Rebekha Sharkie (Mayo, Centre Alliance) Share this | Link to this | Hansard source

I move:

That this bill be now read a second time.

The Royal Commission into Aged Care Quality and Safety and recently the National Ageing Research Institute (NARI) have confirmed what we already know—that is, as we age, most Australians want to stay in our homes for as long as we can.

Not only would most older Australians prefer to stay in their own homes for as long as they can possibly do so, with the appropriate supports and services, but the royal commission also identified that this is the most cost-effective way to provide support.

I could not agree more that the aged-care system needs to be reviewed and rebuilt with the greatest haste possible. This needs to be done in engagement with older Australians about the care that they need and want, moving away from the 'four sizes fit all' approach to build individual support for individual needs. I appreciate the government's stated intention to put in place a new Aged Care Act by 2023.

However, in the meantime in representing our communities we need to do all that we can to positively influence this reform process and improve the system that is facing Australian seniors and their families, today.

There are many regions in my electorate of Mayo where the median age is over 58 years, and where half the community is aged over 65 years.

As a result of hearing the concerns of many of my constituents regarding access to and the costs of aged care at home, I surveyed 15,000 Mayo residents aged 75 years or older regarding their experiences of home care under My Aged Care.

Beyond reporting lengthy waiting lists, half of those respondents with packages advised me that they are unhappy with or unclear about the administration and management fees charged under their home-care packages. Half of those with packages reported that there had been no change in their package over time, yet many were paying the same hefty management fees on their static package, month after month.

The Commonwealth spent more than $23 billion on aged care this financial year and yet there is still too little transparency about how these taxpayer funds are spent by providers.

The Royal Commission into Aged Care Quality and Safety received evidence that the average amount of support for an older Australian on a $52,000-per-annum level 4 home-care package was just eight hours and 45 minutes each week. That is the highest level of home care a person can access. Too many receive far less, particularly in regional areas.

This is not because aged-care workers are getting overpaid, or even paid fairly. As I have discussed on several occasions in this place, we need to address the fact that the workers providing valued care to our older Australians are unjustly being paid up to 25 per cent less than workers in the disability sector.

I heard from Margaret earlier this year, who reported that after she refused provider charges of $800 per month to manage four hours of care per week, she was offered a private arrangement at approximately $60 per hour by the provider, who planned to pay her carers only $28 an hour. She now engages a private cleaner at $30 per hour. Margaret is managing this herself because of her concerns that older Australians are being thoroughly taken advantage of, and that this is preventing others from accessing the care they need.

Another elderly woman has contacted me who says that she needs far more care than she currently receives. She has managed to secure a level 2 package worth $1,270 per month, $575 of which is taken out in administration and management fees. This represents nearly half of her package which does not directly contribute to the much-needed care that she deserves.

They are sadly not isolated examples. As one constituent explained:

The problem we often wonder (is) how they arrive with their exorbitant charges and on top of that the costs they add to the services they provide.

Home Care providers already have a legislative responsibility to keep package management fees and business costs to 'reasonable' amounts. Clearly some Home Care providers believe that taking 45 per cent of a person's package is reasonable. My community and I beg to differ.

If passed, this bill will require providers to identify the amount of a participant's home-care fees which is directly attributable to the costs of administering and managing the provision of aged care in the home. Other components may not be inflated or padded with additional administration and management charges. Fees for administration and management will be capped at 25 per cent of lower-level home-care packages, and 20 per cent of higher-level packages. That is reasonable.

The bill also prohibits approved providers charging 'exit' fees, which in mid-2019 averaged $225 for a published maximum exit amount when a recipient of home care wished to leave a home-care service and perhaps go to another one. This will give older Australians greater autonomy to exercise their choice of provider based upon their satisfaction with the services, and the fees charged for their care.

This bill also requires providers to give prospective care recipients a list setting out comparable home-care fees for at least five approved providers of the care sought, in the area in which the recipient is seeking care. If there are fewer than five such providers of the care sought in that area, a list of fees must be provided for all approved providers for delivering that service.

The bill simply seeks to ensure that home-care funding is used to provide more hours of actual care for older Australians, and fairer wages for aged-care workers, rather than being siphoned off by providers for other purposes.

I therefore commend the Aged Care Amendment (Making Aged Care Fees Fairer) Bill 2021 to the House, and I would urge the government and the opposition: let's move on this issue soon. We can't leave it for a new act in the next parliament. People are suffering today. Let us address this issue urgently.

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

Is the motion seconded?

Helen Haines (Indi, Independent) Share this | Link to this | Hansard source

I second the motion. The member for Mayo is a crusader for a fairer aged-care system. She represents one of our oldest electorates and, during her last five years in this place, she has fought tirelessly for senior Australians. Before the aged-care royal commission exposed the system's failings in black and white, the member for Mayo shone a light on what people chose to ignore and she urged the government to do better. Today is the next step in her fight, with the making aged-care fairer bill.

Ageing at home is the clear preference of older Australians. Demand for homecare packages is set to surge, as the baby boomer generation ages. Yet, astoundingly, up to 45 to 50 per cent of the costs of homecare packages can go to management and administration fees. There's no way to tell if the reasonable fees that providers are allowed to charge bear any relationship to the actual cost involved. This bill will ensure that these fees are directly attributable to the costs to administer or manage the provision of home care to the recipient. This seeks to prevent price gouging and give older people and their families an informed choice and greater autonomy about their home care and what they pay for that care. The royal commission reported that the most common concern among homecare respondents to a survey was finance and administration, including value for money and transparency around fees and charges.

High management fees could be justifiable if they went towards better wages for our aged-care workers, but, sadly, this is not the case. Our aged-care workforce is chronically underpaid and undervalued. The government's response to high management fees is to make pricing more transparent and let competition put downward pressure on the fees. Yes, the royal commission reported that, despite increased pricing transparency measures, care management fees had increased as a proportion of all fees, so it does not seem to be working.

It's not simply about information scarcity or consumer choice. I represent hundreds of constituents in rural and regional areas who simply do not have a choice of providers. There is one provider, and you take whatever they offer you, including—possibly—exorbitant fees, because it's better than nothing; you can't shop around.

We need regulation like this, so we know that older Australians and their families aren't getting ripped off. Over 55,000 people are still waiting for a homecare package. When their wait is over, let's make sure they get value for money and a high-quality service, so that they can age safely and happily in their home.

Mark Coulton (Parkes, Deputy-Speaker) Share this | Link to this | Hansard source

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