Helen Polley (Tasmania, Australian Labor Party, Shadow Assistant Minister to the Leader (Tasmania)) Share this | Hansard source

I appreciate the opportunity to outline Labor's position on the government's Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018. Labor supports these bills. However, in saying that, I will raise a number of concerns. But, firstly, I would like to thank the minister for facilitating a briefing to Labor on this bill. We are grateful that he extended that invitation. These bills are a consequence of the Carnell-Paterson review that was handed to the government in October last year. The Carnell-Paterson review recommended bringing together the functions of the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner. This was one of 10 recommendations included in the Carnell-Paterson review.

The purpose of the Aged Care Quality and Safety Commission Bill 2018 is to establish a new Aged Care Quality and Safety Commission from 1 January 2019. The new commission will be tasked to help restore the confidence of aged-care consumers in the delivery of aged-care services given the context of recent public concern. The new commission will provide a single point of contact for aged-care consumers and providers of aged care in relation to quality of care and regulation. It will be responsible for accreditation, assessment and monitoring, and complaints handling of aged-care services and Commonwealth funded aged-care services. These aged-care services include all four areas of aged-care services—residential aged care, home care, flexible care services, the Commonwealth Home Support Program and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program.

The new commission will be led by a statutorily appointed Aged Care Quality and Safety Commissioner, who will be advised by the Aged Care Quality and Safety Advisory Council. The commissioner will be appointed for a term of five years. The bill also establishes that the commissioner may seek and consider clinical advice. This would take the form of an expert clinical panel that would support the work of the commission. I also acknowledge that funding of $16 million will be allocated to the new commission.

The second bill, the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018, provides for the administrative matters required to transfer the functions and operations of the existing authorities to the commission. This bill also provides for the continuation of the appointments of the members of the existing Aged Care Quality Advisory Council for the remainder of their current term as new members of the Aged Care Quality and Safety Advisory Council.

I mentioned that Labor has a number of concerns regarding these bills. Firstly, we on this side are concerned about the length of time it's taken the government to introduce legislation into the parliament. The Carnell-Paterson review was handed to the government almost a year ago. This is unacceptable. It is now November, and this new commission is set to be operational in around eight weeks. Why has there been a hold-up? Labor has not at any stage impeded the passage of this legislation being introduced into the House. We know that the bills are important in restoring the confidence of older Australians, their families and carers.

As already mentioned by the shadow minister in the other place, these bills are also a missed opportunity for the government to give the new commission stronger arbitrary powers given the level of public concern in relation to service providers. What the public don't want to see is another toothless tiger. Labor believes it is a shortfall of the government that it didn't consider giving the new commission greater arbitrary powers.

Since the introduction of these bills into the parliament, the government has announced it will establish a royal commission into aged care. Labor supports the royal commission, but the Liberals can't wait for the royal commission to finish before they start genuine reform to fix the aged-care crisis made under their watch. I also want to take this opportunity to raise the terms of reference for the royal commission. The Leader of the Opposition and the shadow minister wrote to the Prime Minister back in September to request the broadening of the terms of reference. We are pleased that the Prime Minister listened to Labor and adopted a number of the suggestions we put forward, including long-term sustainability of the sector, funding and the aged-care workforce. Of some disappointment was the Prime Minister not supporting the inclusion of retirement village living as part of the terms of reference. We know that older Australians living in retirement villages are increasingly receiving home care services. We are also pleased that there is an opportunity for the royal commission to examine the impact of the Liberals' years of cuts. You don't fix aged care by cutting it.

