Tony Smith (Speaker) Share this | Link to this | Hansard source

I have received a letter from the honourable member for Hotham proposing that a definite matter of public importance be submitted to the House for discussion, namely:

The Government's neglect of the nation's aged care system, evidenced by the final report of the Royal Commission into Aged Care Quality and Safety.

I call upon all those honourable members who approve of the proposed discussion to rise in their places.

More than the number of members required by the standing orders having risen in their places—

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

I will get to the MPI, but before I do I want to say something very brief about the opposition whip. As one of the previous speakers mentioned, this person has been instrumental in making many members on this side of the House able to do their jobs while they have had newborn children in Canberra. I am one of those people who really is just so grateful for Chris Hayes' support through having my two babies here in Canberra. In his entire work as whip, Chris has never made me feel like I have had to choose between looking after my baby and doing my job as a member of parliament, and I will be forever grateful for that. I will really miss you, Chris.

There are an awful lot of very important issues being discussed and debated in the parliament and around politics at the moment. Clearly, we have a crisis on foot about the treatment of women in this country and it's a challenge that we must face together as a country. But it is not the only challenge that we face. About 3½ weeks ago the royal commission made its final report into our aged-care system. What we must not allow in this parliament, and what I know Labor will not allow to happen, is for that report to gather dust on the desk of the Prime Minister, like the 21 reports into the aged-care system that he received before it. There is absolutely no question that we have an aged-care system today that is in crisis. If anyone was in any doubt about that we now have an eight volume royal commission, which details, in the most harrowing manner, the way in which older and senior Australians have been treated by this system. We have a system today that is so unbelievably contrary to our national values. I know a lot of people who have looked into or who have read this report cannot believe that the type of neglect that is outlined in these documents is happening in our country. It is shameful, it is rage inducing and it is heartbreaking that we have got to the point that we are at today.

The royal commission's eight volumes are a truly harrowing read. I want to highlight some of the things that I found most shocking when I read through that report. We have an aged-care system today in which two-thirds of the people who are living in residential aged care are malnourished or at risk of being malnourished. I want to make that point clear to the House. These people are under the care of the Australian government and two-thirds of them are not getting enough food to eat every day. That is the system over which the Morrison government presides today.

We heard that there are endemic problems with basic aspects of caring for older people. We heard about maggots and ants crawling through wounds. We heard about aged-care facilities that are rationing incontinence pads so older Australians are having to sit for hours in faeces and urine. We heard about the routine overmedication of older Australians. Sixty-one per cent of aged-care residents today are on some type of mind-altering psychotropic medication and the royal commission tells us that 10 per cent of these instances are actually medically justified. We learned that there are 50 sexual assaults a week happening in residential aged care, often the victims in these cases are the frailest, most elderly women who live in our country. Again, under the care of government this has been allowed to occur.

That is before we get onto the very pressing and urgent issues in home care. We know that most Australians would like to age in their own homes. Governments should facilitate that. Instead what we have today is a system that is rationed cruelly so that people who want to stay at home are being forced to wait years for the support they need. The system that this government presides over makes the frailest people, the people who need the most support, wait for the longest—for years. The tragic outcome of that is that over the last two years 28,000 Australians have died waiting for the support that this government has already told them that they need but will not provide. I don't think any other group in the Australian community would be treated this way. If this were happening to children this parliament would be shut down and we would be marching in the street. I think when we look at the system today what we see is pure and simple age discrimination and it has to end.

I want to very quickly share a story that was very generously talked about by the member for Canberra today of an experience that her family had with this system because I think it so well demonstrates many stories that millions of people around this country have. The member for Canberra's grandmother had dementia and she lived in an aged-care facility. There were eight residents living in close quarters. There was one person who was staffed to assist those eight people who were very unwell with dementia. Anyone in this House who has had experience with dementia would know it can be very challenging. That one person perhaps could have dealt with those eight people at certain periods of time, but that one person was expected to feed those eight people at every meal. That one person was not able to do that, and so the food that would be laid down in front of these unwell dementia patients would be taken away uneaten. We heard how the member for Canberra's mother would go to the facility once, often twice, a day just to ensure that her mother was getting enough food to eat. How can this be happening in Australia? It's happening right now in every one of our communities to the people that we love and to the people that deserve better.

