most elderly and frail people in our whole country. Not just that; they are people who contributed to this system their whole lives by paying taxes. I think that, as Australians, they have a reasonable expectation of getting a dignified life and a good quality of life in their retirement, but not in Scott Morrison's aged-care system.

I want people to really take notice of this. We will have the royal commission final report released in about three weeks. This is a report that doesn't affect just the quarter of a million Australians in residential aged care and their families; it is a report that is going to affect all of us. It affects all of us because we have many millions of people who are using the system or are families of people using the system. We have a very large generation of Australians, the baby boomers, who are starting to make decisions and have discussions about how they are going to age. I don't think that that generation of Australians should feel fear about what might happen to them as they age. It's important for people of my age, as most people of my age have ageing parents and we're also having to think about how we are going to help them as they age, and about the issues that happen as one ages. But it's also very important because many, many millions of Australians are going to access this system themselves. The royal commission report talks about the fact that, if demographic trends remain as they are today, more than half of all Australian women are going to spend time in residential aged care. So, if you are a 20-year-old out there on the street and thinking that aged care isn't important for you, that's not right. This is a system that we need to invest in and that we need to fix, because no Australian could read this report and think, 'That's the system I want to end up in.'

It's absolutely the case that there are providers of aged care in Australia—and, most importantly, the amazing staff who work in this sector—who are doing extraordinary things. I want to include in that my amazing mother-in-law, who's one of my heroes and who's an aged-care nurse in regional Victoria. I could not respect the work that she does more. She looks after people who are at the most vulnerable and difficult phase of their entire lives, and she does it with more love and more commitment and more community spirit than you could ever imagine. But what the royal commission report points out is that the providers that are doing a beautiful job of looking after elderly people, and the amazing staff who are so undervalued and so unsupported by this government, are doing that not because of this system but in spite of this system. There is nothing in the system today that actually promotes great quality of care and great quality of life for Australians.

One of the things I want Australians to be outraged about is the cost of this system to the taxpayer and the outcomes that we're getting. As I've said, this is a system that is in abject crisis. There is no room for debate about that question. Today we are paying literally billions and billions of dollars—$22.6 billion—to an aged-care industry. While this has happened, while we have had maggots in wounds and vulnerable people sitting in urine and faeces for days, we have also had operators of aged-care facilities that have essentially behaved like profiteers, who have accumulated vast fortunes on the back of, really, the poor treatment of older Australians. Whatever we do, coming out the other side, to fix this system—a conversation that Labor are more than keen to have—we need to address that problem. It is despicable that we have had people getting rich off the mistreatment of older Australians. With every power that we have to control what lies ahead, Labor will not allow that to continue.

I've talked a little bit about Labor's commitment to this; I actually don't think that the Australian public are going to have much trouble believing in our absolute and genuine desire to see this problem resolved once and for all. We have, over long periods of Labor government, invested in this system. We have reformed this system, and we have done everything we can to look after older Australians. In the last eight years, we've had eight years of despicable neglect. There has been neglect from the point of view of funding, but also—and more importantly, perhaps, for this parliament—a neglect in prioritisation. I want to come back to the bill before us. We make choices in this chamber and, in particular, the government makes choices about what it will legislate and how it will prioritise the different issues that face the country. Whenever it has had the chance, the government has put aged care and vulnerable older Australians at the back of the queue. That is what has to change, and I am looking forward to Labor holding the government to account for that over the coming months.

I move the second reading amendment circulated in my name:

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:

(1) notes the systemic, ongoing failures in Australia's aged care system as evidenced by the Royal Commission into Aged Care Quality and Safety, including, but not restricted to, serious incidents in residential aged care;

(2) further notes the bill as drafted only deals with incidents in residential aged care facilities and not incidents that occur in home care; and

(3) calls on the Government to explain their plan to deal with serious incidents that occur in home care."

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

Is the amendment seconded?

Photo of Brian MitchellBrian Mitchell (Lyons, Australian Labor Party) Share this | | Hansard source

I second the amendment and reserve my right to speak.

