Chris Ketter (Queensland, Australian Labor Party) Share this | Hansard source

I rise to speak on the Aged Care (Single Quality Framework) Reform Bill 2018. If there was one area of government policy which one would have thought required bipartisanship it is the care of aged Australians. I think this an aspect of the debate that is being neglected at the moment.

On this side of the chamber we are passionate about our aged-care sector. I have no doubt that on the other side there are people who care about this issue, but the evidence is that this government has presided over an aged-care crisis for five years, which includes not only a crisis in the residential system and the home care system but also a crisis in relation to the workforce. This government is doing nothing to address the crisis in our aged-care workforce. So we all need to be committed to improving the aged-care system. It is one thing to talk about standardising the quality framework across the various parts of aged care; that is important, but I would suggest that the average Australian is more concerned about whether the standards can actually be delivered for their loved ones out there in the sector.

We on this side of the chamber have a track record in relation to bipartisanship. In the previous Labor government there was a lot of consultation involved and there was a hand extended to the other side to get involved in policy formulation. I understand that our Living Longer, Living Better reforms were the result of attempts to bring bipartisanship to this sector. We delivered our $3.7 billion Living Longer, Living Better reforms in our last term in government. For the benefit of those listening to this speech, I just want to recap some of the aspects of that $3.7 billion program.

It included $955.4 million to help people stay at home through an integrated home support program; more home care packages with new levels of packages; greater choice and control through consumer directed care available across all new home care packages; fairer means testing arrangements for home care packages; $54.8 million to help carers access respite and other support; $660.3 million to deliver better residential aged care through more residential care facilities to be built; supporting the viability of services in regional, rural and remote areas; trialling consumer directed care in residential aged care; strengthening means testing for residential care by combining the current income and asset tests; establishing a new Aged Care Financing Authority and improving the Aged Care Funding Instrument; $1.2 billion to strengthen the aged-care workforce; $39.8 million to support consumers and research through empowering consumers through advocacy; better connecting the lonely and socially isolated; improving the knowledge of older peoples' care and support needs; and $80.2 million to ensure better health connections through complex healthcare multidisciplinary care service innovation. So it was a comprehensive package.

We invite those opposite to steal our policies from time to time. Unfortunately, that doesn't happen often enough. But we do have a proud record of investing in aged care, in our seniors and in age pensioners. But that is no surprise to anybody who has an interest in support for communities: people would know it was Labor that legislated for industry superannuation, it was Labor that legislated for the Medicare safety net and it was Labor that began the National Disability Insurance Scheme. I want to take a brief moment here to pay tribute to the phenomenal work that the Hon. Jenny Macklin did in conceiving the scheme along with our federal Labor leader, Mr Shorten.

Labour supports measures intended to make later life better for Australians. They have earned it. That is why we are supporting this bill, which amends existing acts to provide for a single set of Aged Care Quality Standards to apply across aged-care providers and the Aged Care Act and varies the functions of the CEO of the Aged Care Quality Agency to reference the new standards. The new standards will come into effect from 1 July next year and will cover three different areas: residential aged care, home care and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program quality review.

However, I do want to point out some of the concerns that we have in this area. The government has dragged its feet on these reforms, as it has in so many other important reforms—payday lending, banking accountability and superannuation just to name a few. It is Labor who has had to drag this government kicking and screaming to these reforms. These particular reforms that we're considering today have been talked about since 2015. But it is only now in 2018, three years later, that the government is bringing them to the parliament. Perhaps if this chaotic government spent less time on shuffling the deck chairs and infighting, Australians—particularly older Australians in need of care—would get the attention and respect they deserved. Labor also has concerns about the extension of the Freedom of Information Act 1982 to exempt some documents from disclosure. With scant details on what these exemptions would be, Labor has ongoing concerns about the transparency and truthfulness of this government. I will touch on that a bit later on.

As I've indicated, we have an aged-care system in crisis. There are significant challenges ahead of us in this industry. We have 2.49 million people, or over 10 per cent of Australia's population, who are aged 70 or over as at the 2016 census date. By around the year 2050, I think that proportion is set to double. Around 20 per cent of the population will be aged 70 or over. As at 30 June this year, over 200,000 people were living in residential aged-care facilities. We know that this is a sector that requires a lot of government support; $17.4 billion was spent by governments on aged care in 2016-17 and 69 per cent of that was for residential aged care. We know that women outnumber men in aged-care services two to one. That is because women live longer and have higher care needs. On average, people spend 2½ years in permanent residential care, just over 1½ years in home care and one month in respite care. Aboriginal and Torres Strait Islander people account for less than one per cent of all people in permanent residential care and four per cent of people in home care. These statistics just illustrate the size of the issue that we are dealing with.

In delivering our landmark aged-care reforms, the Living Longer Living Better package, Labor acknowledged a number of challenges in the aged-care sector. These included the matter of choice. We recognised that older Australians often preferred to age at home. We provided more support to enable them to make that choice. We recognised inequities in the cost of residential aged care and took steps to ensure more protection for the most vulnerable. We recognised that volunteer carers, a critical part of our aged-care system, needed more support. We strengthened links between aged care and the wider health system, particularly with a view to improving support for the increasing number of Australians diagnosed with dementia and Australians requiring palliative care.

A key feature of our reform was to recognise and take steps to address the workforce pressures in the aged-care system—namely, the need to attract and retain trained, qualified staff in the sector. I think we need approximately three times the number of people we currently have working in our aged-care section. To this end, Labor committed $1.2 billion over five years for an aged-care workforce productivity strategy, including a workforce compact to improve wages across the sector. Those opposite will recall that in 2013, almost immediately upon attaining government, this was one of the very first measures that the Abbott government sought to scrap. I will be coming back to this later when I talk about the dismal record of those opposite when it comes to appropriate wages for the workers in our country who look after our most vulnerable people.

