Louise Miller-Frost (Boothby, Australian Labor Party) Share this | Link to this | Hansard source

I move:

That this House:

(1) notes:

(a) that on 1 November, the Government's once-in-a-generation reforms to aged care began, giving more older Australians and their loved ones better access to a system that puts safe, high quality and dignified care at its core; and

(b) the Aged Care Act 2024 and related reforms deliver a range of improvements to ensure older people and their needs are at the centre of the new aged care system including:

(i) strengthened aged care quality standards;

(ii) a statement of rights;

(iii) a new model for supported decision-making; and

(iv) introducing the Support at Home program to help older Australians remain in their homes for longer; and

(2) acknowledges that the commencement of the Aged Care Act 2024 is the next step in the Government's aged care reforms, which has already included:

(a) the introduction of star ratings;

(b) more direct care for over 250,000 older people in aged care homes;

(c) 24-hours, seven days a week nursing in aged care homes;

(d) higher wages for aged care workers;

(e) a new single assessment system; and

(f) more transparency on provider finances and operations.

When the Albanese government was elected, one of our priorities was fixing the broken aged-care system. Nothing explained better how broken aged care was than the 2019 interim report from the royal commission into aged care, entitled simply Neglect. The royal commission final report was delivered two years later, in March 2021, and woefully little was done to address the catalogue of horror stories the royal commission had heard. By mid-2022, the previous coalition government had responded to fewer than 10 of the 148 recommendations.

We all heard the heartbreaking stories the royal commission was told of how older people—our parents, our grandparents, our neighbours and our friends—had been treated, and this government was the one to stand up and say that we can and must do better

The New Aged Care Act, which came into force over the weekend, responds to 58 of the 148 recommendations. This means that this Albanese government will have now responded in part or in full to 103 of the royal commission's recommendations, and, of course, the work continues. These generational reforms to aged care are really important for every older Australian and their families, carers and providers. Australia has an ageing population, and we know that there will be increased demand on the aged-care system. We owe it to every older Australian to ensure that, when they need aged care, it will be there for them.

Over the past three years, we have already introduced some very important improvements to the sector. We mandated 24/7 registered nursing in every nursing home, delivering more care minutes to residents. There is now a registered nurse on site in aged care more than 99 per cent of the time, delivering more direct care for over 250,000 older Australians. Our reforms are giving older Australians 7.1 million additional minutes of care every single day compared to under the last government. This is a great initiative to keep people healthy in their nursing home, their home, and also to avoid inappropriate transfers to hospital EDs for minor ailments and injuries.

We have already invested $17.7 billion to increase the wages of aged-care workers. Ultimately, the care you receive in a nursing home or aged-care facility is a direct product of the quality of the staffing. This government values the critical role workers play in this sector. We want aged care to be a career of choice, attracting and retaining quality workers who love providing care to other humans, who love aged care. Too often we heard that good carers and nurses were having to leave the sector because they couldn't afford their mortgage on aged-care wages or because they could get better pay somewhere else. Increases in aged-care workers' wages means they can pursue the career they love in the aged-care sector, providing quality care to residents.

Most importantly, we've improved the standard of care. In December 2023, only 54 per cent of aged-care homes had an overall star rating of four or five stars, which is good or excellent. Today, 79 per cent of homes do. Thanks to our reforms, older Australians are now receiving more care and better quality care under Labor. Now the New Aged Care Act is underway, we'll continue to make sure residential aged care is meeting the demand of an ageing Australian population and delivering truly equitable, sustainable and high-quality care. We know people want to stay at home, and the new act is making sure that they can do that with dignity, safety and quality support. But, when they need extra care, we'll make sure a bed is there for them.

And it's important to note that the new act isn't just more of the status quo; it's better care for more older Australians. It puts them at the centre of their decision-making. It's a rights based framework. The act's statement of rights makes sure that older people can make decisions about their own lives and have their decisions not just accepted but respected. It's more support at home, including bigger budgets and separate streams for home modifications and assistive technology. And, of course, it's a transformational change in residential care, with places now being delivered to people not homes. This will allow older people and their families to get the care they want where they want it, closer to the people they love.