Labor has been saying for a long time that the aged-care system is in a state of national crisis. When the Leader of the Opposition said this in the parliament in May, the government likened it to committing elder abuse. We are glad that they are now listening and have changed their minds. There have been more than a dozen inquiries, reports and reviews into the aged-care sector which the government hasn't acted on, many of which have been sitting on the desk in front of the minister. There have been three ministers in five years. They have known about the problems. They have known that this sector has been progressing towards a crisis but have done little, if anything, to act. With three ministers in five years and billions cut, the government has ignored dozens of its own reports and reviews on what is needed to fix the problems we know about with aged care. We already know what the problems are. These reviews and reports have been allowed to collect dust instead of being acted on. Instead of the minister acting on reform and responding to the plethora of reviews, reports and inquiries, we now have an aged-care crisis and a royal commission. This royal commission is an admission by this government that it hasn't done enough and hasn't driven the reform it should have. This is totally unacceptable. We can't call ourselves a fair and generous country until we give elderly Australians the love, care and respect that they deserve. Whilst the chaotic and divided Liberals have fought amongst themselves, the care of older Australians has been neglected.

On top of the inaction on the reform, we've seen billions of dollars cut from the aged-care sector. This has not helped a sector in crisis. The Prime Minister has been the architect of cuts that have gutted aged care and put the sector under immense pressure. As Treasurer, in his first budget alone, he was responsible for ripping $1.2 billion from the care of older Australians. You cannot rip almost $2 billion out of the aged-care sector over five years and not have an impact on quality. No wonder the system is in crisis! Those opposite must explain to the Australian people how these continuous cuts to the aged-care budget have contributed to the crisis we now face in aged care. Why did the Prime Minister, when he was Treasurer, sign off on a $1.2 billion cut in the 2016 budget? It is deeply concerning that the Liberals responded with cuts, not compassion. Those opposite willingly cut aged-care funding because they don't value older Australians. The Prime Minister must take responsibility for these cuts that are now impacting on the care of older Australians. It's the right thing to do. You only have to look at the budget papers signed off by the Prime Minister when he was Treasurer. His name is on these papers, in black and white. These are the cuts that he is denying. Page 101 of Budget Paper No. 2 of 2016-17 says:

The Government will achieve efficiencies of $1.2 billion over four years …

Older Australians deserve much more than a Prime Minister who cuts funding to aged care and then lies to them about it. Embarrassingly, the Prime Minister continues to crab crawl away from his own cuts. The Prime Minister is pretending he is a recently interested bystander and not one of the key figures in a government that has been responsible for the cuts and for the aged-care crisis that has occurred under the Liberals' watch. The Liberals are too busy fighting amongst themselves to focus on what matters. It's time the Liberals started doing better in this critical area of policy.

I want to spend a bit of time talking about the aged-care reform or, more importantly, the lack of aged-care reform. There is no doubt that there are a lot of things this government needs to do when it comes to aged-care reform. In September this year the Leader of the Opposition, the shadow minister for ageing and I held a round table with around 40 of Australia's leading aged-care experts. This was an opportunity not only for Labor to learn and listen about the issues and challenges but also for us to seek advice about short- and long-term solutions so that we can ensure older Australians are able to access a range of services with dignity and choice. We know from these conversations there is a lot of work to do. Four hours wasn't long enough to talk about all that needs to be done. It is obvious that the government has dragged its feet on reform. It has been slow paced and has mismanaged every part of the reform process.

What we are very concerned about is that the government is going to cease doing anything around aged-care reform and wait for the conclusion of the royal commission. This won't do. It won't do because the government is already five years behind on the reform front. Take, for instance, the Carnell-Paterson report. It's been over a year since the release of the report on the aged-care regulation, and in this time the Liberals have done too little to progress this important body of work. The Liberal government has fully implemented just one—just one!—of the report's 10 recommendations. Labor called for the implementation of the one recommendation the government has introduced—unannounced accreditation audits for residential aged-care facilities—six months before the government adopted it. Legislation to enact another of the review's recommendations—the creation of a new Aged Care Quality and Safety Commission—is only being debated in the Senate today. The new commission is meant to begin on 1 January 2019. There's not a lot of time for the government to get their act together. To date, the Liberals have responded to less than half of the recommendations of the Tune review into aged care.

