House debates

Thursday, 8 September 2022


Aged Care Amendment (Implementing Care Reform) Bill 2022; Consideration in Detail

11:52 am

Photo of Rebekha SharkieRebekha Sharkie (Mayo, Centre Alliance) Share this | | Hansard source

I move the amendment circulated in my name:

(1) Schedule 2, item 1, page 5 (line 11), omit "recipient;", substitute:

recipient, including a schedule of reasonable charges associated with the provision of the following to the care recipient:

(i) administration and management of care;

(ii) services;

(iii) equipment;

This amendment is very simple. It aims to supplement measures provided in schedule 2 of the bill. It does not limit matters which may be provided for in the User Rights Principles under the Aged Care Act. It does, however, specify that those principles should include a reasonable schedule of charges associated with the provision to care recipients of administration and management of care, services, and equipment.

The purpose of this amendment is this: as sure as night follows day, if we put a cap on administration and management fees on this side, we are going to see people who receive a home-care package no longer being charged perhaps $90 an hour or $150 an hour on the weekend. That is the usual fee that I see, and I've surveyed more than 1,200 residents in my community and asked them to go into detail for me. I've seen their invoices. As sure as night follows day, those fees will go up. I understand that the minister is saying, 'We're going to keep a watchful eye on this.' That's going to be after the damage, after people are charged $200 or $300, because providers will share and shift the cost on this. There's no reason why a reasonable schedule of fees couldn't have a metropolitan layer and a regional, rural and remote layer. There's no reason why you couldn't have a range of fees.

I have constituents in my electorate who are being charged $700 for an occupational therapist to spend 10 minutes in their home to tell them that they need to get a shower chair or get a little hanging basket instead of putting their shampoo on the ground—'Just get a little hanging basket from Kmart; that's $700'—or put a rail in their wardrobe. This is extraordinary. They're being charged $700 for an occupational therapist to visit them and tell them that they need that, and then it's $440 for a company to come out to a home to provide a quote and $1,000 to install the rail. And it's all taken from the funds. Then what happens when it's taken from the funds? Older people are told, 'We're going to have to cut back your hours this month, and when we get the next lump of money for you at the end of the month you can go back to your normal hours of care.' It is outrageous that we would not fix this problem properly, right now in this parliament, and not say, 'Oh, the department's going to look at this in the future' or 'We're going to be really keeping a watchful eye on this one'.

I will be talking with my constituents as soon as this is implemented, saying: 'Tell me, how much are your hourly rates now? What are you being charged for an hour of home care, or 20 minutes of home care, now? And how much are all those quotes for occupational therapists who come out and spend 15 minutes with you, and how much are you being charged?' As I said, they are going to profit-shift from where they're currently making obscene amounts of profit on administration and management fees, where providers are not changing month to month the actual care plan for a person but still taking 50 per cent, and move those profits over to the other side, where we're not putting caps in.

Minister, this is an area I have cared deeply about for six years. It's one of the few areas in this parliament in which I would say I actually have a very reasonable amount of knowledge. We are going to make older people even more vulnerable to some of the unscrupulous practices by many home-care providers. I have a regional electorate. I understand what you're saying with respect to, 'We don't want to make sure it is not profitable and that people move out of delivering regional services'. I can tell you right now: on Kangaroo Island it is incredibly difficult. You get given a home-care package by the government—but try and find anyone willing to do it. That's already an issue. We're going to see, in areas where they're still willing to deliver, that they're just going to profit-shift from one side of the equation over to the other. We in this place want to see people get more hours for their home care, and that will not happen with this legislation as it currently is.

11:57 am

Photo of Stephen BatesStephen Bates (Brisbane, Australian Greens) Share this | | Hansard source

I want to thank the member for Mayo for her work on this bill and the amendment she has circulated. We recognise and agree with the broad concern she's raised about the level of delegated legislation in this bill. It certainly isn't our preference, and we would encourage the government to address those concerns in a way that addresses the issues highlighted through the Senate committee inquiry process. I understand a number of crossbench MPs and senators have raised those issues with the minister, and I look forward to the outcome of those discussions.

