Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Aged Care, Disabilities and Carers) Share this | Hansard source

Labor welcomes discussion on the Aged Care Amendment (Residential Care) Bill 2006. It is largely technical in nature but has some policy implications which we need to discuss. Schedule 1 of the bill is to amendthe Aged Care Act 1997 to harmonise aged care and pension assets tests in relation to income streams and gifted assets under the asset test for entry into permanent residential aged care. This was announced in the 2006-07 budget and is largely non-controversial, and Labor will support the measure. Schedule 2 of the bill amends the act to allow the secretary to delegate specific members of the aged-care assessment teams—the ACATs, as they are known—the powers under the Residential Care Subsidy Principles 1997 to increase the maximum number of days allowed for a care recipient to receive residential respite care. This is also non-controversial, and Labor will support this amendment. The measure to delegate authority to specified members of the ACATs allows those members to react in a timely way to events that individual families are facing. Often families in respite are, for a range of reasons, in somewhat of a crisis, and people need extended care for all sorts of emergency situations, so we support this measure.

The bill was referred by the government to the Senate Standing Committee on Community Affairs for inquiry. The sector, I have to say, was somewhat bemused by the fact that the reference was made by the government, given the largely non-controversial intent of the legislation. But the committee did its job, undertook an inquiry and recommended passing the bill without amendment. But during the course of the inquiry it was recognised that a very small number of people—people who will move from one facility to another during the course of this legislation taking effect—will receive a different assets assessment when they move to the second facility. I recognise that that is a very small number of people, but I think the sector should be alive to that and alive to the fact that it may cause a little bit of confusion for some people.

The move to align asset testing with pension asset testing was recommended by Professor Warren Hogan in his Review of pricing arrangements in residential care, a report that was handed down in 2004. We know the government provided what was called the short-term response to Hogan in the 2004-05 budget, but along with that was a commitment by the government to develop what is now commonly known as the long-term response to Professor Hogan’s report. That long-term response was intended to address issues of strategic financing of the residential aged-care sector. We know that the government established a committee and that committee undertook a range of consultations, and it is well known in the sector that the long-term response to Hogan—the report developed by that committee—was handed to the previous minister in August 2005.

Here we are, 14 months later, after $1.3 million was spent on that activity, and we have still not seen the report. It is the result of hours of work—from not only departmental officials and the committee itself but volunteer time from the sector—and, in this policy vacuum, frustration in the residential aged-care sector has grown, and it is frustration that the Labor Party shares. It is essential that the government release this paper so that the discussion can be reinvigorated in an informed environment and consensus about the direction we need to take can be found.

Late on Thursday afternoon, a government amendment was circulated in this chamber, and there was a supplementary explanatory memorandum which states that the government’s amendment to its bill is in response to ‘concerns raised in consultations with the community that prospective aged-care residents who purchased an income stream on or after 20 September 2004’ could be financially ‘disadvantaged by the new subsections 44-10(1A) and (1B)’ that were originally proposed. The supplementary explanatory memorandum states:

Changes to pension arrangements announced in February 2004 mean that the then 100 percent aged pension asset test exemption for purchased complying income streams was reduced to 50 percent for products purchased from 20 September 2004.

New subsections 44-10(1A) and (1B) originally proposed would align the aged care asset test with the current aged pension asset test, such that 50 percent of the asset value of the complying income stream would be assessable upon entry into residential aged care.

Currently people entering residential aged care have 100 per cent complying income exemption for income streams. If these assets are now tested at 50 per cent to bring them in line with the aged-care pension assets test and they already have an aged-care assessment that is current for 12 months, they will be disadvantaged. Given the time that we have had to deal with this very late amendment, it is our view that this amendment removes the disadvantage. As a consequence—but we do need to hear the debate on this—it will be supported by the Labor Party.

I cannot let this pass without making some comments about the process by which this amendment and the explanation of this amendment came before the chamber. As I said, the amendment first appeared in the chamber on Thursday and then we had no supplementary explanatory memorandum until mid-afternoon on Friday. In the committee stage of this bill I will want to have from the minister an explanation as to why the amendment was so late. I will want to know when the consultations occurred and with whom. I want to note that this issue was not raised during the inquiry, and it was an opportunity for the department surely to indicate at that time that an amendment was required.