12:43 pm

Photo of Katie AllenKatie Allen (Higgins, Liberal Party) Share this | | Hansard source

As a doctor, I'm deeply committed to ensuring better health outcomes for not only my own constituents in Higgins but all Australians. As we all know, Australians are living longer, and they want the security and protections that the aged-care sector will provide for them in their twilight years. The Morrison government is passionate in leading, improving and reforming this aged-care sector. Yes, I know there can be complaints that it's not happening fast enough. But let's be very clear: this sector has been changing incredibly rapidly, and that is because of the population bubble that is occurring before our very eyes. We know that Australians are getting older—and getting healthier in the process—and there is a baby boomer bubble ahead of us. By 2030 there will be more Australians over the age of 80 than ever before in our history. Steady economic growth, smaller nuclear families and a high propensity for people to work later into their older years mean that there is more need for aged-care facilities than ever before. This bill before us today, the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020, is a step towards much-needed reform, introducing a Serious Incident Response Scheme for residential aged care and for flexible care delivered in a residential aged-care setting.

It can be very hard to trust others to care for your loved ones. I personally know how it feels; I experienced this with my father. He had a long career as a doctor. Later in life, he developed Alzheimer's. Because of his career as a doctor, he knew what it was like to care for patients with dementia. He knew what lay ahead. And, as I said in my first speech in this House, it was heartbreaking to watch as this gentle man, who had himself cared for so many with this disease, was tortured by it. Throughout his slow and unrelenting deterioration, he never once complained. In the last year before his death, he lost the faculty of speech, but he had two words left: thank you. Dad's gratitude for the family and the life he was given was boundless. But I know as a daughter that putting my father into aged care was a very difficult step. We as a family kept my father at home as long as possible because we wanted to care for him in his own home. It can be very, very challenging for those who have loved ones in aged care and even more challenging if that loved one is unable to communicate with you and you have no option but to trust the people whom you have employed to care for your loved one. It can be so unsettling for families and loved ones, and this bill will help give them a sense of comfort.

The Australian government has no tolerance for abuse and neglect in aged care. Our Prime Minister, Scott Morrison, cares deeply about this issue, and the first royal commission he called for as Prime Minister was into aged care, so it's something that is very much at the centre of his agenda.

Australians have rights which do not diminish with age. This bill will see improved legal frameworks which will provide appropriate protections and safeguards for older Australians, who should be enjoying their golden years without having to face any form of abuse. This bill will also provide much-needed confidence to loved ones who have placed a family member in aged care.

This bill implements key recommendations from the Australian Law Reform Commission's report entitled Elder abusea national legal response and from the report of the Review of National Aged Care Quality Regulatory Processes handed down by Ms Kate Carnell and Professor Ron Paterson. The bill is also consistent with the National Plan to Respond to the Abuse of Older Australians (Elder Abuse) and aims to address issues raised in counsel assisting's final submission to the Royal Commission into Aged Care Quality and Safety.

The Serious Incident Response Scheme will replace the current responsibilities, under the Aged Care Act, of approved providers of residential aged care and flexible care delivered in an aged-care setting in relation to reportable assaults and unexplained absences. The bill will require approved providers to manage incidents and take reasonable steps to prevent incidents, including through implementing and maintaining effective organisation-wide governance systems for management and reporting of incidents of abuse and neglect. Both as a previous chair of a school council and as a board member of a hospital, I know how important these checks and balances are.

The bill will also require approved providers of residential care and flexible care delivered in an aged-care setting to report all serious incidents to the Aged Care Quality and Safety Commission. A wider range of incidents, including but not limited to unreasonable use of force; unlawful sexual contact or inappropriate sexual conduct; psychological or emotional abuse; unexpected death; stealing or financial coercion by a staff member; neglect; inappropriate physical or chemical restraint; and unexplained absence from care, will all be reportable.

The Serious Incident Response Scheme will also remove the existing exemption for reporting assaults where the alleged perpetrator is a residential aged-care recipient with cognitive or mental impairment and the victim is another care recipient. I know it might seem shocking to those listening to hear that such a step is required, but we need to remain alert, not alarmed. These events do happen, and we cannot turn a blind eye to them.