The people who are victims of this absolutely broken system are not just older Australians and their families. I want to speak a little bit about the staff—the hundreds of thousands of people who come into this sector simply because they want to provide care to older people who need their support. These people are our national heroes. They're doing some of the most important work in the community. They're there, holding the hands of older people as their life ends. We know today that these people are fundamentally and profoundly mistreated by this system. How we repay them for the important work that they're doing is by making them some of the poorest paid people in the whole community. You can literally earn more stacking shelves in Woolworths today than you can earn looking after a very, very sick person in the final stages of their life. That is wrong. It is just unmitigatedly, absolutely, 100 per cent wrong.

It's not just about the pay they get. The people who work in this sector are subject to rampant casualisation in a working environment where there's no real incentive or opportunities for them to get properly trained up. The worse thing that we are making these people do is care and work in a way that they don't want to work. They came into this sector to provide care for older Australians and, because staffing levels are so low, we are making them make heartbreaking choices every day about the people who they will care for and the people they do not have time to care for. Many people won't realise this, but there are no minimum staffing requirements in aged care today. None. We have minimum staffing requirements for child care, hospitals and schools, and yet for older people, nothing. That's how you end up with situations like that described by the member for Canberra.

When I talked to staff who were working in this sector, they talked to me about coming home from work traumatised. They actually can't speak to their family for a period of time when they get home, because of the decisions they have had to make between looking after a person groaning with pain or trying to help someone eat who has lost dramatic amounts of weight since they've gone into aged care. People should not have to make those choices. We should have a system, which gives people and the people who work for them dignity in what they do. We just need to show them little a more respect.

How did we end up here? The Prime Minister has, I think, in a very routine manner, run from the things he's directly responsible for we. We see that every day in this chamber, and aged care is no different. The fact that we have as situation that's in crisis hasn't happened by accident. While the Prime Minister was Treasurer of this country, he oversaw vicious cuts to this sector. More than $1.7 billion was cut over a period of 2015-17.

Only the Liberals could savagely cut a sector like this and then turn around and look surprised when standards have slipped so badly. We do see that when we look at what has happened in aged care funding over time. I'm sure those on the other side of the House will get up and talk about how aged-care funding is going up year on year. Well, of course it's going up—we've got an ageing population. The Morrison government is the first government that has seen that big shift of baby boomers start to come into the system. What matters is how people are being treated per capita. What we know is that funding is going down. As a share of people over the age of 70, we know that funding is going down for the people who are receiving home-care services under this government.

Let's not mince our words here. We've got a government that has cut funding to this sector and that has had seven aged care ministers in eight years. They have neglected the people who live in aged care. They have neglected this issue as an important issue that faces the government. The question I have for the government—I'm glad to see the minister at the table here—is why, when they have been so much a part of breaking this system, would we ever trust them to fix it?

Greg Hunt (Flinders, Liberal Party, Minister for Health and Aged Care) Share this | Link to this | Hansard source

I'm actually pleased and delighted to be able to take on this MPI, for the simple reason that, for 23 days, the opposition has neglected to ask a single question in question time about this. I would have thought that on a matter as this, after the government has provided an initial response with $452 million, there would have been a single question. But then in many ways it's perhaps not a surprise because going into the last election there was no funding—zero dollars—for residential aged care or for home care. And then, after billions were spent in the budget in reply in a matter of minutes, in October there was zero funding from the opposition for aged care in terms of residential or home care. So there have been three opportunities and three failures. That does represent a form of neglect.

But let me respond in a more positive way, and that is to—

Opposition Member:

An opposition member interjecting—

Greg Hunt (Flinders, Liberal Party, Minister for Health and Aged Care) Share this | Link to this | Hansard source

I gave you a fair chance. That is to say this: where we do agree is that we don't want to see the incredible work of those who have been supporting and assisting—carers, nurses, cooks, cleaners and personal care workers—be lost, because the vast majority of people in the Australian aged-care system are doing an extraordinary job. The vast majority of people in that aged-care system are helping to save and protect lives. That is something that's it's critically important we acknowledge right from the outset.

Having said that, let me turn to some of the claims made before the royal commission and our response to the royal commission. Firstly, I think it's very important to understand that, in home care, funding has gone up at a time when there's been a 28 per cent increase on our watch in the over 70s, but our home-care packages have gone up by 230 per cent in that period. That's more than seven times the rate of increase compared with what it was under the previous government. Our funding has gone up by 360 per cent or 12 times the rate of growth than that which it was on a per capita basis under the previous government. That is a very, very important thing to understand. It's the largest increase in home-care packages and home-care funding in Australian history. It's gone from 60,000 packages to 195,000.