The Labor Party are also moving an amendment today to this legislation. The amendment we are moving will ensure that all aged-care facilities in Australia do actually receive one unannounced support contact every year and that, during this spot check, the facility will be assessed against all of the 44 quality outcomes of the Aged Care Standards and Accreditation Agency. The reason I am moving this amendment is to ensure that the government does its duty by the 166,000 frail older Australians who reside in residential aged care, who deserve the best our society can give, and to ensure the confidence of residents, their families and the Australian public in Australia’s residential aged-care system. Following the revelations of elder abuse earlier this year, the minister indicated that each residential aged-care facility would have one unannounced spot check annually. It has been brought to my attention though that the government intends doing the spot checks on a reduced number of the 44 quality outcomes of the Aged Care Standards and Accreditation Agency. This is equivalent in my view to taking your car in for a service and the mechanic only kicking the tyres. The newsletter to members of Aged and Community Services Australia on 7 September 2006 carried a report which stated:

In response to the issue of abuse of older people, the [Aged Care Standards and Accreditation] Agency will be conducting more spot checks and it is expected that every facility will receive at least one spot check each year. The procedure for support contacts and spot checks will change from the previous process. The Agency will decide which outcomes are to be assessed prior to the visit and the assessors will be required to keep within this framework. The decision of the outcomes to be assessed will most likely relate to issues raised in the additional information part of the accreditation report and specific outcomes as determined by the Agency. In preparing for a support visit or spot check, members should review the additional information in their report and highlight for action any issues that may have been mentioned.

So not only are spot checks going to be undertaken on a reduced number of quality outcomes but any aged-care facility will have a fair idea of what they will be checked on. The vast majority of residential aged-care providers in Australia deliver excellent care, but this gives poor providers the opportunity to put on their Sunday best in anticipation of a visit. The Australian public deserve to know what the government is planning. At the end of the year the government will be telling the people of Australia how fantastic they are because they were able to undertake all of these spot checks. What the public will not know is that the spot checks will only be done on a reduced number of the current 44 quality outcomes.

Under this government, we have seen a series of scandals in some aged-care facilities. The kerosene baths incident in 2002 and the appalling sex abuse scandal that came to light this year are two that come to mind. After the kerosene baths incident, the then Minister for Ageing, Mrs Bronwyn Bishop, announced ‘a stepped up program of random spot checks’. It is important to ask: what happened? There are about 3,000 residential aged-care facilities in Australia. In 2000-01 we saw 360 spot checks. In 2001-02 we saw 449. In 2002-03 there were 242 spot checks, out of a total of around 3,000 aged-care facilities in Australia. In 2003-04 we saw 553 spot checks and the following year 563. In 2004-05 this meant that one in five aged-care facilities in Australia received a spot check. In my view, and in the view of many residents and their families, this is not good enough. Mrs Bishop said that random spot checks would be ‘stepped up’. Those were her words. Has that been the case? I do not think so. The government should be given one out of five for their effort.

The current Minister for Ageing repeated a similar promise earlier this year. He said that every home will receive one announced visit each year. He went on to say, ‘These spot checks will focus on care standards and provide an incentive for consistent delivery of high-quality care.’ Labor called for one spot check on every facility every year back in 2001. Finally the government seems to have picked up Labor’s policy, even though it is five years too late and after several appalling incidents in residential aged-care facilities. Labor want to ensure that these spot checks actually happen and that facilities are checked with regard to all of the care services that residential aged-care providers provide. That is the basis for our amendment. It puts the government’s rhetoric into legislation. Since the minister’s announcement at the May budget this year, we saw 142 spot checks in May and 139 in June. But it seems we have a new category of spot check: a partial spot check. The minister wants to do these spot checks on a reduced number of the 44 quality outcomes of the accreditation agency—for example, you might look at privacy and dignity but not look at nutrition and hydration; maybe you assess infection control but not the issue of adequate staffing.

I would have thought the public’s expectation would be that spot checks would be undertaken on all 44 quality outcomes—that a spot check actually means an assessment of the facility’s compliance with all elements of quality care. If the minister wants to ensure that all aged-care facilities receive a spot check every year, instead of cutting the number of quality outcomes inspected he needs to work with the accreditation agency to ensure this can be undertaken against all 44 quality outcomes. Yet again, we see the Howard government and the Minister for Ageing trying to pull the wool over the eyes of the public.

Only recently, an aged-care facility in Victoria failed 30 of the 44 quality outcomes. The accreditation agency said in its report on the facility: ‘Given the widespread non-compliance against the accreditation standards, the agency considered whether the home should have its accreditation revoked.’ Instead, the only penalty the facility received was a reduction in its accreditation period by four months. What sort of confidence does this give the Australian community in the delivery of quality care in our community?

The minister needs to come clean and tell the Australian public what his real intentions are. These frail Australians and their families are reliant on his government to provide quality care in Australia’s residential aged-care facilities. But all the minister is requiring the agency to do is to kick the tyres and not do a thorough assessment that would go some way towards assuring that quality care is provided to the 166,000 residents in aged-care facilities when they require it most—when they are frail and feel powerless.

I will be moving an amendment to ensure that each residential aged-care facility has at least one unannounced spot check annually, that no notice of the spot check is given and that the facility is assessed against all 44 expected outcomes of the Aged Care Standards and Accreditation Agency. This is only what frail older Australians and their families would expect of our government at the time of their greatest need. The minister must ensure that residents, their families and the public can have greater confidence in the quality of care. The Howard government needs to be held to account, and this amendment will ensure that the rhetoric of this minister and previous ministers is delivered upon.