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

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

I too rise to speak on the Aged Care Quality and Safety Commission Bill 2018—to be referred to as the commission bill from here in—as well as the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018. The Australian Greens broadly support these two bills. However, we consider that some amendments are required in order to strengthen the legislation, provide further protections for aged-care consumers and strengthen the Aged Care Quality and Safety Commission and its powers. The commission bill establishes the new independent Aged Care Quality and Safety Commission—to be referred to as the commission for the rest of my contribution—and was announced in the 2018-19 budget following the recommendations of the Carnell-Paterson review. The commission will initially bring together the functions of the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner. A commissioner is to be appointed by the minister to lead the commission, and the commission bill sets out the various functions of the commissioner, including the consumer engagement function, complaints functions, regulatory functions and education functions.

The establishment of the commission will allow a more holistic approach and better oversight of the aged-care sector as a whole, where information will flow more readily and easily throughout the commission, allowing better identification of where the risks and issues are, and for these to inform decision-making rather than being siloed into various agencies and the Department of Health. This will allow better analysis of the data being collected, assist in working out why there are certain trends, help drive quality improvement and enable innovation to ensure a better quality of life for older Australians and uphold their human rights. Given recent incidents that have played out in the media, it is incredibly important that we get the commission bill right so that older Australians, providers and the public have confidence in the aged-care sector and are clear on the purpose and the role of the commission and so that there are fewer grey areas than currently exist. From 1 January 2020 the aged-care regulatory functions of the Department of Health, including the approval of aged-care providers' compliance and compulsory reporting of assaults, will transition to the commission. A separate bill will be needed to transfer the regulatory functions from the department, and the Australian Greens understand that this bill is anticipated to be introduced and debated some time during 2018.

An overarching concern for us is that the bill does not refer to the human rights of older Australians and instead refers to their consumer rights. At the hearing for the inquiry into these bills, Mr Mitchell of the National Older Persons Legal Services Network—a network of national associations of community legal centres—said:

The national association notes that the bills engage older Australians from the perspective of consumers and build a guarantee of a quality base within the frame of consumer rights. The various incidents, inquiries, reports and reviews that have led us to this point in time have been very clearly about the human rights of older persons. The national association respectfully submits that the framing of rights expectations for older persons within the regulatory framework of aged care should be on the basis of inherent human rights, acknowledging the interdependence and interconnectedness of those rights.

The Australian Greens believe that the human rights of older Australians will be a strong focus of the upcoming royal commission and that there is a need for these rights to be acknowledged in the commission bill. I will be moving an amendment to include reference to human rights in the object of the commission bill.

In our additional comments to the inquiry into these two bills, we outlined that we consider that the commission bill should include reference to the Chief Clinical Adviser and specify that the Chief Clinical Adviser's role should have responsibility for overseeing and monitoring restrictive practices on medication management. We cannot envisage a time when the Chief Clinical Adviser's position will not be needed and are of the view that the requirement for certainty for the position into the future outweighs the need for flexibility that was articulated in the minister's second reading speech on the commission bill. We are pleased to see that the government will be amending the commission bill to reference the role of the Chief Clinical Adviser, establishing that the commissioner will be required to appoint a person for this position to assist them in the performance of their function.

In relation to restrictive practices, the Carnell-Paterson review recommended that the commission have oversight of the use of restrictive practices in residential aged care. While the Carnell-Paterson review also recommended that the Chief Clinical Adviser have responsibility for reviewing the use of antipsychotic medications, the Australian Greens would be satisfied with the Chief Clinical Adviser having oversight and monitoring responsibilities for restrictive practices and medication management in the first instance. This is extremely important. We need to ensure that there is someone responsible for ensuring that restrictive practices are used only as a last resort and in the least restrictive way, as well as someone advocating and pursuing the elimination of their use.

Medication management is also desperately in need of oversight. At the hearing for the inquiry into the bills, Dr Kidd, the chair of the Australian Medical Association Council of General Practice, said:

Many of the cases of abuse and neglect in aged-care settings involve inadequate clinical care. The clinical care accreditation standard was the single highest outcome not met by residential aged-care facilities in 2016-17, followed by the medication management standard.

