Rachel Siewert (WA, Australian Greens) Share this | Hansard source

I rise today to speak on the Aged Care Legislation Amendment (Emergency Leave) Bill 2020. This bill introduces emergency leave for residents living in aged-care facilities. At the moment residents have 52 days social leave during which they can leave the facility—for example, to stay with family members or others. However, if a resident spends more than 52 days away from the facility, providers can ask residents to pay a fee to reserve their place. This creates problems during emergency situations, such as the current coronavirus pandemic, when residents decide to temporarily leave a facility to live with family members instead.

This bill enables the Minister for Aged Care and Senior Australians to make a determination about an emergency situation for a specific area and a specified time period. Once an emergency has been declared, residents in the aged-care facilities can access emergency leave and don't need to use up their 52 days of social leave. It also prevents aged-care providers from charging residents to reserve their place in an aged-care service during declared emergencies. The determination can relate to a natural disaster, pandemic, epidemic or other large-scale emergency that might impact on the safe provision of aged care. It can be made at a national, state, territory or individual service level. The bill also allows for retrospective payments of the residential care subsidy to be made to affected services for residents taking emergency leave.

The Australian Greens support this bill. It ensures older Australians aren't unfairly disadvantaged if they decide to move back in with their family during, for example, this pandemic. I hope that the flexibility built into the legislation will allow the minister to enable emergency leave during a wide range of scenarios. However, there are still some gaps in our legislative process that I would like to address today, hospital leave being one of them that I have raised on a number of occasions in the past. I will note that I've had a lot of complaints from people about it.

I would like to go to address this issue of hospital leave. Long-standing issues around hospital leave have become even more apparent in this coronavirus pandemic. If you take leave from a residential aged-care facility to go to hospital you are still charged fees and daily accommodation costs. After 29 days of hospital leave, residents may have a reduction in their means-tested care fee. Quite frankly, it is unreasonable that older Australians continue to pay fees for day-to-day services such as meals, cleaning and laundry when they are in hospital. It's also unfair that they are charged fees for extra services clearly not being used at the time.

That brings me to the point that yesterday we learned that the federal government has ordered Bupa to pay $6 million in penalties and millions more in refunds for residents who have paid thousands of dollars a year for services they have not received. I have raised the issue of providers charging residents for extra services a number of times at Senate estimates. I welcome the federal government's decision, but it shows that we desperately need greater oversight of when the so-called extra fees are charged and what they are charged for. If someone goes to hospital for coronavirus, they shouldn't be required to pay fees for services and care they are not receiving. Instead, there should be an option to freeze or waive residents' fees while on hospital leave, especially during a declared emergency. Older Australians deserve better, and I hope that the government will address this issue urgently.

One of the key issues raised when I was talking to people about this bill is that it doesn't address other types of aged-care services, including home care and CHSP. We don't want older Australians to abandon their home-care services. The coronavirus crisis is a critical time for many older Australians living at home and we have to ensure that they are supported. The crisis does raise questions about choice and control around aged-care services during emergencies. Under the Charter of Aged Care Rights, older Australians have the right to have control over and make choices about their care, and the right to exercise their rights without it adversely affecting the way they are treated. While some aged-care providers may be flexible in delivering services during this coronavirus crisis, there is no guarantee this is happening across the board. I would like to see the government allowing flexibility in the way that home-care packages are used and delivered during emergencies.

There are also issues around how we notify older Australians when they have been offered a home-care package. At the moment, older Australians receive a letter when they have been assigned a home-care package. They must respond to the letter within 52 days of its date. I have concerns around this time frame given we are experiencing postage delays across Australia because of coronavirus. I will be seeking assurances from the government around this time frame during a short committee process. I have a couple of questions that I want to get on the record. I want to go to issues raised in some of the aged-care inquiries that have been undertaken by the Community Affairs Committee and some of the recommendation have been made.

We are deeply saddened by the situation at Newmarch House, a residential aged-care facility. Newmarch House has highlighted how things can go wrong. Last year, the Senate finished an inquiry into the 'effectiveness of the Aged Care Quality Assessment and accreditation framework for protecting residents from abuse and poor practices, and ensuring proper clinical and medical care standards are maintained and practised'. Yes, it's a mouthful; it's also a very important issue. As noted in my second reading amendment, which I should indicate has been circulated, the recommendations from the clinical care inquiry highlight some of the urgent reforms that are still needed to be undertaken in aged care. The committee recommended the development of benchmarks for staffing levels and skills mix. We know that aged-care facilities suffer from chronic understaffing and under-resourcing. Sadly, the coronavirus crisis has highlighted this problem.

Last week, the Australian Nursing and Midwifery Foundation found that three-quarters of aged-care staff surveyed said there had been no increase in staff or hours during the coronavirus pandemic. Aged-care staff are trying their hardest. We give a strong shout-out to all the people that are working in aged care right now. But, without enough stuff with the appropriate skill mix, they are always going to be struggling to provide the best care that they can. The national average of care provided is around two hours and 50 minutes per resident per day. This falls significantly short of the four hours and 18 minutes a day required to provide a safe environment for residents. I appreciate that the government is funding the deployment of emergency response teams to aged-care facilities. I very strongly acknowledge that and thank the government for that. However, these are only temporary measures. I strongly believe that adequate staffing levels and skill mixes would allow us to better manage the risks of coronavirus and, in the longer term, once we get past this, the proper care that older Australians deserve in residential care.

The Community Affairs Committee also recommended that the government work with the Aged Care Quality and Safety Commission to drive continuous improvement in quality and safety in aged care. The quality and safety commission provides a critical role of oversight in aged care, especially during the current pandemic. These responsibilities must go hand-in-hand with a framework for aged care that provides continuous improvement through evidence-informed best practice. As the royal commission into aged-care quality and safety highlighted, our aged-care system is in a shocking state of neglect. Short-term interventions are just not enough. There needs to be more to deliver an aged-care system that meets the needs of older people. Our system needs fundamental reform and redesign, which must be underpinned by a continuous improvement approach. Some of the other recommendations made by the committee include the implementation of a clearly articulated principle that the duty of care for regulation of residential aged care rests with the quality and safety commission, and that relevant government agencies and stakeholders work together to develop an industry model of care and work collaboratively to achieve better integration of aged care with primary health and acute-care services.

On behalf of the Greens, I move the second reading amendment on sheet 8964:

At the end of the motion, add:

", but the Senate:

(a) is of the opinion that:

  (i) this bill does not address the issue of hospital leave, meaning aged care residents will still be required to pay fees and daily accommodation costs while they are on hospital leave during the coronavirus pandemic, and

  (ii) the roll-out of home care packages should not be delayed by the coronavirus pandemic;

(b) notes that the Community Affairs References Committee presented its final report on its inquiry into the effectiveness of the Aged Care Quality Assessment and accreditation framework for protecting residents from abuse and poor practices, and ensuring proper clinical and medical care standards are maintained and practised on 3 April 2019, to which the Government is yet to respond; and

(c) calls on the Government to:

  (i) accelerate the roll-out of home care packages to expand the number available to older Australians, and

  (ii) urgently respond to and implement the recommendations of the final report of the Community Affairs References Committee inquiry, particularly recommendations 3, 5, 6, 8 and 14".

This highlights that the government must address these issues urgently. I sincerely hope that the government revisits these inquiries into aged care so that we can start implementing urgent reforms and better protect older Australians throughout the coronavirus pandemic. I would like to end with another call-out to workers in our aged-care facilities and home care, who are providing so much important care and support for older Australians.