I also want to deal with something that I think is somewhat beneath the opposition, and I am surprised that they would go there. I would make the point that, with our elderly Australians, no matter where they are, there will be, very tragically, the passing of those people. Ninety-eight per cent of those who are seeking home care or home support have been offered packages or received support. But, of those that are seeking higher packages, the loss of life is 4.7 per cent in any one year. The loss of life in the general population for the same age group is 5.6 per cent—significantly higher. So it's a dangerous, false and misleading comparison which is utterly shown to be inaccurate by the facts. I think that that is fundamental. Any loss at any time is agonising. The actual rate of loss is lower for those, and 98 per cent of those that have been assessed as in need of home care or home support have either received or been offered that support. So I think that's a fundamental part.

Then, in terms of the overall increase, one very important thing that we have seen is that we've gone from $13 billion when the opposition was in government to, over the course of the budget period, $24 billion, $25 billion, $26 billion and $27 billion. That's a doubling of funding over this course of time.

An honourable member interjecting—

I will deal with exactly that point that's been raised on alleged cuts. And I will quote from the budget papers. I note:

The Government will refine the Aged Care Funding Instrument to better align the funding claimed by aged care providers with the level of care being offered. This measure will allow $1.6 billion—

except this is from the 2012 budget papers. This is exactly the thing that the member opposite has just claimed was a savage cut. But those were their words, with an identical outcome, from what was a demand-driven process, where there was change in that demand under ACFI—so, exactly their words, almost exactly the amount, yet a completely different representation of it.

That brings me to the royal commission. This Prime Minister called the royal commission when no-one else had done this, on our side or on the other side. He called the royal commission to deal with what has been a generational problem. So, that was done, shortly after he came into the role. We said at the time that there would be challenges and that it would reveal things that would be difficult and shocking. But it should never undermine the extraordinary support that has been given by our carers across the country. Already we've said that there will be five pillars to our response, and we thank all three of the commissioners, including Commissioner Tracey, who has passed, for their groundbreaking and critical work, which has laid the pathway for fundamental reform in a way that has never been done before.

Our response to that commission is across five pillars. The first is home care, where already we've set out that there will be an additional 500 audits. But, more significantly, we will take very transformative processes forward as part of the budget response. In particular, we're focusing on fraud and quality, as well as on that transparency, but above all else the capacity to assist people with places. The second is quality and safety right across but particularly in residential care, with 1,500 extra audits, $32 million, an Aged Care Quality and Safety Commission with regulatory powers for chemical and physical restraint, the appointment of a senior restraint leader and extension of the pharmacy program to 2025. The third pillar of the response is residential aged-care facilities, services and sustainability, with $280 million immediately put into this, including $190 million to extend the viability supplement, $760 per resident in metropolitan areas and $1,145 per resident in rural and remote areas. So, this is a major initiative, along with $90 million as part of that for the targeted support fund for providers facing stress.

Then, importantly, there is workforce and skills: 18,000 places, with $91 million immediately made available to ensure that we can have better-trained staff and more staff and assist them in their journey of protecting older Australians. The final pillar is governance. This is all part of the interim response, and that is that we will respond by 31 May, as we've said, using the budget as our principal vehicle. Already we've allocated over $30 million for governance and training of 3,700 leaders in the field, to make sure that there will be a new aged-care act. But when we step back, there are three principles that we take. One is about respect, the second is about care and the third is about dignity. We said that in an ageing society, which has become a reality, where we've made these investments but we've gone to the next step, we knew this commission would present challenges. We knew it would be confronting. And we didn't shy away from it. We did what no-one has done before, because we wanted to make these changes.

Those five pillars are our guidelines and our framework. They're the steps we put in place. But as we go forwards, they become the guiding framework for our response during the course of the budget. They set the path for the coming years. We've said five pillars, a five-year plan, as set out by the royal commission, and we're committed to that. So, it's our watch, and it's our time, and it's our change that we will work on, and we look to work constructively with the opposition, and I invite the opposition to work with us on that front.

Ged Kearney (Cooper, Australian Labor Party, Shadow Assistant Minister for Health and Ageing) Share this | Link to this | Hansard source

'Unacceptable', 'deeply concerning', 'weak', 'ineffective', 'besieged by neglect', 'unkind' and 'uncaring'—these are all words the aged care royal commission used to describe the aged-care system that is the sole purview of the government. These are not words that anyone with a loved one in aged care or in a nursing home wants to hear. The commissioners went on to say:

… it has felt like the government's main consideration was what was the minimum commitment it could get away with, rather than what should be done …

The aged-care royal commission report was an indictment not only of this government but of this nation.