Older Australians deserve the very best, and that requires transformational change. We'll continue to be responsive to older Australians who need more supports, whether that's specialist memory support services, mental health care or care for those living in regional areas. It's better care for more older Australians that puts them at the centre of their decision-making.

Zaneta Mascarenhas (Swan, Australian Labor Party) Share this | Link to this | Hansard source

Is the motion seconded?

Matt Burnell (Spence, Australian Labor Party) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

Dai Le (Fowler, Independent) Share this | Link to this | Hansard source

I'd like to thank the member for Boothby for bringing this important issue to the chamber. This week we enter a new era in aged care with the commencement of the New Aged Care Act and the replacement of the Home Care Packages Program with the Support at Home program. It's understandable that, when a new government comes in, they want to leave their mark on existing policies, but the real questions for my community are these: Will these changes actually make life easier for the people who need care? Will it shorten the waiting time? Will it simplify the system? And, most importantly, will it make sure that older Australians get the support they need when they need it? Because, right now, that's not what's happening.

In Fowler aged-care issues cut right to the heart of our community. Every week I meet families and older Australians who tell me the same thing: the system is too complicated. There are too many forms, too many departments and too many long waits. Even for those with urgent needs, those waiting for level 4 packages, the delays can stretch out for more than 15 months. In that time people's health declines, families burn out and their faith in the system disappears. For many in my electorate, one of the most multicultural in the country, the problem is even worse. Carers who don't speak English fluently are often left struggling to navigate a system written in complex language. They face forms they can't understand and call centres they can't communicate with. Even when language isn't a barrier, navigating the system proves to be complex and time consuming.

Take Jenny—that's not her real name—who came to my office desperate for help. Her brother had been waiting for a year for his home-care package. She'd called My Aged Care again and again, but no-one could tell her where he was on the list. She told me she feared he would pass away before receiving the care he was entitled to. Or take Anna, who works a full-time corporate job and came in to see me to share her frustration at not being able to find a provider to deliver the services her father had been approved for while waiting for his home-care package. Multiple days off work to secure care services for her father left her disheartened when faced with being turned away due to lack of provider capacity and long wait times. Instead of dignity and support, the system delivered months of silence and confusion.

The government says the new aged-care system will fix these issues, promising transparency and better access, but for families like Jenny's and Anna's those promises mean nothing unless they're delivered in practice. This massive transition introduces new contribution structures and new rules. But, if we're not careful, we'll simply replace one bureaucratic maze with another. The ones who will suffer most are our most vulnerable—our elders from culturally and linguistically diverse backgrounds, those least able to navigate complexity or advocate for themselves.

The dignity of our elders must never depend on their ability to decode government bureaucracy. While the aged-care changes provide some positive relief, such as the $25,000 payment to help recipients spend their final three months at home and a new 12-week program to help when recovering from an illness or injury, what measures are in place to ensure a change such as capping admin fees to 27 per cent, which is designed to leave more funds to spend on care, doesn't drive perverse behaviours from providers who may increase their prices to recoup their costs? I call on the government to ensure this new system works with people, not against them. That means investing in frontline advocacy, frameworks that ensure provider accountability, accessible translations and face-to-face support that is culturally appropriate—not just digital portals, fragmented service delivery and policy papers.

In Fowler people don't need more announcements; they need a system that delivers. The dignity of our elders is not negotiable. It's time the Albanese Labor government matched its words of reform with real action for the families of Fowler and those in western and south-western Sydney to ensure that no-one will be worse off or left behind under the new-aged care system.

Luke Gosling (Solomon, Australian Labor Party) Share this | Link to this | Hansard source

Over the weekend Labor's once-in-a-generation reforms to aged care kicked off. It's been a long journey to get here, working closely with older people, their families, carers and the industry to build a system that we can all be very proud of. The new act is a huge step in the transformation to deliver rights based, dignified age care for every older Australian, those senior Australians that we owe so much to. We're putting older Australians at the centre of their care and decision-making, building a high-quality, respectful and sustainable system. For the first time, the act's statement of rights makes sure that older people can make their own decisions about their own life and have their decisions not just accepted but respected. From bigger budgets to separate streams for home modifications and assistive technology, the new program will deliver more high-quality care to older Australians. These reforms build on the work we've done in our first term and show that we are absolutely committed to fixing the aged-care crisis and that we are committed to seeing it through.