We have to improve on this. We are pleased to see that the supplementary explanatory memorandum to the commission bill outlines a number of possibilities for the scope of work for the Chief Clinical Adviser, including best practice clinical care, minimising infection-related risks, clinical governance and the use of restraints. While we will not be seeking to amend the commission bill today to specify the scope of the Chief Clinical Adviser's role, we will be keeping a close eye on the development of this position following the commission's establishment and may seek to deal with this during the debate on the next bill in the new year.

In our additional comments to the report on the inquiry into these two bills we outlined our concerns regarding the commission being referred to as 'a single point of contact for older Australians and their families' given the commission will be unable to receive complaints about My Aged Care or the assessment processes. We argued that the government should not be separating the processes of assessment and determination of eligibility from service delivery. We think this is illogical, as they are entwined with one another. The commission's complaints function should be broadened to allow older Australians and their families to lodge complaints with the commission about their experiences with My Aged Care and the assessment teams. I will be asking the government about this during the committee stage. We understand that this issue is somewhat complex; however, the Australian Greens, at a minimum, want to see this issue resolved in the next bill next year.

In relation to the commissioner's consumer engagement and education functions, the Australian Greens raised concerns in our additional comments regarding the lack of reference to representatives of consumers in clause 17 of the commission bill and the lack of reference to the workforce of providers in clause 20. In relation to the first of these concerns, COTA Australia said in its submission:

… many consumers of aged care services (in particular those care recipients in residential aged care) require support to be involved in these functions of the Commissioner, and indeed family and friend carers are a key and absolutely valid consumer constituency.

The government's amendments to clause 17 address our concerns. The amendments will ensure that representatives of aged-care consumers are also consulted in relation to and are the beneficiaries of the commissioner's development of best practice models for the engagement of aged-care providers. In relation to the second of these concerns, we do not want to see the education of the workforce of providers, in the broader sense of the term, disappear once the commission is established. The specification in the supplementary explanatory memorandum that reference to aged-care providers in relation to the commissioner's education function includes their staff addresses this concern.

It became apparent during the hearing for the inquiry into the bill that clause 59, which provides the commissioner with the power to make information about an aged-care service publicly available, did not include the Commonwealth Home Support Program or, for that matter, any Commonwealth funded aged-care services. It is important that, once all Commonwealth funded aged-care services come under the remit of the commission, the commissioner is empowered to release information about them publicly, as they will be able to be an aged-care service. The government's amendment to include clause 59(A) to the commission bill will fix this omission. However, we have an amendment to both clauses 59 and 59(A) specifically to allow the commissioner to make information about the number of staff and the skill mix of staff of an aged-care service providing direct care to aged-care consumers publically available. This is important as we believe the current ratio of aged-care workers to aged-care consumers is too low, and this needs to be addressed. Allowing the commissioner to release such information will encourage public scrutiny of the situation and informed assessments to be made and will hopefully lead to the situation being improved.

We raise concerns in our additional comments regarding the consent provisions in relation to the powers of the authorised complaints officers and regulatory office officials in relation to premises. The Australian Greens believe that only aged-care consumers should be able to withhold consent if the premises are their own home and that only aged-care consumers should be able to withhold consent in residential aged-care facilities if a commission officer is there to see them. We will be asking questions during the committee stage about this issue.

We have also called for a review of the legislation. In our additional comments, we suggested a review after three years. The government's amendment will cause an independent review of the operation of the act and the rules to occur within six months of the fifth anniversary of their operation. The Australian Greens support the addition of a review provision and that the report of the review will be required to be tabled in each house of parliament.

The Australian Greens have concerns regarding residential aged-care facilities refusing access to advocates and other formal representatives of older Australians. At a hearing for the inquiry into the bills, at least two witnesses outlined their experiences of the relevant services being refused entry on a number of occasions. We have a great deal of concern about that. The Australian Greens want to ensure that advocates and other representatives are able to enter residential aged-care facilities as appropriate. I will be asking questions during the committee stage about the issue, as it is critical that aged-care facilities do not block access to advocates and other representatives. After all, these facilities are people's homes.

We are pleased to see that the government will be amending clause 23 of the commission bill to ensure complainants won't be charged fees by the commissioner for making a complaint, nor will the commissioner have the ability to charge fees to consumers and their representatives in relation to their consumer engagement function. Likewise, we are pleased to see the government will be amending clause 41 of the commission bill to ensure that those with the experience and knowledge of issues affecting aged-care consumers be appointed as members of the advisory council.

