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

I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020. This bill builds on the changes that were passed at the end of 2020 around the way home-care subsidies are paid to providers. It will ensure that providers are only paid home-care subsidies for the services they actually provide to the consumer, instead of receiving the full subsidy each month regardless of services delivered. This bill also makes changes to unspent funds from September this year. The Commonwealth will now retain unspent funds on behalf of the home-care recipients instead of approved providers. Providers will also be able to return unspent funds to the Commonwealth within six months of this bill coming into effect.

Unspent funds have been an ongoing issue in aged care. The current pool of unspent funds sits at around $900 million. Unspent funds provide older Australians with flexibility to pay for future care needs or budget for unforeseen events. However, there have been serious problems in allowing providers to hold onto this money. Some providers have been using these funds as part of their working capital and making money from interest earned, sometimes even allowing the money to be held by a third party. This practice doesn't encourage openness and transparency in the way consumers' funds are being used.

The Australian Greens support this bill because it introduces a new level of transparency to the way home-care subsidies are paid to providers. However, I would like to raise some serious concerns we have with the implementation of the new payment arrangements and other matters. During the consultation phase of this bill, some providers raised concerns about the costs that would be incurred implementing these changes. The Australian Greens share the concerns raised by COTA that these changes must not adversely impact on the outcomes for older people and their families. I will be seeking assurances from the minister that this bill will not result in providers passing on additional fees and charges to home-care recipients and indicate that I will be seeking a short—hopefully—Committee of the Whole to address some of these issues.

This bill also introduces administrative changes to software and business systems for both providers and the government. Some stakeholders raised some concerns—and I don't blame them—about the capacity of Services Australia to implement the required changes to their systems to allow for a smooth transition. I would like to take this opportunity to again urge the government to continue its discussions with providers and put in place a robust transition plan. These changes should not result in any disruptions to the delivery of home care. I don't want to see any older Australians left disadvantaged by these changes.

As providers have traditionally held onto unspent funds, some are concerned about how these changes will impact their financial viability. This is especially concerning for providers who are operating in thin markets who might find it difficult to adjust to the new systems and arrangements. I understand providers will be eligible for transition support funding and business advisory supports if needed. The Australian Greens will be monitoring this process closely. We do not want to see aged-care providers failing because of poor support during this transition phase.

This bill takes a small step towards improving transparency and accountability in aged care, but there is still a lot of work to do in this space. I'm convinced that a fundamental lack of transparency, especially around funding, has contributed to some of the abuse and neglect we see in aged care. There is currently no requirement for providers to publicly report on how government funding is being used. This means that we don't have access to public information on the number and skills mix of staff; staffing qualifications and training; and the amount of money spent on direct and indirect care, including medication and food. Without improved transparency and accountability across the aged-care sector, we will never see the level of reform and change we so desperately need.

I have a range of questions that I want to put to the minister during the Committee of the Whole stage. Some of these questions regard the issue of protected information under division 86 of the Aged Care Act. For years stakeholders and constituents have raised concerns about the definition of protected information under the act. COTA believes that the broad definition of protected information means that very little information about complaints or decisions is published. Access to information about family members in aged-care facilities or information about complaints is often denied on the basis that it is interpreted as protected information under the relevant acts. This detracts from the community's confidence in the complaints system.

One constituent who contacted my office made appeals right up to the High Court but never got to the bottom of the understaffing issues in the aged-care facility that his mum was living in. The department, the commission and the courts have all denied this constituent access to information on the basis that it is considered 'protected information' under the act. People should be able to access information easily about the experiences of their family members in aged-care facilities. This is an extraordinarily concerning matter, and I will be asking questions about it, as I articulated.

Fundamentally, one of the key issues here is how we look after older Australians and how older Australians are treated in aged care, whether it be home care or residential aged care. But we also need to think about the journey before somebody is in the aged-care system and when they are applying for an aged-care package. At the moment, it is my belief that we are seeing more people having to apply for residential aged care because we are not managing the journey into home-care support properly. We have ad hoc systems across the country where information is not provided to the older person or to their family. Services are not connected, and we need to be thinking about that very, very clearly. At the moment people are having more incidents, more falls, more lack of attention, and there is a lack of understanding of people's journey into aged care. It is not being thoroughly addressed by hospital services, by GP clinics or by anybody that comes into contact with an older person. Sometimes it's the luck of the draw, depending on who an older person gets as their contact person or their support person when they have an incident. That has to stop in this country. We need to make sure that we are providing the sorts of services that support older Australians in their home, if that's where they want to stay, or in residential care. We need services that provide support to family members, information flow and transparency about how decisions are being made, what decisions are being made and how money is being spent.

Finally, I would like to foreshadow a second reading amendment, which I have circulated, that notes that this bill does nothing to address the urgent need for additional home-care packages. Every year 19,000 people who are approved by government for home care are forced into residential aged care before they receive a package. We need the government to act immediately to ensure that home-care package waiting lists are cleared by 31 December 2021, that people already receiving aged-care packages are actually receiving the aged-care package that meets their needs and that people aren't forced to take a lower package because they can't get access to aged-care package levels 3 and 4. You shouldn't have people having to second-guess the system because they know that they'll have to wait a long time to get an aged-care package that actually meets their needs. What you're getting at the moment, which the government said they wanted to avoid, is people staying on CHSP rather than going onto an aged-care package level 1, 2, 3 or 4 because they are actually getting better support and less hassle from the CHSP compared to going into the aged-care system. People don't know when to actually get an ACAT assessment done because the system does not meet people's needs. I speak from personal experience here, so I have some knowledge of the troubles that people are having while trying to get joined-up services in the system. We have to do better in this country.

I'll be asking the minister some questions around this bill and around the funding that's currently available for these packages, because older Australians' home-care needs are not being met. That is very clear. While people are passing away before they can get the care they need, while they are sitting on packages that don't meet their needs, while they are not getting access to accountability and transparency—and we know that because we have a royal commission on right now—we cannot claim that this system is meeting the needs of older Australians and their families, carers and support people. We need change; we need it urgently. This bill is part of that step, but there's a lot more that needs to be done in this country so we can, first, assure older Australians that they have a system that will meet their needs and provide the care that they need and, second, reassure families that their loved ones are getting the appropriate level of care when they need it and where they want it.