This bill will also strengthen protections for people who disclose incidents of abuse or neglect in aged care. These protections will extend to both existing and former staff members as well as to current and past residential aged-care recipients, their families and others supporting them, including volunteers and advocates. This bill will protect people disclosing such failures against any civil or criminal liability. As in any system, whistleblowers need the courage to speak out, but more than that they need protection from a natural, innate tendency for organisations to protect themselves against criticism. An open, transparent and accountable system provides an important underpinning to build trust in an organisation. Whistleblower protection is just such a mechanism that builds trust. All Australians would want to have this protection for themselves and their loved ones.

This bill will also expand the Aged Care Quality and Safety Commission's powers to enforce the requirements of the Serious Incident Response Scheme and the responsibilities of approved providers and related offences more generally. These will include standard regulatory powers which provide the commission with a more graduated suite of powers for ensuring compliance and protecting consumers. An additional information-gathering power will also ensure the commission is able to obtain the information and documents it requires to administer the Serious Incident Response Scheme. But we are not simply stopping there. We are not stopping at residential aged care; we're extending these provisions into other aspects of the aged-care sector. That is why the government has also put forward a feasibility study to inform future government decisions on the potential introduction of a similar serious incident response scheme in home and community aged care.

This bill is further proof of the Morrison government's commitment to improving aged care for all senior Australians, which remains one of the government's key priorities. We are delivering record investment across the aged-care sector. It has grown from $13.3 billion in 2012-13 under Labor to $23.9 billion in 2020-21 under our Morrison government. It is estimated that funding for aged care will grow to more than $27 billion by 2023-24. Senior Australians are increasingly choosing to remain in their own homes for longer. This is something our government is committed to and supports. We believe in supporting choice. More than $746 million in aged-care COVID-19 response measures has been part of the $1.6 billion in COVID-specific support in aged care. This investment in the budget will see an additional 23,000 home-care packages to help care for older Australians in their homes in this financial year. That is because we recognise that Australians want to stay home longer, want to stay healthy and want to stay in their own homes.

The Morrison government has delivered, and will continue to deliver, on aged care. This bill enables the next phase of aged-care reform, which I hope will receive a bipartisan approach across the parliament—working together to ensure we are delivering the best possible outcomes and protection to our older Australians living within the aged-care sector, now and into the future.

12:53 pm

Photo of Brian MitchellBrian Mitchell (Lyons, Australian Labor Party) Share this | | Hansard source

The safety of older Australians has never been more critical than in the past year or so, with the revelations of shocking abuse and neglect, as outlined by the shadow minister. Australians know we need to do more to protect our elderly in residential aged care—in home care as well—and they expect government to act and to lead. Older Australians have spent their lives contributing to this country. Whether as workers, homemakers or volunteers, they have built our communities and nurtured our young people. Older Australians deserve respect, dignity, comfort and support; they do not deserve neglect and abuse. The country's aged-care homes should be the best that our nation can afford, not the least worst that is legally possible. Tasmania has the oldest population of any jurisdiction in Australia, and my electorate covers the three areas in the state with the oldest population. This bill comes four years late, but I am pleased to support any measure that seeks to ensure older Australians, their families and aged-care workers are provided with a comprehensive set of protections.

The bill introduces a serious incident response scheme for residential aged care, amending previous legislation to clarify and add further protections for both victims and advocates. Under this scheme, approved aged-care providers will now have to manage and take reasonable steps to prevent incidents at an organisation-wide level. Additionally, all serious incidents will have to be reported to the Aged Care Quality and Safety Commission, which will be given greater powers to enforce the requirements of the scheme. Those powers will include a more graduated suite of responses to ensure the commission has the flexibility it needs to address a wider range of issues, and additional information-gathering powers to ensure the commission does the best job it can to protect residents. The bill expands the definition of an incident and consolidates the expanded definition under one regulation. Incidents will now include neglect, psychological and emotional abuse, unexplained absence from care and unexpected death. Additionally, the bill removes the exemption that allows the nonreporting of abuse where a perpetrator has cognitive and mental impairment. It is crucial that every incident is reported.