We have consulted with a number of stakeholders on the amendment circulated by the member for Mayo in the time that was available. As I said, we support the intent to ensure greater accountability in legislation and greater protection for consumers. Given the policy development underway by government, the advice we've received from a number of stakeholder groups is they support the existing process. So we won't be supporting this amendment in the House. However, we remain open to improvements to the bill and will continue to consult with stakeholders on how we can ensure this legislation is as transparent and strong as possible.

Photo of Milton DickMilton Dick (Speaker) Share this | | Hansard source

The question is that the amendment be disagreed to.

12:09 pm

Photo of Anika WellsAnika Wells (Lilley, Australian Labor Party, Minister for Aged Care) Share this | | Hansard source

I present a supplementary explanatory memorandum to the Aged Care Amendment (Implementing Care Reform) Bill 2022 and move the government amendment as circulated:

Schedule 1, item 2, page 3 (line 26) to page 4 (line 6), omit subsection 54-1A(4), substitute:

(4) Without limiting subsection (3), the Quality of Care Principles made for the purposes of that subsection must:

(a) provide for the circumstances in which an exemption from this section may be granted (on application or otherwise) to an approved provider in relation to a residential facility, including that:

(i) such an exemption may be granted by the Secretary; and

(ii) before granting such an exemption, the Secretary must be satisfied that the provider has taken reasonable steps to ensure that the clinical care needs of the care recipients in the facility will be met during the period for which the exemption is in force; and

(b) provide that such an exemption that is granted to an approved provider in relation to a residential facility must not be in force for more than 12 months; and

(c) provide that more than one such exemption may be granted to an approved provider in relation to a residential facility; and

(d) provide for the conditions that may apply to such an exemption that is granted to an approved provider in relation to a residential facility.

(5) If an exemption from this section is granted to an approved provider in relation to a residential facility, the Secretary must make publicly available information about the exemption, including:

(a) the name of the provider and the facility; and

(b) the period for which the exemption is in force; and

(c) any conditions that apply to the exemption; and

(d) any other information of a kind specified in the Quality of Care Principles.

Before I speak directly to that amendment, I'd like once again to acknowledge and thank everybody who has contributed either to the Senate inquiry or to the ongoing consultation around the delegated legislation. One thing that has been extremely clear to me throughout this process is that we all have a very clear shared goal—to see older Australians get the care that they deserve from the aged-care sector. There is clear support for the intent of this bill.

The government is progressing amendments to the bill because of feedback received during the Senate Community Affairs Legislation Committee inquiry and their subsequent report. I would like to specifically thank Senator David Pocock and his office for their productive and early engagement on these changes, as well as all of the members and senators that have engaged with me and my team on this. I'm open to working with anyone who wants to see improved outcomes for our aged-care sector.

The amendments will clarify points in schedule 1 of the bill. They specifically relate to exemptions that may be granted to approved providers in relation to the 24/7 registered nurse requirements. The amendments provide that the secretary will be the decision-maker in respect of any exemption and that the secretary must be satisfied that the provider has taken reasonable steps to ensure that the clinical care needs of the care recipients in the facility will be met if that exemption is granted. This will ensure that the needs of the care recipients are central to any decision to grant an exemption. The amendments also provide that an exemption cannot be granted for longer than 12 months, ensuring that exemptions are regularly being reviewed. Finally, the amendments provide that the secretary must publish details in relation to any exemptions that are granted. These decisions should be public, as this will incentivise providers to meet that requirement rather than seeking an exemption. It will also increase transparency, providing older people and their families with information so that they can make more informed decisions about their care.

We are committed to getting aged-care reforms right to deliver the care that older Australians deserve, and we will continue to work through the details with the sector, with unions, with older Australians and with our colleagues in this place. We continue to be very open to having discussions and working with other members of this parliament to work towards better outcomes for older Australians. We want to do this reform once and we want to do it well for a lasting positive impact on people's lives. That will require all of us to work together to make it happen.

Question agreed to.

Bill, as amended, agreed to.