The system has failed our elderly, failed their loved ones and failed the nurses and carers, who have been left with impossible workloads and literally run off their feet. The member for Hotham very eloquently described the untenable situation for workers in aged care and the impossible decisions they have to make. There can be two carers for up to 50 residents. They have to decide whether they leave a resident in a soiled bed in soiled clothing to attend someone who is in pain, has had a fall or is distressed because of their dementia. A lot of aged-care workers have been in this House over the last couple of weeks and they've told us that there's no longer any time for that tender touch or a loving chat. The commission said that the aged-care workforce is underpaid and undervalued. That is an understatement.

In my electorate a Blue Cross residential aged-care facility has announced recently that it is going to close. They have given the residents there until 25 April to find somewhere else to live. This is very distressing. The residents there have survived COVID, when many around them in that very facility died. They were locked up with other residents for months and months and now they have to move on apart. One family member rang us today and said that he's trying to find a new place for his mother and her friend, as they can't bear to be separated since they've all been through the COVID crisis. I suspect we will see more of this.

The government needs a plan for aged care. It needs a plan with the residents, not just the providers, at its heart, and it needs it now. As the wonderful Sarah Holland-Batt wrote:

Too often, Australia's aged-care sector fails to care for our elders with dignity and respect, and traduces their human rights. Too often, vulnerable older Australians experience appalling failures of care in their final years: physical and sexual assaults, dehydration and malnutrition, preventable injuries and deaths. Too often, the toothless regulator allows negligent providers to continue operating with impunity, and too often providers are driven by profit rather than care.

Not all of them, I grant you. There are many very good providers out there who give very good care, but there are many who don't.

Since the government was handed the report, we have hardly heard a peep from them on this seminal report. True to style, there was a crude press conference where journalists had no time to read the report and prepare questions. True to their style, there was an announcement and then nothing. This time they were hardly there for the photo-op at all, let alone the follow-up.

It's reminiscent of their handling of aged care during COVID, when we saw the Prime Minister stubbornly refuse to step up to the job when his minister bungled through the whole affair. The PM, disgracefully, tried to blame the states for that. During the COVID outbreak in nursing homes, where nearly 700 people died, the Prime Minister commented, 'When it rains, everyone gets wet.' He told us he didn't hold a hose, and we know he didn't have any empathy then. He told us what he thought about our aged-care people, and he proved it. We have certainly seen his lack of empathy in these last few weeks.

As Commissioner Briggs put it, the government must step up and embrace its responsibilities for aged care—no more shirking and no more empty promises or marketing doublespeak. Act now. Do the proper hard reform that the commission has demanded of you. A country can be defined by how it treats its vulnerable, and right now we are failing them. We can't wait any more. We need a government that genuinely cares about this issue and shows it through action.

Tim Wilson (Goldstein, Liberal Party) Share this | Link to this | Hansard source

It's a privilege to be able to speak on this motion because, like many other Australians, I understand directly the consequence of the impact of aged care and of making sure there is quality service provision, because we have all been in this situation with family members who need support because they're no longer able to live independently, and we want them to be able to do so with dignity and security. However, as the minister outlined, it is disappointing, given that the opposition claims to care so much about aged care, that it has taken them three weeks to move this matter of public importance. It was this government that established the royal commission because we identified very clearly the concerns in the sector and the need to address these challenges if we want a sustainable system that will enable older Australians to live out their years with dignity, security and health and wellbeing as best as they possibly can.

There are shortcomings. We know there are shortcomings and not just those shortcomings that the royal commission has identified. There are shortcomings in making sure that families are fully engaged in the care of their elderly parents and seniors. Unfortunately, there has been violence and abuse against some of the most vulnerable people within our community—those who are least in a position to call out and respond. But we also should not ignore the thousands of people who work in the sector every day, many of whom, by the way, are members of unions allied to those on the other side of this chamber. They do an outstanding job in providing care and support to elderly Australians, and they deserve our thanks and our respect, as do those who manage aged-care homes and, of course, those who build them and who are part of making sure there's enough supply in the system. We've gone through a very difficult patch, not just because of the problems that have been identified because of the start of the royal commission but also because of the direct consequences of the COVID-19 pandemic. Like you, Deputy Speaker Kevin Andrews, I come from the great state of Victoria, and one of the tragedies of last year was that 95 per cent of deaths in aged care in our state occurred as a result of COVID-19, and that was because of community transition which made its way into aged-care homes.