This inaction fits the pattern of the Liberal government, which has sat on more than a dozen reports and reviews into the aged-care sector and done very little. It is crucial to the future of the aged-care sector that families have faith and confidence that their loved ones will be safe and receive high-level care in residential homes. The Prime Minister and the Liberals need to do better—much, much, better.

Then there's the work around the workforce that hasn't even been started. The minister sat on the Aged Care Workforce Strategy Taskforce report A matter of carefor more than two months after the chair, John Pollaers, handed this strategy to him. Ironically, this strategy was only made public after the shadow minister sent out a media release having a go at the minister for sitting on this reform document. Of great concern is that the government has yet to commit any funding to this strategy. How does the government expect to drive reform without providing additional funding? We know there aren't enough aged-care workers. We know aged-care workers aren't given enough pay, respect or support. We also know there needs to be greater focus on training and education. But that report is sitting idle instead of being implemented and made operational. This is deeply concerning.

The aged-care workforce is expected to increase by 300 per cent in the next 30 years, underscoring the challenges and opportunities of getting this right. Labor has called on the government to immediately implement the workforce strategy and thanks the chair of this report, John Pollaers, for his important work. We also believe that the government must work with the unions and the aged-care providers to implement this strategy to meet growing demand. This strategy must consider issues such as the proposal for 24-hour registered-nurse coverage at residential aged-care homes.

In regard to staffing arrangements in residential aged-care homes, the role of nurses and personal-care workers in the care of older Australians is critical and will only become increasingly important. Labor also understands the important role of other health professionals, such as GPs, occupational therapists, physiotherapists and dietitians. All have a very important role overall in the wellbeing of older Australians. We will need to see a tripling of the aged-care workforce in the next 30 years to provide a high standard of living and care for this growing proportion of older Australians. Whether it is from the aged-care providers, workers or consumers, the message has been consistent: this government must take action to ensure we have an adequately skilled and equipped aged-care workforce to care for our rapidly ageing population.

Another area mismanaged by this government is the home care package waiting list. Outside of residential aged care we have the majority of older Australians, who are receiving care in their homes. Under the government's watch, there are now more than 121,000 people on the home care package waiting list—including 96,000 people with high needs, many living with dementia. Around 56,000 of these older Australians waiting have no home care package at all. It's a disgrace. As I've said, the release of the June 2018 data sadly reveals that there are now more than 121,000 older Australians waiting for a home care package. These numbers are shocking. It is now clear that the government and the minister have failed to curb the growing home care package waiting list and are not doing enough.

A bigger concern is that the minister has deliberately delayed releasing the March and June data. The March data was delayed by more than three months. The June data was also delayed. The government continues to cherrypick its way through the figures so as to paint a rosy picture rather than to reveal the reality of the waiting list. This is a sad reflection on the government and on how it prioritises the care of the most vulnerable Australians. It doesn't matter how the government and the minister try to spin their data, the numbers are clear: there are more than 121,000 people still waiting for care. The average wait time, according to the government's data, for a level 3 or level 4 package is still more than 12 months. We know that some older Australians have been waiting more than two years for care. The Department of Health has previously committed to releasing the data two months after the period that the data covers. To delay the data without any reason is intolerable and unacceptable. There is no excuse for continuing to delay the release of any future data. I note that the next round of data should be due any week now.

Labor does support these bills. We also remain committed to working with the government and the aged-care sector to ensure that older Australians can age safely, happily and with dignity, whether that is in residential care homes or in their own home. Labor again puts the government on notice that, even though it has announced a royal commission into aged care, it must continue all of the important reform work it has before it. I would also like to put on record my thanks to Senator Griff for his genuine interest in this area and for the good intentions of his second reading amendment. I give the senator credit for what he is trying to do, but Labor will not be supporting the amendment being put forward. Again, I reiterate: Labor will be supporting these bills, but we put the government on notice: I really don't want to see the next round of data, which is due anytime, released on Christmas Eve.