Continuing with the challenges that we have in this sector, the issue of dementia is first and foremost. Most people nowadays have a family member or know of a friend, a work colleague or an acquaintance with experience of dementia, whether it's age related or the tragedy of younger onset dementia. I want to echo the words of Mr Shorten, who said in November last year that 'tackling dementia will be a defining health and aged-care challenge of the next generation' and that it is 'our generation's duty' to get started on it. In what was a seminal speech, Mr Shorten identified that this is a matter which has touched him quite deeply, and I think he has a genuine concern about this particular issue. He pointed out in a recent speech that a NATSEM report has estimated that dementia costs Australia over $14 billion a year. The same report found that even a five per cent reduction in the number of people with dementia over the age of 65 could lead to savings of $120.4 billion in less than the next 40 years. However, if we hold to our present course, more than 500,000 Australians will have dementia by 2025 and more than a million of us by 2050.

One in three Australians born today will eventually be diagnosed with dementia. Already this year, for the first time, dementia is now the leading cause of death for Australian women. Within the next five years, it will be the leading cause of death for all Australians. This means that we need better standards and training for residential facilities and for in-home care, and we support the elements of this bill that address that. It's estimated that 70 per cent of people in residential aged care have dementia, so everything we do in aged-care policy has to link up with dementia policies. Senator Burston touched on some of the reports of elder abuse or substandard aged care that have occurred and that we hear about all too often in the media. Unfortunately, it's possible that they're the tip of the iceberg. This goes to the issue that we do have a crisis in this sector. Mr Shorten noted that addressing this issue is within our grasp. We do have the resources and the capacity to deal with it. We just need to be better at utilising those resources.

I don't need to tell you this, Mr Acting Deputy President Williams, that the challenges of dementia care are amplified in rural and regional Australia. In February this year I instituted, in this place, a Senate Economics References Committee inquiry into regional inequality. The terms of that inquiry are deliberately broad to allow us to examine a whole range of drivers, including health and aged care. Last month, on 29 August, the committee held its first public hearing in Emerald in Central Queensland. I want to take a moment to make reference to a submission that we received from Mrs Gai Sypher to the inquiry. The focus of her submission—and she appeared before us as a witness—was the unsustainability of the aged-care industry in regional and remote regions based on the current business-driven model.

Mrs Sypher is most familiar with the Central and central-west Queensland examples. In her submission she stated that an examination of the data shows that access to residential aged care in remote and very remote communities is extremely limited and that private providers are not found in locations that operate on marginally sustainable business models, such as those you find in remote or very remote communities, so consumer choice is constrained and there is more of a need for legislative requirements and regulation to guarantee access to residential and community based aged care at an acceptable level. Mrs Sypher told us that aged provision in rural and remote areas may be limited to one or two providers who have less need to compete for custom through marketing or self-promotion than their metropolitan counterparts.

Mrs Sypher's recommendation is that it will be important for service providers to collaborate and innovatively develop models of care that will work in rural and in remote areas. She's advocated on behalf of aged people to the federal government to consider all these sorts of things. I wish there was some evidence that the government is taking on board some of these ideas.

Sitting suspended from 18:30 to 19:30

I was speaking about some of the regional challenges associated with our aged-care sector and, in particular, the workforce for the aged-care sector. But, with every challenge, there is an opportunity for regional Australia, and I think that it's important to note that TAFE—which has, for so long, been neglected—provides that opportunity for filling the gap, for training for our aged-care workforce.

Labor is committed to revitalising this long-neglected sector. I've seen this firsthand on my recent visits to regional Queensland, to the Roma campus of TAFE. They have outstanding nursing training facilities there. Unfortunately, they're not being utilised to the extent that we would like them to be, but they are outstanding facilities and I'm sure that they will find students for that campus. I also saw the Townsville campus of TAFE last week. They also have very good facilities. I'd like to commend the Queensland government for injecting $26 million for a new building which is being constructed there at the present time. A couple of weeks ago I visited the Mount Isa campus of TAFE, where they provide courses in relation to health and aged care. It's so important that this training be delivered in regional Australia so that we can have opportunities for regional Australians to age in their locality.

But, in order for us to realise the opportunities that exist with these challenges, we do need a federal Labor government. Even before the chaos of this Liberal-National government claiming another Prime Minister and paralysing positive reforms, those opposite had already started to wreck Labor's aged-care reforms, ripping $2 billion out of aged care and cutting the $1.2 billion Workforce Compact fund.

Unfortunately, the new Prime Minister has not acquitted himself well in this space. In fact, I would argue that he's failed his first test because he has not included aged care in his new cabinet. So this does not give us a great deal of confidence that this issue of aged care and the crisis which is confronting the sector are going to be addressed by this government. In one of his first acts as Treasurer, Mr Morrison slashed almost $500 million from aged-care funding in the 2015 MYEFO. As other speakers have said, we have 108,000 Australians on the waiting list for home care packages, and the latest budget did not deliver one new dollar of funding for aged care. What's most concerning to me—and I think Australians would be concerned—is that, of the 108,000 Australians waiting for home care packages, 88,000 older Australians are waiting with high needs, many with dementia. That is a crisis in anyone's language.

Labor believes in a helping hand for those who need it most. We follow through with our values by investing in affordable health care, education and fair pay for fair work, especially for those workers caring for our most vulnerable Australians. Now more than ever we need a Labor government to restore the balance of fairness in Australia.