Thursday, 14 May 2020
Aged Care Legislation Amendment (Emergency Leave) Bill 2020; Second Reading
That this bill be now read a second time.
I seek leave to have the second reading speech incorporated in Hansard.
The speech read as follows—
Today I am introducing the Aged Care Legislation Amendment (Emergency Leave) Bill 2020.
This Bill amends the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 to introduce a new type of leave which can be utilised by permanent residents of aged care homes, in particular emergency situations.
The Australian Government is committed to ensuring that all older Australians have access to high quality aged care services whilst ensuring that they are treated with respect and dignity. Integral to this is the empowering of aged care residents to make their own decisions about their emotional wellbeing and physical health and safety.
This is particularly relevant in emergency situations, such as the COVID-19 pandemic. If a resident, or their family, is concerned that the current health emergency is impacting on the safe provision of residential aged care, they have the right to choose to take leave from the aged care home - without incurring financial burden and without the fear of losing their room.
In the current environment, permanent residents of an aged care home are entitled to take up to 52 days per year of what is known as social leave. When a resident exceeds their 52 days of social leave, the aged care provider no longer receives a subsidy payment for that resident. Therefore, in order to retain their place within the aged care home, the aged care provider charges a fee to the resident.
The current COVID-19 pandemic has highlighted the inadequacy of these leave provisions. Many permanent aged care residents are seeking to temporarily relocate to stay with family and reduce their risk of exposure to the virus. For these residents, the only options available are to use their social leave allocation or remain in the aged care home.
The difficulty is that many residents will exceed their social leave before they are ready to return to the aged care home. If they choose to remain on leave, the additional charges that may be incurred to secure their room place a significant, and unnecessary financial burden on families, carers and residents. In many cases, residents may simply not be able to afford the additional charges and therefore cannot take the leave they desire.
The Government has received a large number of representations about this issue. The isolation, lack of visitation and inability to stay with family for the duration of the current COVID-19 pandemic, has caused great anxiety for a significant number of aged care residents and their families. Many residents, and their families, are fearful of the risk of contracting or spreading the virus whilst in an aged care home.
The amendments in this Bill introduce a new emergency leave type for permanent aged care residents, which will be activated during pandemics, natural disasters and other large-scale emergency situations, as determined by the Government.
This new leave type will not be available on a regular basis. Once activated the emergency leave will only be available for a set period, as determined by the Government, and will be applied either nationally or to a specific area or service. This will ensure the flexibility needed to allow the Government to address situations such as floods, bushfire emergencies, or future instances of isolated or regional outbreaks of COVID-19.
In light of the current emergency, provision is being made to apply these changes retrospectively to 1 April 2020. This will ensure that residents who have already been financially impacted by the need to take leave from their aged care home will be adequately covered. It will also ensure providers are not financially disadvantaged.
This Bill ensures that permanent aged care residents and their families are supported to make decisions about personal safety in emergency situations, and not suffer unnecessary financial burden as a result. It also ensures that following an emergency, residents are still able to use their social leave entitlement to maintain their normal visiting and special events routine with their families and friends, which is important for emotional and mental health.
This change is in the best interests of all older Australians and the broader community, by supporting the resident's right to make their own decisions about their care.
I made clear at the outset that Labor supports this bill. The Aged Care Legislation Amendment (Emergency Leave) Bill 2020 amends the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 to introduce a new type of leave that permanent residential aged care residents may utilise during situations such as natural disasters, pandemics or other large-scale emergencies that can impact the safe provision of residential aged care and the safety of the resident.
Once an emergency situation has been determined, the leave would be applied to a specific area, such as national, state and territory aged care planning for an individual service. This leave is for a specified time period and provides for a level of flexibility needed to allow the Commonwealth to address situations such as floods and bushfires or future instances of isolated or regional outbreaks of COVID-19.
Under each of the above-mentioned acts, permanent aged-care residents are entitled to take up to 52 days of nonhospital related leave, known as social leave, within a financial year. When an aged-care resident exceeds their annual social leave entitlement, the aged-care home no longer receives a Commonwealth residential care subsidy for that person, and the provider passes those costs onto the resident.
The emergency leave is not limited to a number of days or a specific timeframe. The minister can deem the length of time that emergency leave remains in place as well as an end date. Any declaration of emergency by a minister or his or her delegate for the purposes of this bill will be done as a disallowable instrument to allow scrutiny and oversight. There is no financial impact for the government by the proposed amendments. Any costs associated with updates to the aged care payments system will be funded from existing programs.
I'd like to take this opportunity to thank the minister for the spirit of bipartisanship he has undertaken to date. I understand the shadow minister has been briefed regularly in relation to COVID-19 but also in relation to this bill. We're also pleased that the government has listened to Labor around the issues of social leave. It is an issue that we have raised directly with the minister because we know there would have been an ongoing financial burden for many Australian families who are caring for their loved ones at home. There are around 500 Australian families currently caring for their loved ones under social leave arrangements.