The royal commission has, rightly, identified a number of challenges in the sector, in making sure that people are able to go into aged care and get the touch, the sense of empathy and, critically, the support they need at their most vulnerable stage of life. The Morrison government has already delivered record investment across the aged-care sector of $13.3 billion in 2012-13 and that, of course, continues to grow thereafter. It's estimated that funding for aged care will grow to more than $27 billion by 2023-24. That's on average $1.5 billion of extra support for older Australians each year over the forward estimates. That's a significant cash injection. But the previous speaker, the member for Cooper, correctly identified that this is a discussion about responsibility, and it's about responsibility for everybody in the sector. It's about the responsibility of children and family members to their seniors in having an active role in supporting people in aged care and not simply using it as a vehicle to off-load their elderly parents. Everybody has that responsibility. It's a discussion about responsibility in terms of development of new aged-care homes and the capital contribution that needs to be made by individuals and by the private sector to invest in the growth of the aged-care system. It's a discussion about responsibility to make sure that individuals take responsibility in the management and operation of these aged-care homes so that people get the best standard of care and, of course, support from the government as well. It's also critical that government shares its responsibility in delivery of that care so that older Australians can go into aged care with confidence, particularly at the vulnerable stage when they're leaving their private home—often reluctantly, we need to acknowledge—and so that they can go to a place where they feel safe, secure and cared for so that they can live out their lives with dignity and with the support they critically need.

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

I rise to speak on today's MPI with a heavy heart, especially after hearing the minister speak about those who lost their lives waiting for care as 'rates', not human beings; and it appears that he's read his three principles of 'care, dignity and respect' off the cover of the report. I lost my father, Grant, to younger onset dementia when he was 68 years old. I lost my grandma Molly to dementia. I promised my mother, Barbie, who cared for my grandma and my dad, that I would do everything I could in this job to ensure that other people and families would have good care.

I was saddened but not surprised by the final report of the Royal Commission into Aged Care Quality and Safety because my experience of aged care, of substandard care, goes back to my first year as a registered pharmacist, in 1998, when I was responsible for the daily medication orders for several psychiatric aged-care homes in the inner west of Sydney. The shock I felt walking into a psychiatric aged-care home for the first time was overwhelming. I had to walk out, try to pull myself together and walk back in because people needed care and that day's medication order had to be delivered.

And now, over 20 years later, the government has received a final report of the Royal Commission into Aged Care Quality and Safety, shining the light on the abuse and neglect that has been going on for decades. The royal commission detailed 274,409 self-reported cases of substandard care and 32,715 calls to the My Aged Care hotline that went unanswered in just one year. Many people will remember that the government only called this royal commission because it was shamed by a Four Corners media scandal back in 2018. This inquiry, 'the most in-depth and thorough examination of Australia's aged-care system'—according to counsel assisting, Peter Rozen—held almost 100 days of hearings and accepted more than 10,500 public submissions. And the result? A tale of neglect.

The interim report released in 2019 found that the aged-care system failed in its duty to support older Australians. I know that the minister is not in the chamber anymore, but I'm going to quote directly from the interim report. I think he needs to hear this after talking about older Australians needing care as 'rates', not human beings. The interim report states that the aged-care system 'does not deliver uniformly safe care for older people. It is unkind and uncaring towards them. In too many instances it simply neglects them.' This government has had nearly eight years to look after older Australians properly. It has had nearly 18 months to act on the urgent recommendations of the interim report.

This crisis, as others have said, is largely of the government's own doing. The Prime Minister was Treasurer when the government cut $1.7 billion from aged care. Now there are close to 97,000 older Australians waiting for a home-care package during COVID, when many people and families are afraid of entering residential care. Those needing more support while waiting for level 4 packages are often waiting more than a year for the help that they and their families and carers so desperately need. Over 28,000 older Australians have died while waiting for a home-care package. They're not a rate, Minister; they're not a percentage to compare to the wider population. These are people; these are mums and dads and grandparents; these are people who matter. And you have reduced them to a rate or a percentage; that is a disgrace. In my community, on the Central Coast of New South Wales, one in five people are aged over 65 and there are currently 1,109 people waiting for a home-care package—people like Enid, who, at 96, was told she would have to wait 12 months for a level 4 home-care package. It's not good enough.

