Jenny McAllister (NSW, Australian Labor Party, Shadow Cabinet Secretary) Share this | Hansard source

Labor will be supporting this bill. As outlined in the explanatory memorandum, the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020 amends the administration arrangements of paying home-care subsidy to approved providers. This is the next phase of amendments to the home-care payment arrangements. The first bill changed the payment of home-care subsidy to approved providers from being paid in advance to being paid in arrears.

Under this bill, home-care providers will only be paid subsidy for the care and services delivered to a home-care recipient during a month, with Services Australia retaining the unspent subsidy which a home-care recipient is eligible to receive each month. This changes the current arrangement so that the Commonwealth, rather than the approved service providers, will hold the unspent funds. The explanatory memorandum states these changes will provide for better transparency in the use of home-care funds.

The bill will introduce a mechanism whereby providers who elect to return unspent funds can start doing so within six months of the bill coming into effect. Providers who elect to return unspent funds will do this through a 100 per cent subsidy reduction until the unspent funds are exhausted. Any unspent Commonwealth subsidy withheld as a result of this bill will be available for a provider to draw down on behalf of a home-care recipient as care and services are provided in the future. There is no change to the consumers' access to their full subsidy and no change to the treatment of consumer contributions. In the lead-up to the introduction of this legislation, the Minister for Aged Care and Senior Australians sought the advice of ACFA. I understand the government is expecting to implement these changes by September 2021.

I do want to put on record Labor's concerns. Firstly, there has been a growing concern around the increasing amount of unspent home-care funds currently held by the approved provider. These unspent funds are a combination of the Commonwealth subsidy and consumer contributions. According to the Aged Care Financing Authority in its eighth report, released in July this year, unspent funds continue to increase significantly, with home-care providers holding $751 million at 30 June 2019, an increase of 39 per cent from the previous year, when $539 million was held at 30 June 2018. ACFA estimates that, based on the current rate at which unspent funds are increasing, these funds could be around $1 billion by 30 June 2020, although they may be even higher, due to some consumers putting their services on hold during the COVID-19 pandemic. According to aged-care accountants StewartBrown, the average unspent funds per client are approximately $7,000.

As with the first bill, there remains an increase in financial risk for some smaller service providers and those in regional, rural and remote areas that don't have adequate cash flows to deal with the payment changes and are unable to hold unspent funds. As suggested in the ACFA report, some service providers may have to revert to finding other financing arrangements, including loans and equity injections. Some service providers are concerned that, as a result of cashflow pressures arising from changes, they may be reluctant to take on new consumers during the transition phase. With the Royal Commission into Aged Care Quality and Safety to hand down its final report in February next year, more reform may be required for the home-care payment system.

This leads me to the Morrison government's lack of serious reform across the home-care system. We know that the Morrison government has turned its back on older Australians who are waiting for care and support in their own homes. If the Morrison government really cared, it would have done more for older Australians. This month marks the fourth anniversary of the government's reforms of increasing choice in home care. Almost four years on, the question is: what has been achieved for older Australians who are choosing to receive aged-care services in their own homes? Well, there's not much to show for it, is there? These reforms have done nothing to address the growing waitlist for home-care packages. Consistently there have been 100,000 older Australians waiting for their approved home-care package over the past two years. More than 100,000 older Australians are on a never-ending waitlist. Sadly, more than 30,000 older Australians died over three years while still waiting for their approved home-care package. More than 32,000 older Australians over a two-year period entered residential aged care prematurely because they could not access their approved home-care package. Waitlist times have blown out. Older Australians waiting for their higher-level package are waiting almost three years to get the care they have been approved for.

The government has made improvements to the transparency of home-care fees. However, we are still getting reports from people all over the country about rising costs. People are concerned about administrative fees, exit fees and other fees that they're being charged, and that is limiting the amount of care and the hours that people are able to receive. The former minister said that he would have a look at the fees and that he was going to do something about this but, again, there doesn't seem to have been any action from the government on that. We do need to hear from the government about whether or not it is going to do something about these fees and the concerns that I'm sure are being communicated to all of the people on the other side in their electorate offices as well. If we're getting them from all over the country, the government must be too.

Then there is the royal commission's interim report, which was handed down in October 2019. In that report, tellingly titled Neglect, the commission put forward three recommendations that required urgent action. They recommended that the Morrison government urgently fix the home-care package waitlist, which was described as 'cruel', 'unfair' and 'discriminatory'. Has that waitlist been fixed? No, it has not. The government's response to the interim report was woefully inadequate: a meagre 10,000 packages when the waitlist at that time was 119,000 persons long. That is 119,000 older Australians without the care and support that they were approved for. And this was a mere drop in the ocean when you consider how chronic this never-ending waitlist is and the impact it has on older Australians, their families, their carers and their loved ones.

But this is the hallmark of this Prime Minister. It's the hallmark of the Morrison government: drip-feeding home-care packages on an ad hoc basis, the majority of which are not the higher-level packages that tens of thousands of older Australians have been approved for, are entitled to and continue to wait for. The Morrison government has no plan to deal with the growing waitlist, no plan to deal with future demand and no plan to help the older Australians who need care right now. This government needs to do better.