Stirling Griff (SA, Centre Alliance) Share this | Hansard source

Centre Alliance supports this bill, the Aged Care Quality and Safety Commission Bill 2018, as I'm sure every senator and party in this place does. It puts in place a beefed-up aged-care commission as part of a new regime that we expect will provide much better oversight and regulation of aged care. This bill creates the Aged Care Quality and Safety Commission, which will be headed by an independent commissioner and will combine the functions of the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner. Following a second tranche of legislation next year, this new entity is also expected to take on the regulatory functions of the department from 2020. This was a key recommendation of the Carnell-Paterson review of national aged-care quality regulatory processes, which was critical of the fragmented regulatory system we now have. The review itself came in the wake of the appalling treatment of vulnerable residents at Oakden, in my home state. The inexcusable conditions residents endured, the abusive and negligent treatment they suffered and the agony their families still feel are what drive us here today. Every step we take to improve the residential aged-care system is one more step towards making sure that that horror is never repeated. We support this bill and we are relieved that it doesn't end there. There are measures on the horizon for performance ratings and a general embrace of greater transparency.

But, in saying we support the bill, we can also see a few areas where some minor improvements can be made. To start, we intend to amend the government's amendment, which in part provides for the role of a Chief Clinical Adviser—again, as recommended in the Carnell-Paterson review. We absolutely support the creation of this position to provide clinical leadership and assist the commissioner, but we note that the government hasn't stipulated the baseline skills required of the appointee. It is, instead, relying on the job description in the explanatory memorandum to do that. Normally that may not be an issue, but it's not a foolproof system. By way of a similar example, for about 10 months the Acting Chief Medical Officer's role in the home affairs department was filled by a senior department official who was not a doctor—this is despite the obvious description of the role—and yet she was meant to advise the department of the health issues of asylum seekers, refugees and Border Force personnel. So, while everyone fully expects that the Chief Clinical Adviser will, in fact, always be a medical specialist with expertise in aged care, I would feel more comfortable seeing it in black and white so we don't end up, somewhere down the track, with someone like a senior public servant with no medical training sitting in that important role.

We have a second reading amendment that voices our intention that aged-care providers be required to publish on their own websites any noncompliance, notifications or sanctions they have received and to do this in a timely way. We believe this information should be on a provider's website as well as the My Aged Care website to make it easy for families and residents to check the provider's status and be able to act on it if desired. No doubt, this is something most of us agree should happen, and Centre Alliance will continue to push for this to become a reality. A recent search of the My Aged Care website showed there were 55 providers across Australia who had been issued with noncompliance notifications and 19 providers had current sanctions against them, but only one of those 19 referred to their sanction on their own home page. Sanctions can mean there was an immediate or severe risk to the health, safety and wellbeing of residents. It is self-evident that we need to make it easy for families and care recipients to know about them.

I'm pleased to flag that we will also support the Greens amendment that would allow the commission to disclose the number and type of staff employed by aged-care providers. We had planned to circulate a similar amendment to reflect a private member's bill that my colleague Rebekha Sharkie had circulated in the other place. As we know, staffing levels are a critical issue when it comes to delivering good quality aged care, including the number of nurses and allied health professionals who will ensure the ongoing health and medical needs of residents. What we saw at Oakden was the opposite of this, where abuse flourished under a regime where there were nowhere near enough skilled staff to manage the complex needs of its residents. This minor addition to the legislation is all about transparency. When it comes to staffing numbers, disclosure can be a very useful signal of whether the service is providing the level of care that is expected by us all.

There are significant risks to residents from inadequate staffing numbers: increased medical errors, increased risk of bed sores and malnutrition, and higher risk of falls and choking, all leading to preventable deaths. Falls reflect a lack of adequate staffing as it means residents are getting around without sufficient assistance. Choking episodes can also reflect a lack of adequate staffing as it can indicate residents are being fed or are self-feeding without appropriate assistance. Weight loss of more than 20 per cent from admission is also a concern, especially in residents with dementia and, again, it can reflect a lack of adequate staffing as residents with dementia need to be fed because they lack the drive to feed themselves.

This bill is only the start of a long journey towards a better aged-care system. We expect further legislation next year and will no doubt see more reform once the Royal Commission into Aged Care Quality and Safety delivers its findings in 2020. But we also know that there is more that government can do now without waiting for more reasons or more evidence. For instance, it can do much more to tackle preventable deaths, such as those caused by falls or by choking. How might this happen? Quite simply, at admission all residents should have a falls risk assessment and a plan made for managing this. All residents should also have a swallowing risk assessment and a plan made for managing this. In addition, residents should also have a pressure sore risk assessment and a plan for this. Their weight should be monitored to ensure they are eating enough and are not at risk of malnutrition. Every six months, these plans would be reviewed to ensure they are kept up with the residents' changing health and needs. We should also mandate that aged-care facilities report critical incidents, such as the rate of falls and the rates of choking per 100 residents and that these reports are made publicly available on the My Aged Care website. These are two very simple and effective measures that can move everything forward in a positive way.

As I mentioned before, this is a continuous journey of improvement, so I urge the government to continue on the positive road it's on, but to also take up more stringent monitoring of key welfare outcomes and very much the public reporting of these. Once we get that right, it means neglectful hellholes like Oakden and its ilk will have nowhere left to hide. I move:

At the end of the motion, add:

", but the Senate calls on aged care providers to publish on their websites details of any sanctions imposed on the provider and any notices of non-compliance issued against the provider as soon as possible after the sanction is imposed or the notification is made.".