A gaping hole in this legislation is its failure to include home care in the safety provisions. More than one million older Australians receive care in their home, and there is an equal risk of a serious incident occurring in that setting as in an aged-care facility, yet such incidents will not be captured by this bill. It's a serious shortcoming, and it's a serious shortcoming from a government that already has a woeful track record on aged care. In 2018-19, there were 5,233 reported assaults in residential aged care, more than 100 a week. But, in November 2019, KPMG told the government there were 50,000 unreported cases of assault across Australia every year—10 times the reported number. Discovering the true number of assaults will help inform better resourcing and better staffing. Closing this exemption is essential.

We know that the challenges that come with aged care fall too often and too disproportionately on aged-care workers, who are understaffed, underfunded and most definitely underpaid. The shadow minister mentioned how in this country we've got a situation where you can be paid more for working behind a check-out or stacking groceries in a supermarket than you can be paid for looking after older Australians in residential aged care. It is a disgrace.

Aged-care staff are doing the best job they can with the limited resources they have access to. I know aged-care workers, many of them women in their 50s and 40s, who are distraught at not being able to provide the care they know their residents deserve and need. Staff are practically running between jobs, with only a few minutes to provide meals, a few minutes to remove dirty dishes, a few minutes to wash and a few minutes to assist with toileting. There is never enough time, certainly not to sit down and just talk, be with and comfort often lonely residents desperate for human contact, a hand to hold or a chat.

The expanded definition of 'incidents' will appropriately place more focus on providers, their systems, their governance and their resourcing. Importantly, this bill will provide enhanced protection from civil and criminal liability for staff and other people who disclose abuse and neglect. This will include current and former staff members as well as current and past aged-care clients, their families and their volunteers.

We know that aged-care workers are often the first line of protection against abuse, and we need to ensure they have the protections and systems in place to allow them to safely advocate for themselves and their clients by having the confidence to speak up when things go wrong. When aged-care workers see problems in their workplace that impact the care of older Australians, they should never have to worry about the impact on their job. When so many workers are part time or casual, it is all too easy for aggrieved managers to put staff on blacklists and to cut their hours. It is just one of many reasons why there should be less casualisation in aged care and more job security and permanence.

Labor supports this bill, but Labor does not support the government's frankly appalling record on aged care and elder abuse. In 2017 two separate reports recommended that the government enact a serious incident response scheme, which this bill now seeks to introduce. It has taken this government nearly four years to act. How many older Australians have died in substandard care because of this government's unconscionable delays? The government failed to act again, in 2019, when it budgeted for the scheme but then failed to follow through. All announcement, no delivery. It failed to follow through after receiving the KPMG report on rampant, unreported abuse in aged-care facilities. That report and its findings were not released until 2020.

All this, of course, is in addition to the interim findings of the aged-care royal commission. We will see the final report in the next few weeks, and I'm sure it will not make for good reading. The title of the interim report, Neglect, tells us all that we need to know about this government's frankly incompetent management of aged care and its woeful disregard for the dignity of older Australians. These are Australian lives. You do not lose your human rights just because you get old. So we support this bill, but attention must focus on this government's woeful, incompetent handling of aged care, and we will see what the aged-care royal commission has to say in a few weeks.

1:02 pm

Photo of Nicolle FlintNicolle Flint (Boothby, Liberal Party) Share this | | Hansard source

I take great issue with the allegations those opposite have made in the several speeches we have heard so far. Our government has done more than any federal government to make sure that our senior Australians and our elderly Australians are cared for and protected. As someone from South Australia who was in this place when the Oakden disaster was reported, I take particular issue with the allegations of those opposite, because it was a state Labor government that oversaw and, in fact, ran the Oakden facility and that terribly neglected those very vulnerable senior Australians in their care. People died, people suffered injuries, and the families who fought for their loved ones still suffer the scars from fighting for so long to get justice for their family members. So I refuse to be lectured by those opposite.

We have done many things in this space to protect our senior Australians. We legislated for new aged-care quality standards—the first upgrade of the standards in more than 20 years. We established the Aged Care Quality and Safety Commission. The Morrison government also established a royal commission. The Prime Minister led this. The Prime Minister has led on this issue for the entire time that he has been Prime Minister. The royal commission was into the aged-care sector, and was one of his first acts as Prime Minister. We cannot and we will not tolerate instances of older people being hurt, abused or neglected, and we are working very hard to make sure that families who put their vulnerable loved ones into care have confidence in our aged-care system.