Growing old is not easy. As the interim report observed—and I think it is important that this be read onto the record—'we avoid thinking and talking about it, leading to an apparent indifference where, left out of sight and out of mind, these important services are left floundering'. I know of people, some living with dementia, who, after a fall or a hospital stay, have ended up in residential care after their families and carers have become exhausted trying to keep them at home. I was with my Dad when, after an exhausting battery of tests, he was finally diagnosed with younger onset Alzheimer's dementia. He said to me: 'You will never leave me dribbling in a nursing home.' This is a very real fear for many people living with dementia, and I am determined to keep my promise to my mum, Barbie, that it will be better for other families. But kind words and good intentions won't help people like my dad's friend Steve, who was moved into residential care during COVID. It has to be better; it's urgent. What the government have done so far suggests that they don't care and don't know that it matters.

Gladys Liu (Chisholm, Liberal Party) Share this | Link to this | Hansard source

When the Prime Minister called the Royal Commission into Aged Care Quality and Safety, I think we all knew that the final report would deliver some home truths. We knew it wouldn't be pleasant reading. I'm sure that's one of the main reasons why the decision enjoyed such broad support from both sides of the House and across the political spectrum. That's also why it was so necessary that the Prime Minister acted in this way. You don't get anywhere by avoiding the big issues, and that's not what he did or what we plan to have happen.

The stories we heard through the royal commission's hearings and the media are harrowing; in some cases, they are downright distressing. If I'm honest with myself, I thought we were better than that. The commissioners have identified substandard care across the aged-care system and have agreed that fundamental and systemic reform is required. Our comprehensive response to this report takes up this challenge.

The response will be framed through five pillars: home care; residential aged-care quality and safety; residential aged-care services and sustainability; workforce; and government. In doing so, it will build upon our initial response announced at the start of this month, which included more than $450 million in funding in those areas. The government will commence work on a new Aged Care Act to ensure our reforms are built on strong foundations, with senior Australians at the centre and respect for individual needs at the front of our minds.

That is the path ahead of us, but the Morrison government is already delivering record investment across the aged-care system over the forward estimates, with $13.3 billion in funding in 2012-13, growing to more than $23 billion in 2020-21. It is estimated that funding for aged care will grow to more than $27 billion by 2023-24. That is on average $1.5 billion of extra support for older Australians each year over the forward estimates. On top of this, government funding for residential care this financial year is $14.1 billion, up from $9.2 billion in 2012-13.

Meanwhile, at the last election, Labor provided no additional funding in their costings for home care places and no additional funding for aged-care quality workforce or residential aged care. So, while I think we can all agree that aged care needs work, the implication of the member for Hotham's proposal, that the system would be any better under a Labor government, beggars belief. But we are not here to play politics; we are here to get the job done and to deliver for older Australians.

Under the Morrison Liberal government, home-care packages are up, residential care places are up and, as mentioned, record investment is being delivered across the aged-care system. That shows a commitment on behalf of this government to aged-care quality and safety. It shows a commitment and a belief in humanity dignity in aged care. And it shows a commitment to doing better by our old Australians. If we can agree on one thing in this place, it's this: they deserve it.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

I've got my speech in front of me but, if I can first just say, I am very upset by the complete dissociation of this government from any responsibility for what's happened in the aged-care system. They've been in power for over eight years. I was part of the standing committee that did an inquiry into aged care starting in 2016, which amply demonstrated the terrible neglect that was happening in aged care and the exploitation of people involved in the aged-care system, including residents in residential aged care and staff in aged-care facilities. So it is pretty disgraceful that this government walks away from any responsibility for what has happened. The government had to be dragged kicking and screaming to the Royal Commission into Aged Care Quality and Safety after many reports—after our report, after the aged-care workforce strategy report and after some terrible exposes on Four Corners. For the government to say they have no responsibility for what's happened is disgraceful.

These issues were before the pandemic; they have been magnified by the pandemic. But going back to 2016 and 2018, I spoke about the neglect that was happening in aged care in this House, as did many others, about how the Turnbull government had failed to deliver on home-care packages and people were dying before they could get access to home care, about the terrible neglect that was happening in some aged-care facilities while private profiteers—that's all you could call them—were reaping billions of dollars from the system. For those opposite to say 'nothing to do with us' is disgraceful and they should own up and take responsibility.