We have already mandated 24/7 registered nursing, delivering more care minutes for older Australians, and there is now a registered nurse onsite in aged care more than 99 per cent of the time, delivering more direct care for over 250,000 senior Australians in aged-care homes. That's 7.1 million additional minutes of care, every single day, compared to when those opposite were in government. We have already invested $17.7 billion towards increasing the wages of aged-care workers. Our government values the critical role workers play in the sector, and we want those willing to join the sector to stay, and to be able to afford to stay, to help deliver the care that older Australians deserve.

Most importantly, we've improved the standard of care. In December 2023, only 54 per cent of aged-care homes had an overall star rating of four or five stars—that is, a good or an excellent level of care. Today, 79 per cent of homes do. Thanks to our reforms older Australians are now receiving more care and better quality care under our federal Labor government. We promised to lift the standard of aged care and we are delivering. After the new act is underway, we'll continue to make sure that residential aged care is meeting the demand of an ageing Australian population and delivering truly equitable, sustainable and high-quality care. We know people want to age at home, and the new act will make sure that they can do that with dignity and quality support, but when they need extra care we'll make sure that there's a bed there when they need it.

We are delivering on our government's election commitment to ensure that more older Australians in Darwin, in my electorate, can access the world-class residential aged care they deserve. Last week an expression of interest was opened to identify our delivery partner for a new residential aged-care home of at least 120 beds in greater Darwin. The government will invest up to $60 million through the Aged Care Capital Assistance Program to build this residential aged-care facility, with the objective of addressing critical supply shortages in aged care in Darwin and to relieve some of the current pressures in our hospitals. This new home will help reduce the number of older Territorians experiencing delayed discharge from our hospitals, and it will also give Aboriginal and Torres Strait Islander elders access to culturally safe care that allows them to stay close to their families in country as well as delivering services to people with complex and high-care needs.

Next month a transformational expansion project for Pearl Supported Care in Fannie Bay in my electorate will open. The Albanese government provided an $18 million capital grant to deliver 26 new aged-care beds in a purpose-built dementia-friendly unit and an age-friendly health and fitness centre, which will help transform aged-care and healthy-ageing services in the Northern Territory. Whether it be our national aged-care reform program that has now been launched, including more support for our seniors to stay at home, the new dedicated dementia-friendly unit or the $60 million for a new aged-care facility in Darwin, we are looking after our seniors.

Alison Penfold (Lyne, National Party) Share this | Link to this | Hansard source

Aged care is a big concern in the electorate of Lyne given its demographics. One of the greatest challenges is staffing and the difficulty providers face in trying to find aged-care workers. I've been contacted by several aged-care facility managers in my electorate, stating that their situation, with respect to staffing, workers and viability, is dire. They've said to me that there is a chronic shortage of both registered nurses and aged-care workers in aged care, which has been exacerbated by the mandated care-minute requirements. I'm told that aged-care facilities have beds that are closed because they can't staff them and therefore can't open them and that there was a mass exodus of qualified, highly knowledgeable and experienced aged-care staff due to the COVID vaccine requirements. But there's also the NDIS, which is a massive competitor. Staff can work fewer hours, do dayshifts or work one on one in the NDIS with similar or at times higher pay than staff in aged-care facilities. An aged-care facility in my electorate told me that, to address the shortage, the vast majority of workers will have to come from overseas.

The government has mandated care minute targets, which is fine, but the government has done nothing on the other side to support aged-care providers in expediting the approval of visas for overseas care workers. To the contrary, the waiting time for the processing of a 407 training visa has blown out from two to three months to 10 months plus. I checked the Home Affairs website today. The figure has blown out even further, with 50 per cent of applications processed in nine months but 90 per cent, the overwhelming majority, processed in 11 months. This is neither a reasonable nor acceptable timeframe.