We have also put billions of dollars of extra funding and resourcing into aged care. Our funding has grown from $13.3 billion in 2012-13 to currently $23.9 billion this year to support senior Australians who want to stay at home for as long as possible. The government is providing an additional 23,000 home-care packages, which means the number of home-care packages has now tripled, from 60,300 in 2013 to around 185,500 this year. And 99 per cent of all those seeking an in-home aged-care place now have access to some form of in-home support.

We are also doing a huge amount in the dementia-care space. I am incredibly proud that, thanks to the federal government, my government, and the South Australian Liberal government, the former repat hospital site, another state Labor disaster—they shut down the much beloved repat hospital when they were in government—reopened and we will have one of the nation's very best dementia-care facilities there. That is something that I am incredibly proud of to have delivered for my local community.

I have a high number of senior Australians residing in my electorate. There are three groups in our society who deserve a very particular level of care from us all: children, those with a disability and, of course, the elderly. That's what we're speaking about today. These are some of our most vulnerable citizens who often can't advocate for themselves. They can't protect themselves, and I am, as I said, very proud that under our government we established the royal commission into aged care, we passed new quality and safety standards and we are introducing this bill today and speaking on this bill today, which I hope will pass through this place and the other very quickly, because we need to ensure that people understand how they can be protected, the help that they can seek if they need it and what the specific measures are that we will be putting in place through this bill.

The Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill introduces: a serious incident response scheme that will respond to and take steps to prevent the incidents of abuse and neglect of older Australians in residential aged care and those receiving flexible care delivered in a residential aged-care setting; and a range of broader powers for the Aged Care Quality and Safety Commissioner consistent with the Regulatory Powers Act. Specifically—and these are some of the really important elements—under this bill, which will become the act, residential aged-care providers will be required to manage all incidents with a focus on the safety and wellbeing of consumers and reduce the number of preventable incidents from reoccurring. This will expand the responsibilities of residential aged-care providers in relation to identifying, recording, managing, resolving and reporting assaults and a broader range of serious incidents in residential aged care. The reporting will include a range of new matters, which is really important, such as sexual misconduct, neglect, psychological abuse, inappropriate use of restraint—which was one of the key issues that was uncovered at Oakden, and it was absolutely appalling—and unexpected death, amongst others.

The bill does a range of specific things, as I've just outlined. Importantly, it includes broader protections for whistleblowers who disclose information about reportable incidents and it introduces the ability for the commissioner to issue compliance notices in order to deal with enforcement of the incident management responsibilities, including in relation to reportable incidents. The bill also introduces new enforcement powers for the commissioner to impose civil penalties, infringement notices, enforceable undertakings and injunctions under the Regulatory Powers Act in relation to this bill and more broadly.

I'm very happy to commend this important bill to the House, and I look forward to making sure everyone in my local community is well aware of the standards that we expect to be applied to our most vulnerable citizens.

1:08 pm

Photo of Graham PerrettGraham Perrett (Moreton, Australian Labor Party, Shadow Assistant Minister for Education) Share this | | Hansard source

Deputy Speaker Mitchell, happy new year to you and to everyone in the chamber.

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

And you.

Photo of Graham PerrettGraham Perrett (Moreton, Australian Labor Party, Shadow Assistant Minister for Education) Share this | | Hansard source

I speak today on the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020. I want to start by pointing out something that occurs in my family, and that is that my two sons, aged 12 and 15, call me a boomer. They also call my wife a boomer, who's only a year younger than me. I'm 55. I want to put on the record that I am not a baby boomer. I am actually too young to be a baby boomer. The reason I take that sort of approach is to point out some facts. The reason we have the term 'boomers'—apart from my children trying to insult me, and I'm talking about you, Stanley and Leo—is that after World War II, after six years of world war, there was an explosion in the number of children in Australia. That generation are called baby boomers.

We hear people opposite saying that there's record funding. They go on about the increase in the number of home-care packages et cetera. I just want to make very clear upfront that the reason there are record numbers is that there are more seniors. The baby boomers are moving through the system. World War II was a long time ago, and we have more Australians who are baby boomers. We hear those opposite talking about the incredible new numbers—there being one-third more et cetera—but it needs to be put in the context that there are more elderly Australians. That's why governments are not to be commended for just doing their job but should be called out—and I notice that the shadow minister did that very well in her opening remarks—for not implementing the recommendations that a responsible government would do.