The final report of the Royal Commission into Aged Care Quality and Safety cannot be ignored by this government; they know that now. But they are reluctant to make any meaningful changes. There were 148 recommendations of the aged care royal commission final report, but I would like to focus on what I think are the three main issues.

Firstly, we must have an independent regulatory system. The aged-care system did have regulators in place by both the government and by private industry and they monumentally failed, demonstrably. For the initial report of the aged-care royal commission to be titled being entitled 'Neglect', surely there's a message there. The regulators failed in their duty to the Australian community, and the government failed in its duty to older Australians, so we must have an independent regulator. Clearly, the present regulatory system has failed.

Secondly, we need to urgently increase the number of staff in residential aged care. We know that, in many places, in fact, the majority of places, residents were malnourished. They weren't given access to adequate pain relief, dementia care or physical care. Yet we allowed the administrators of these homes to reduce staff and increase profits at the same time as older Australians were suffering. The staff did the very best they could, and I am very grateful to all those that work in aged care for the work that they have done. I know how exhausting it is to provide personal care to people on a 24-hour basis. They're exhausted and they're stretched to their limits. They're crushed at the end of their shifts. Many work overtime, some unpaid. Aged-care workers deserve to be treated better.

Lastly, they also need to be given appropriate training, because with appropriate training comes better care, better pay and better wages. We must make sure that our aged-care workers are looked after and want to stay in the industry because, at the present time, many are leaving the industry because they are exhausted and they feel that they are not listened to. The blatant disrespect and lack of humanity demonstrated by this government to aged-care residents and their staff is disgraceful. I repeat: it needs to change. The government needs to change its philosophy, needs to act urgently and needs to stand up for our older Australians because, at the present time, many people are reluctant to even consider residential aged care for their family members because of the blatant lack of care and neglect. (Time expired)

Andrew Laming (Bowman, Liberal Party) Share this | Link to this | Hansard source

There is a common thread in this debate today, and it's great that aged care is being taken so seriously. Some of the more histrionic observations aside, there were generally excellent contributions from both sides, including the previous speaker. It's obvious, with a royal commission already having draft recommendations before us, that this is a government which is committed to action. I was working in aged care back in 1992, when I used to visit as a country GP and walked the wards of residential aged-care facilities feeling like I could spend an hour with every single patient if that were possible. There is the need to look after both those who work—those who provide the services—and the families, let's not ever forget this, who want the best for their loved ones. Ultimately, that's what home and residential aged care is all about.

My second observation is that we still have one of the really extraordinary and high-quality residential aged-care systems in the world. As you travel the world you realise that Australia's blend of home and residential aged care is quite unique. We've already heard from the health minister about all the significant investments, adding up to nearly half a billion dollars. The health minister talked about this and referred to the $16 million, which is about raising safety and quality standards initially. And there's a focus on 18,000 new workers—that in itself is an investment of about $90 million. And there's $280 million for standards and services within residential aged care. A significant chunk of that is about supporting metropolitan and outer metro with individual payments per resident of $11.45 and $7.60. Then, of course, there are those who are at risk, particularly in regional areas of financial stress, through this period.

We have two of the most eminent Australians writing the recommendations, and it's a chance for this very chamber to contribute ideas—to talk about how we address the issue of an aged-care nurse who isn't paid the same as a hospital nurse doing equivalent roles. Here's an opportunity for both sides of this chamber to work through the Fair Work Commission and to make sure that is addressed. The money paid has to bring in and retain the highest-quality nursing staff in the sector and they'll give great supervision to the rest.

But the patently obvious observations are that those who run nursing facilities sometimes attempt to cut corners on ratios and not have that emphasis on face-to-face bedside time. Anyone who has worked in medicine knows that the temptation to sit back at the nurses' quarters and do the paperwork for hours doesn't count towards face-to-face time. Every family member deserves the right to know whether their loved one is actually getting that face-to-face time. It's not just about the total time or ratios if those caregivers are nowhere near the patient. We can talk about the six-minute goal to respond to a buzzer, but how many of us have ever stood for six minutes knocking on a door and had no-one answer it? Six minutes in and of itself is unacceptable for response times.