When I wrote to the government, to the Minister for Immigration and Citizenship, the response I got was that a 10-month timeframe—which has now blown out to 11 months—was normal. This is an insensitive and uncaring response from a minister who seems to not understand the vital role that immigration plays in getting skilled workers for regional aged-care facilities. It is simply not good enough for the minister to have a hands-off approach to the problem. This government cannot work in silos. Has the aged-care minister, who would be well across the issue, sought the assistance of his colleague to help address this issue? Surely the aged-care minister, too, would be ashamed of the delay.

The implications of these staffing shortages are incredibly high waiting times for older Australians, whether that be waiting for an assessment, waiting for approval of a package or waiting to progress to a higher package level. An assessor in my electorate confided to me that, for home-care packages, local aged-care clients can be waiting months to have their assessments completed and, once approved, they are waiting at least six months before being assigned the funding. In addition to this, there is the issue of finding providers and health professionals whose books are not full.

One of my constituents, Dr Peter Ineson, wrote to me about his experience, which I would like to share with you: 'My wife, Ann Victoria, and I moved from Port Macquarie here to Wauchope for a less stressful way of life. We find that to be the case in all aspects of life, except for aged care support. In order to ensure Ann Victoria can live a comfortable and supportive life in Wauchope we have to modify the property for her needs. It would appear that we "need" the visitation and approval of an occupational therapist for any action to process modifications. Finding one of these persons is like looking for a needle in a haystack. We have already been waiting almost two months. Medically my wife is deteriorating rapidly and may well be dead before aged care provides the care and support as defined in the proposed legislation.'

From their initial contact with My Aged Care, clients in Lyne are commonly waiting 18 months before being able to access the home-care package, now called the Support at Home program. There is also very significant concern in the electorate over the co-payment requirement for personal services. Given all that this government says about co-payments—and I can hear the rebukes from the Minister for Health and Ageing from across the chamber—it is this Labor government that introduced the co-payment into aged care. In fact, in health the two co-payments required of Australians, the PBS and Support at Home, are both Labor initiatives. Labor members, next time you take out your green card, remember that, in fact, you are two for zero when it comes to co-payments.

In terms of the co-payment, this is a wait-and-see space. Where these reforms land in one of the poorest electorates in the country is yet to be seen, but I hope the government will ensure it is agile enough to move quickly and act if it proves too much for our older Australians.

Ash Ambihaipahar (Barton, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the government's reforms to aged care that came into effect over the weekend just passed. Every older Australian deserves the same care and respect they gave this country through a lifetime of work, love and contribution. These long overdue reforms put care and respect back at the heart of the system. Everyone with older loved ones has had to battle with the aged-care system at one point or another. It is a difficult transition period and you find yourself confronted by tough decisions around your loved one's health, home and quality of life. On top of this, we have all heard and lived the horror stories unearthed by the Royal Commission into Aged Care Quality and Safety. In the words of the commission, the system was delivering substandard and unsafe care for Australians. It was too focused on providers and institutions and not on the rights, preferences and dignity for older Australians.

These reforms build on the good work we have already completed as a government. We've already mandated 24/7 registered nursing. Because of this, there is a registered nurse on site in aged care more than 99 per cent of the time. We've also invested $17.7 billion to increase the wages of aged-care workers. This means that dedicated staff are paid what they deserve and that their deep knowledge of their residents and the care they need stays in the system. We've also improved the standard of care. In December 2023, only 54 per cent of aged-care homes had an overall star rating of four or five stars—that's 'good' or 'excellent'. Today, 79 per cent of homes do. These new reforms build on this work and further the fight to deliver rights based, dignified aged care for every older Australian.

These reforms include three key changes. Firstly, they introduce a rights based framework. The statement of rights makes sure that older people can make their own decisions about their own lives and have those decisions respected. The statement includes the right for every person to have independence, autonomy, empowerment and freedom of choice, quality and safe funded services, respect for privacy and person centred communication. The Older Persons Advocacy Network calls this reform a 'historic moment' in aged care.