This bill will require approved providers of residential aged-care facilities to manage incidents and take reasonable steps to prevent incidents. This includes through implementing and maintaining effective organisationwide governance systems for the management and reporting of incidents of abuse and neglect. It will establish the Serious Incident Response Scheme. This bill will expand the powers of the Aged Care Quality and Safety Commission to enforce the responsibilities of aged-care providers. Currently aged-care providers are required to report incidents, suspicions or allegations of assault on residents to local police and to the commission within 24 hours. Last year there were 5,717 notifications of assault under the act. Last year there were 244,363 people in permanent residential aged care. This area of responsibility rests with the Commonwealth government. There is currently an exemption from reporting incidents of assault where the perpetrator is another resident with a cognitive or mental impairment. On one level this is a practical response, but I do stress and point out that such victims still have human rights.

In 2019 KPMG completed a study commissioned by the Department of Health. It estimated that, in a year, there were more than 50,000 incidents of assault on residents that were not reported. As I said, they should notify the commission and the local police. Even before the KPMG study was completed we knew there was a problem in aged-care facilities. George Brandis, who recently visited Australia, in his time as Attorney-General commissioned the ALRC to inquire into and report on existing laws to prevent elder abuse. The ALRC handed down its report in May 2017. The ALRC report from 2017 recommended the Serious Incident Response Scheme, which would require reporting of an expanded list of incidents and be monitored by an independent oversight body.

The terrible abuse uncovered at the Oakden nursing home in South Australia shocked the nation. A review of the nursing home by the state's chief psychiatrist was described as a 'deeply troubling report'. The Oakden facility was closed in 2017. So there have been some very quick kneejerk reactions from those opposite, but good government is much slower. Any time that there's an image in the media, the image trumps the actual carrying out of responsible government. Following the failures identified at the Oakden facility, the Commonwealth government commissioned the independent Review of National Aged Care Quality Regulatory Processes, or the Carnell-Paterson review. Without taking away from the fine work in that report, I think that we could easily list 50 inquiries into aged care.

Photo of Linda BurneyLinda Burney (Barton, Australian Labor Party, Shadow Minister for Families and Social Services) Share this | | Hansard source


Photo of Graham PerrettGraham Perrett (Moreton, Australian Labor Party, Shadow Assistant Minister for Education) Share this | | Hansard source

We wouldn't have to go back that far—just a decade or so, Member for Barton. It wouldn't take long to find where people were investigating people having kerosene baths and the like. We don't have to go that far back. There have been lots and lots of inquiries looking into aged care. I can save you reading all 50 of them because they basically say we need to invest more resources in the care of our elderly Australians.

I go back to the Carnell-Paterson review. It was completed in October 2017 and the review concluded that the current scheme to report assaults in aged care was not adequate and did not protect aged-care residents from abuse and neglect. The Carnell-Paterson review endorsed the recommendation of the ALRC to establish a serious incident response scheme to be overseen by an independent body. The House of Representatives Standing Committee on Health, Aged Care and Sport, in their report on the quality of care in aged-care facilities tabled in 2018, noted that the government was considering establishing a serious incident response scheme, as recommended by the ALRC. The committee also recommended the exemption for the reporting of resident-on-resident assaults be removed. The Royal Commission into Aged Care Quality and Safety handed its interim report to the Governor-General back in October 2019 and that report, as I'm sure people following this area would know, was simply titled Neglect. The royal commission reported that a high incidence of assaults by staff on residents and by residents on other residents and on staff had been brought to their attention. In October 2020 counsel assisting the royal commission proposed an extensive list of recommendations for aged-care reform, including developing a new and expanded serious incident response scheme.