With the COVID-19 pandemic, many family members have made a decision to continue caring for their loved ones in their own home and not return them to their residential facility to receive care. This has and will result in many older Australians passing the capped 52-day social leave arrangements. The consumer would ordinarily then be required to pay the government subsidy of around $230 per day to save their place in the residential aged-care facility they are taking leave from. For many families and consumers, this is a cost that they are unable to sustain. Amending the acts will ensure that the family or consumer will not take on any unnecessary financial burden if they have passed the 52-day social leave arrangements.
For social leave, there will be a retrospective date of 1 April 2020 so that families are covered as a result of the COVID-19 pandemic. It is understood that the Commonwealth will continue to pay the subsidy to those residents accessing social leave from 1 July 2020, and this we welcome. At this stage, no end date has been put forward. However, we will monitor this as we enter a new financial year.
We acknowledge the difficult and challenging times for residents, their families and of course those who care and support older Australians, all aged-care workers. The COVID-19 virus has had a significant impact on residential and home care. It has infected residents and aged-care workers, and, sadly, the virus has claimed lives. Our deepest sympathies go to the families who have lost loved ones.
Labor has welcomed the opportunity to put forward ideas when it comes to supporting older Australians and aged-care workers. Social leave, as I've already stated, was raised as an issue by Labor, and again I thank the minister for listening to those representations. So, too, was the expanded support for vulnerable older Australians through the Community Visitors Scheme. Again, we acknowledge the government's $10 million announcement in relation to this measure. We hope it provides some much needed support.
Labor has also put forward ways that aged-care workers could be supported during the COVID-19 pandemic. Unfortunately, the government's announcement around the retention bonus has failed to support all aged-care workers. The government has excluded aged-care workers from receiving the retention bonus. It depends on where you work and what role you do. Frankly, this just is not good enough. The shadow minister has written to the Minister for Aged Care and Senior Australians twice, calling on the Morrison government to value all aged-care workers for the care and support they all provide as a team to older Australians.
There have been infection control failures. Residents, their families and staff deserve answers to what went wrong. It is our hope that the Morrison government will join Labor in calling for the royal commission into aged care to investigate the COVID-19 virus' deadly impact at Newmarch House. It's the right thing to do, and the royal commission has the investigatory powers to do this special investigation. This special investigation is important: it will provide many answers so that if a pandemic happens again we will know more about how best to manage this situation in a residential aged-care facility but also Australians must be assured that we have the best infection control practices in aged care. In conclusion, this bill will make a difference to families who are caring for their loved ones. As I've said earlier, we are pleased that the government has listened to Labor's concerns and acted.
I also wanted to take this opportunity to put on the record our thanks to all of our aged-care workers who continue to work tirelessly through the COVID-19 pandemic. We know it's been a tough and challenging time for you and your families. We appreciate the work that you do. You are valued. We value the work that you do, and we thank you for the work that you do to care for and support older Australians.
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.
I rise on behalf of Centre Alliance to speak in support of the Aged Care Legislation Amendment (Emergency Leave) Bill 2020. The changes proposed in this bill are very important, and the current pandemic crisis has underscored the need for such changes. The bill introduces a new type of leave that permanent residential aged-care residents can utilise during situations such as natural disasters, pandemics and other large-scale emergencies. These can affect the safe provisions of residential aged care and, indeed, the safety of the resident
Currently permanent aged-care residents are entitled to take 52 days of non-hospital related leave, known as social leave, within the financial year. When an aged-care resident exceeds their annual social leave entitlement, the aged-care home no longer receives the Commonwealth residential care subsidy for that person, meaning the provider then needs to pass these costs on to the resident or their family. Importantly, the emergency leave under these changes would not be limited to a number of days or a specific time frame. Indeed, the minister can deem the length of time the emergency remains in place as well as the end date.
There is no financial impact for the government created by the proposed amendments. Any costs associated with the updates to the aged-care payment system are to be funded from existing programs. The legislation also provides for each declaration made by a minister or his or her delegate to be tabled as a disallowable instrument so there can be further oversight when this emergency leave provision is enacted—a very important component.
The provisions of this bill will no doubt give comfort to families who have watched the horror of COVID-19 outbreaks unfolding at aged-care facilities such as the Dorothy Henderson Lodge and Newmarch House. There is no doubt that the COVID-19 virus has had a significant impact on the residential and home care of older Australians. It has, sadly, infected residents and aged-care workers and claimed lives. Our deepest sympathies go to all families who have lost loved ones.