I particularly want to speak to putting older Australians at the centre of decision-making and empowering their choices. Since becoming the member for Barton, I've had many constituents contact my office requesting help with navigating the system. I want to speak to these examples but will change their names to protect their privacy. Paul contacted my office because he had approved level 3 funding in October 2024 but still had not seen that funding flow through by October 2025. Khalid reached out because he believed his case had been given a priority status but had not been able to get a new assessment. In both of these cases, these constituents felt like they were not being listened to when reaching out for help and that their requests had been ignored. Whilst I'm happy to help in these situations, a constituent should not have to get their local MP involved just to exercise their rights. In the first instance, both Paul and Khalid's requests should have been listened to, respected and actioned. This new rights based framework enshrines their voices and wishes in the act. Whilst I'll always be here to support those people, this means that older residents of Barton will be listened to and their choices respected from the get-go. That's what this reform this really about: restoring respect and giving back agency to the people who have given so much to all of us.

On top of this, our reforms also increase support at home. We recognise that many would rather stay in their home than move into assisted living facilities. These reforms will help more people to do that. From bigger budgets to separate streams for home modifications and assistive technology, the new program will deliver a high quality of care to residents in their homes.

Finally, we are delivering extra places to people who do need to transition into residential care. Places will now be directly assigned to older people who have been approved for government funded residential care services. Accordingly, mainstream residential aged-care providers will no longer need an allocation of places. Instead, residents will have more choice and control over which provider delivers their services. This is what good reform looks like: a system that listens, respects and delivers for the Australians who built this country.

Tom Venning (Grey, Liberal Party) Share this | Link to this | Hansard source

On 1 November, this government's new Aged Care Act came into effect, and what did older Australians get? Confusion, chaos and higher costs. There was no proper education campaign and no clear communication about what these changes meant, just bewildered elderly Australians wondering why they were suddenly paying more than before for the same support they were already receiving.

These changes have older Australians concerned that they will have to cut back on essential services because providers can now increase their costs. That's right. For eight months, providers can charge what they like for at-home services as the government will not cap these prices until 1 July next year. What happened to the 'no worse off' guarantee that these changes came with? Older Australians are being forced to pick up essential services, like help with housework, personal care and everyday living support. This is yet another broken election promise, one that comes with catastrophic consequences. This doesn't include the thousands of older Australians who are still waiting for the care they deserve. In total, more than 230,000 older Australians have been stuck, left in limbo, waiting for access to home-care support under Labor. The National Ageing Research Institute has shown that older Australians forced to wait longer than six months for a home-care package face an 18 per cent higher risk of death compared to those who receive support within 30 days. Across the electorate of Grey, families are facing impossible choices and heartbreaking situations due to this government's failure to deliver promised care. The stories I have heard from residents across Grey, both raw and devastating, prove beyond any doubt that we are in the midst of an aged-care crisis.

This is the price of Labor's centralisation and their one-size-fits-all policy approach. What works for cities does not work in small regional towns. Where is the compassion for the spouse who can no longer visit their partner because daily trips are around 400 kilometres return? Where is the plan to ensure that a retired farmer in the far north or a beloved community volunteer on the west coast can age with dignity in the town they love? This is what people in Grey are experiencing every single day—the shortage of essential services from aged care to dental care and child care. It's a failure of responsibility by all involved.

This government's failure to deliver adequate aged care in regional Australia is a betrayal of trust and shows a lack of foresight. Real people with real needs have been left behind by a system that does not properly work for regional Australia. Spouses caring for partners while their own health deteriorates, adult children forced to leave their careers to become full-time carers, families stretched to the breaking point—these changes only add to the burden they are already carrying.

When we talk about aged care in the electorate of Grey, we're not talking about statistics on a spreadsheet in Canberra. We're talking about the women who volunteered at the local CWA for 40 years, the farmer who built this community with his bare hands, the teacher who educated generations of our children. These are the people who have made our towns what they are today. They deserve better than confusion about new legislation. They deserve better than broken promises. They deserve better than a government that treats regional Australia as an afterthought. These changes have added another hurdle to an already difficult system for regional Australians to navigate—without proper education, without price protections for eight months, without adequate support. This government has let our elderly down. It can be the difference between living with dignity in the community you love or losing everything you've built over a lifetime. Our elderly built regional Australia. Now, it's our responsibility to ensure they can age in it with the support and dignity they deserve.

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

There being no further speakers, the debate is adjourned and the resumption of the debate will be made an order of the day for the next day of sitting.