The government has known for a long time, at least since 2017, that older vulnerable Australians in aged-care facilities are not being adequately protected from physical abuse and assault. Why has it taken the Morrison government this long to address this serious issue? Not only have the Australian Law Reform Commission, the independent Carnell-Paterson review, the House of Representatives committee and the Royal Commission into Aged Care Quality and Safety all expressed concerns about the safety of residents in aged-care facilities; anyone who has a relative in aged care is very aware that there is a problem. The royal commission's interim report referred to evidence presented to them that family members had installed hidden cameras in their relatives' rooms to ensure their safety, only to be horrified by the rough treatment and even assaults that were captured on these hidden cameras. It is inexcusable that this Morrison government has ignored this problem for as long as it has. This is about protecting some of the most vulnerable members of our society.

Labor identified this as a problem many years ago and has been calling on the government to act. In a speech in February 2018 the shadow Attorney-General said:

A future Labor Government would also look at amending the Aged Care Act to provide for a new serious incident response scheme for aged care.

In his final submission before the Royal Commission into Aged Care Quality and Safety, counsel assisting, Peter Rozen QC, said:

Many witnesses have explained that they placed their loved ones into residential aged care because they felt that it would be safer for them or because safety was a concern. It is therefore entirely unacceptable that people in residential aged care face a substantially higher risk of assault than people living in the community.

We cannot continue to claim we are a country that protects human rights if we are not protecting the most vulnerable members of our society. In a media release in December last year the Royal Commission into Aged Care Quality and Safety said that they estimate 39.2 per cent of people living in Australian aged-care facilities experienced elder abuse in the form of neglect, emotional abuse or physical abuse; that's basically saying two in five people in these facilities would experience some form of neglect, emotional abuse or physical abuse. I think that's disgusting. It is neglect as per the report.

The Liberals have been asleep at the wheel for seven years. They don't care about older Australians in aged care. In his first budget as Treasurer, then Treasurer Scott Morrison ripped $1.2 billion from aged care. There have been four ministers and the aged-care system has lurched from one crisis to another. Going back to the kerosene baths and that approach in aged-care facilities, back to the disgraced former Speaker, Bronwyn Bishop, this is a horrible legacy. So this legislation is welcome, but it does not go far enough. It does nothing to protect the one million older Australians receiving support or care in their own home. These older Australians are equally at risk of a serious incident occurring. They also deserve to be protected by this scheme. Apart from that oversight, I do welcome this legislation, but it is shameful that it has taken so long for this Morrison government to put this legislation before the parliament. As I said, this legislation has been called for since the middle of 2017. How many older Australians have been subjected to abuse during that time with no adequate scheme in place to protect them? There is no excuse for not acting sooner to protect older Australians.

The Royal Commission into Aged Care Quality and Safety is due to hand down its final report in just a few weeks. There have been 10,144 submissions and 6,729 phone calls at last count received by the commission. Aged care should concern every Australian. Our mothers, our fathers, our brothers, sisters, aunties and uncles, our neighbours should all be confident they are receiving proper and dignified care if they require it in an aged-care facility. That is not the case on Prime Minister Morrison's watch.

I will be reading the recommendations of the royal commission with interest and I hope that the Morrison government does not take as long to implement those recommendations as it has to implement the legislation currently before the House. I support this legislation and I support the second reading amendment moved by the shadow minister for senior Australians and aged-care services.

1:21 pm

Photo of Vince ConnellyVince Connelly (Stirling, Liberal Party) Share this | | Hansard source

I am pleased to speak today about the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020 relating to the Serious Incident Response Scheme. Before I cover the detail, I always like to talk about why legislation is being introduced. In this case, this legislation is being driven by the core belief that this government holds that it is our responsibility as a nation to look after and support the interests and the safety of elderly Australians—those Australians who have contributed so much in shaping the nation that we have inherited, those Australians who have helped raise us, the next generation.

At this point I would also like to specifically mention my wife's nan, Patricia Coombe, who died just on Sunday. Patricia was a very fierce advocate of family love. She was a wonderful example to all of her extended family. Pat always led by example in setting up family events, in keeping in touch with loved ones, in sharing information and of course in having a nice full lolly jar at her own home. My personal favourites were the lolly bananas, but, unfortunately, they were Nan's favourites too, and I was left with whatever the kids hadn't already cleaned out. Pat was also a recipient of aged-care services, as many elderly Australians are. Those services were mixed and supported by her own family—her daughters Maureen, Coralie and Kathleen, and their own families as well. Under this model, we can see the expectation that we all have—that when elderly Australians are receiving care on a formal organised basis it is in a safe and supportive environment. That is where this bill comes in.