When it comes to basic, fundamental nutrition and the provision of fresh food, if there's a provider out there spending six bucks per head per day on food and a guy down the road doing it for 10 or 12 then that needs to be recognised. In that sense, we need to be able to report honestly and frankly in the way that we now expect, with complete transparency of the performance of these providers. We're not here to run obfuscation and defence for providers who cut corners. There's always the risk of that happening and, in that sense, we need to act early and pre-emptively to help these providers before they get into trouble. It's not just about the spot checks without warning that might pop up two or three times a year. We don't want any more routine checks, we want unannounced visits, but we also want a constructive approach as regulators so that we address these concerns before they become major violations. Of course it's not as simple as a Tripadvisor website; we can't just put every complaint online, publically available, if it hasn't been substantiated—we need to protect good providers from malicious complaints, which are also a significant concern.

We don't need a nuclear physicist to sort out the aged-care system. We need a bit of ticker from every person who sits in here and who represents dozens of aged-care facilities. We can work together to come up with a better system. There's no doubt that there is the commitment, no matter which party is in power, to put money into the aged-care system. Already, in the time that we've been in government, the population of those aged over 70 has gone up by 28 per cent but the aged-care places in the system have increased by nine times that. The funding is up by 360 per cent. There's no doubt that, per head, this is a different world to where it was in 2012 when the other side were nickel and diming the ACFI system and we are no more innocent of that either. But now is the time for serious solutions and welcome help from both sides to see those reforms by the end, if not the middle, of this year.

Tony Zappia (Makin, Australian Labor Party) Share this | Link to this | Hansard source

After eight years of coalition government, the aged-care sector is in crisis. The facts as reported by the royal commission are absolutely clear about that. There are 97,000 people waiting for a home-care package. There have been 274,000 self-reported cases of substandard care, 32,715 unanswered calls to the My Aged Care consumer hotline, 50 allegations of sexual assault every week and 100 reported assaults of all types every week—and we know that not all assaults are reported; in fact, we heard that in our own inquiry. Sixty-four per cent of private residential aged-care providers claim to run at a loss. Sixty per cent of aged-care residents are given psychotropic drugs when only about 10 per cent of residents need them. Two-thirds of aged-care residents are malnourished, and half of all aged-care residents have dementia or Alzheimer's and, therefore, need high care.

So what does the Morrison government do in response to all that? It cuts $1.7 billion of funding from aged care, then kicks the can down the road by calling an aged-care royal commission when it knew what needed to be done because it had had over 20 reports over recent years about the problems in the sector. In fact, it had the Oakden report only a few months before it made its decision, which clearly outlined what was wrong with the aged-care sector, and it had countless complaints and submissions and reports made to it. Furthermore it had a report from this very parliament—from a committee that you, Mr Deputy Speaker Georganas, deputy chaired—in respect of the quality of aged care in residential facilities in Australia.

Given that some 64 per cent of providers claim to operate at a loss, and that some of the others, including the not-for-profit operators, put profits before people, the consequence is understandable. Drastic cuts are made by cutting higher-paid nursing staff and replacing them with fewer lower-paid and inadequately trained aged-care workers, who are then given impossible workloads. These are aged-care workers who are themselves abused, overworked and underpaid. They deserve to be treated much better. All of this leads to very serious neglect of vulnerable people who then further deteriorate and need higher levels of care.

Along with all this, the federal agencies tasked with oversight and the care provided proved to be incompetent, inadequately resourced or simply indifferent to what was occurring. How can any responsible entity provide notice well in advance if it's going to do an inspection? Why were inspections never done after hours, when the lowest staff-to-patient ratios were on and when the problems were always the worst? It's clear that we need some drastic changes to the way the system is run.

With respect to the inquiry that was carried out by a committee of this House, there were 14 recommendations made as a result of that inquiry. They were handed to the government in 2018. I haven't heard of a single one of those recommendations being adopted by the government. We knew full well, as a result of that very inquiry—and the royal commission simply reaffirmed what we had already found out and established—that there was an urgent need to fix the system. Most of us in this place have also had our own personal experiences with respect to aged-care centres. I could talk about countless stories that I have personally been associated with.

The reality is that the government knew what needed to be done but simply didn't act; it just kicked the can down the road. We are dealing with vulnerable people who deserve the level of care we would all want for ourselves and for our family members. Sadly, and shamefully, they are not getting that care. They deserve better. They deserve real care, not just caring words, as we heard from the minister today, and not just more pieces of legislation that result in no changes to the care people get. The buck stops with the Morrison government, and it needs to deliver the care that every Australian deserves and is entitled to.