There is also a need for clarity regarding what will be included in the next bill, due next year, specifically regarding sanctions and the enactment of a serious-incident response scheme and a quality improvement framework. I note that our friends over the ditch in New Zealand have a process for serious-incident reporting which has led, I understand, to a decrease in falls and fewer older people being admitted to hospital with hip fractures and injuries of that nature. The community affairs committee, on its recent trip to New Zealand, heard from the Health Quality and Safety Commission on this issue and on its powers to establish mortality inquiries, which have also helped. That may be something we should consider in the future here in Australia if we don't see improvements in the current situation.

I'd like to thank the government for taking on board the concerns that have been raised following the inquiry into this bill, once again showing the usefulness of the Senate committee process. I'd like to thank them for the amendments they have made. We will be moving amendments to address issues they have not resolved, and, as I articulated in my contribution, we'll be asking a series of questions to clarify the operation of some elements of the commission. We will be supporting this bill. We think it will significantly improve care. We do think there is some way still to go, but we hope that, if done properly, this will make a significant contribution to improving care in this country.

Stirling Griff (SA, Centre Alliance) Share this | Link to 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.".

Zed Seselja (ACT, Liberal Party, Assistant Minister for Treasury and Finance) Share this | Link to this | Hansard source

The Australian population is ageing and senior Australians and their families deserve to have confidence that they and their loved ones are being properly cared for. The Australian government has established a royal commission to look more broadly at the challenges facing the aged-care sector, particularly as Australia's population ages, including the quality of care provided in residential and in-home aged care. The royal commission is in addition to, not instead of, the action the government is already undertaking.

The government remains committed to continuing its reforms to improve safety and quality in aged-care services. This includes the establishment of a new Aged Care Quality and Safety Commission, announced in the 2018-19 budget. The Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018 are part of the Australian government's fundamental reforms of the aged-care system. The reforms contribute to the promotion of high-quality aged-care services that meet consumer needs and preferences and create a competitive market based system where consumers drive quality.

The new, independent Aged Care Quality and Safety Commission will be a single point of contact for aged-care consumers and providers of aged care in relation to quality of care and regulation. The commission replaces the existing Australian Aged Care Quality Agency and Aged Care Complaints Commissioner and, from 1 January 2019, will be responsible for the accreditation, assessment, monitoring and complaints handling of aged-care providers in Commonwealth funded aged-care services. The commission will also undertake consumer engagement in education of providers, consumers and the general public as part of its functions. The provision of these bills has been reviewed by the Senate Community Affairs Legislation Committee. The committee conducted a thorough review of the bills in the time available, and the government thanks the committee for its support of these bills in recommending that they be passed by the Senate.

The government has considered the comments made in the committee's report, and I'm pleased to announce the government's response to the committee's report. The government has developed amendments to address various issues and recommendations raised in the report. These amendments form part of the government's response and will refine and clarify the government's policy intention for the commission from its commencement on 1 January 2019. The government also notes the additional recommendations and comments contained in the committee's report and is committed to considering these issues during the upcoming opportunity to make enhancements to the commission's bills as part of the second stage of reform, as signalled in the objects of the commission bill.

The important work of the commission will also be strengthened through a number of initiatives announced in the 2018-19 budget, which will be delivered progressively over two years. This includes the development of options for a serious incident response scheme and measures to strengthen risk profiling of providers, with the aim of preventing or responding quickly to failures of care. I thank all senators for their contributions to the debate on these bills.

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

Although I appreciate—and Labor does—Senator Griff's contribution to the debate on the issue—

Cory Bernardi (SA, Australian Conservatives) Share this | Link to this | Hansard source

Senator Polley, sorry, would you resume your seat for a moment. Are you making a contribution to the second reading debate here?

Senator Polley interjecting—

Okay, just a point. If we could get to that point, that would be fine.

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

I just want to put on record that Labor won't be supporting this amendment. We're happy with what the government has done at this point in time, but we do commend the interest that Senator Griff has taken in this debate.

Cory Bernardi (SA, Australian Conservatives) Share this | Link to this | Hansard source

I will now put the amendment moved by Senator Griff.

Question negatived.

Original question agreed to.

Bills read a second time.