This bill introduces a Serious Incident Response Scheme. This will respond to and take steps to prevent the incidence of neglect and abuse of older Australians in residential aged care and for those receiving flexible care delivered in a residential aged-care setting. It also introduces a responsibility for approved providers to manage incidents and to take reasonable steps to prevent incidents, including through implementing and maintaining an incident management system. Importantly, this legislation also defines a reportable incident and provides a broad range of powers to the Aged Care Quality and Safety Commissioner.

The bill will provide protections for whistleblowers who disclose information about reportable incidents. The bill also introduces the ability for the commissioner to issue compliance notices to deal with enforcement of incident management responsibilities. Importantly, the bill will introduce enforcement powers for the commissioner to impose civil penalties, infringement notices, enforceable undertakings and injunctions.

This Serious Incident Response Scheme is all about driving quality and safety improvements to residential aged care at the individual service level and at the broader system level. Under this scheme, residential aged-care providers will be required to manage all incidents, with a focus on the safety and wellbeing of consumers and on reducing preventable incidents from recurring. Reporting under this scheme will include a range of new matters, such as sexual misconduct, neglect, psychological abuse, inappropriate use of restraints and unexpected death, amongst others.

I've got some experience myself in the implementation of incident management systems. I was a captain in the Australian Army, a few years ago now, when an online system was brought in to manage incidents. At first we thought this was just burdensome paperwork but what we soon learned was that this system enabled us to track actions in response to incidents, whether it was a medical response that needed to be followed up, where a soldier had been injured and we needed to track their treatment and care, or whether it related to administrative or procedural controls to help prevent future incidents. We found that the system was great at ensuring actions were implemented and that any macrotrends in incidents that occurred across Army were identified and mitigated. When I moved into the business world I also had experience with incident management systems, including in mining and oil and gas, which are of course high-risk environments where it's really important that incidents are identified and controls are implemented and tracked. That's where this bill will help—by providing a system under which incidents can be defined and identified and the actions relating to those incidents can be tracked so that, importantly, we continue to improve aged care for all ageing Australians.

As has mentioned by previous speakers, this Prime Minister is passionate about continually improving aged care. That's why, since coming to government, this coalition has seen an increase in spending to $23.9 billion this year. It is why, since coming to government, we have tripled the number of home-care packages. These are just some of the measures whereby we are continually improving the provision of services to aged Australians. This scheme will see a fit-for-purpose serious incident response scheme that gives comfort to all of us across Australia. I know this sentiment is shared across the chamber and by all Australians. We want to provide the best quality for our ageing loved ones. This scheme will help by ensuring that, as they enter aged care, our loved ones experience a supportive and safe environment.

1:27 pm

Photo of Peta MurphyPeta Murphy (Dunkley, Australian Labor Party) Share this | | Hansard source

As speakers before me have said, the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020 is legislation that has been some time coming. We know that work had been done before 2017 and that at least two reports were published in 2017 recommending the enacting of a serious incident response scheme. We know that the Australian Law Reform Commission, in its report Elder abuse, recommended that an SIRS be introduced. We know that the Carnell-Paterson review when it was looking at the Oakden facility recommended such legislation. We know that in the 2019-20 budget the government put forward some money to prepare for an SIRS. But it still took some time before this legislation made its way into this parliament. It is of course welcome that it is here now. But no-one in this place and no-one in any of the communities that we represent can say anything other than that we have an aged-care system which is currently broken. Start with the fact that an interim report of a royal commission can be titled Neglect. Then go to the experiences of the mothers, fathers and grandparents across our communities who are in aged-care facilities. The people who work there want to do the best that they can and are dedicated to caring for the people who reside there, but they're hamstrung by the fact that there aren't enough staff from shift to shift. They're hamstrung by the fact that it can be very hard to recruit staff when wages are so low. They're hamstrung by the fact that work in aged care is now so casualised, so precarious that we have people working across three and four different facilities in order to make ends meet.

Photo of Llew O'BrienLlew O'Brien (Wide Bay, National Party) Share this | | Hansard source

The debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour. The member will have leave to continue speaking when the debate is resumed.