The COVID-19 pandemic has meant that many family members have made the decision to continue caring for their loved ones in their own homes and not to return to the residential aged-care facility to receive this care. We're told that there are currently around 500 Australian families caring for their loved ones under these social leave arrangements. This has resulted in many older Australians passing—or soon to pass—the 52-day social leave cap currently allowed for. The resident, or their family, is currently required to pay the government subsidy of $230 per resident per day to save their place in the residential aged-care facility that they are taking leave from. For many families and consumers this is very much an unsustainable cost. The proposed legislation will ensure that the family or consumer will not take on this unnecessary financial burden if they have passed that 52-day social leave arrangement.
Significantly, the legislation will operate retrospectively to 1 April 2020 for the social leave, so that all families can be covered as a result of the COVID-19 pandemic. This, without doubt, will be a huge relief for the many families currently caring for their loved ones in their home. We understand that the Commonwealth will continue to pay the subsidy to those residents accessing social leave from 1 July 2020 as well, and we also welcome this. At this stage, we are told there will be no end date put forward for the current COVID-19 pandemic in relation to this emergency social leave. We will certainly monitor this going forward.
There is no doubt the pandemic crisis has created difficult and challenging times for residents, for their families and of course for those who support and care for our older Australians. The coronavirus pandemic is testing the aged-care sector and many other sectors in our community in ways that none of us could ever have imagined. Facilities have plans in place for infectious diseases such as influenza or a gastro outbreak, but coronavirus makes these pale in comparison. These times call for exceptional courage on all fronts. Older Australians living in aged-care facilities have seen a lifetime of ups and downs and are now the ones absolutely most vulnerable to this pandemic.
The aged-care workforce, working part-time or casually, many coming from overseas, are doing hard work with dedication and care, and we very much thank them. The aged-care facility management are making very tough calls, balancing the respect and dignity of their residents with the care and protection of them and their staff. In the interests of seeing swift passage of this bill through the parliament, we have chosen not to seek to amend the legislation, despite it offering up another opportunity to move significant amendments for much-needed financial transparency for the sector.
I thank senators for their contribution to this piece of legislation. The Australian population is ageing, and senior Australians and their families deserve to be treated with respect and dignity whilst receiving high-quality aged care and services. Integral to this is the empowering of aged-care residents to make their own decisions about their emotional wellbeing and physical health and safety. During difficult and challenging times such as the current COVID-19 pandemic, it is vital that senior Australians are supported in their right to exercise their choice about their care.
The COVID-19 emergency has highlighted a gap in existing residential care leave provisions when faced with a large-scale emergency. Currently, permanent aged-care residents are entitled to up to 52 days of social leave each financial year. If a resident exceeds their 52 days of leave then they are required to pay a significant fee to retain their place within the aged-care home. In the context of the Greens proposed amendment, can I say that hospital leave is already unlimited and there is no financial impost on the consumer, unlike social leave, where, as I've just said, the consumer must pay the full subsidy after 52 days. That is what this bill is seeking to address.
During the current pandemic, many permanent residents have indicated they wish to temporarily relocate to stay with family in order to reduce their risk of exposure to COVID-19. These residents currently have no other option but to use their social leave allocation, which will likely run out before they are ready to return to their aged-care home. If they choose to remain on leave, the additional charges that will be incurred to secure their room will place a significant and unnecessary financial burden on them or their families. In many cases, residents may simply not be able to afford the additional charges and may therefore be forced to return to the home or possibly forfeit their place.
The isolation, lack of visitation and inability to stay with family for the duration of the current COVID-19 pandemic has caused cognitive decline and anxiety for a significant number of aged-care residents. Many residents and their families are fearful of the risk of contracting or spreading the virus whilst in an aged-care home, yet are unable to exercise their right to manage their own health and wellbeing due to the limited leave provisions available. The new leave type being introduced through this bill will ensure that residents have access to appropriate leave during emergency situations, and not just during this current pandemic; the legislation makes a provision for any particular emergency situation, so that future governments have the flexibility that we're seeking to introduce right now. This will not see residents either financially disadvantaged or losing leave entitlements for situations completely out of their control. This change is in the best interests of all older Australians and the broader community, as it supports the residents, and in turn their family and carers, to make their own decisions about personal safety or care.
Can I join with other colleagues across the chamber in expressing our condolences to those who have lost loved ones in the current COVID-19 pandemic. I've had the opportunity to talk to some of the families of those loved ones. They're not just numbers. They are individuals. They are members of families who are loved and cherished by all their families, and we understand only too well the importance of providing high-quality care. Can I say, I don't share the pessimism that's been expressed by some in the chamber about the capacity of the aged-care sector to provide good-quality care. We are extremely fortunate in this country that less than one per cent of aged-care facilities have had an incidence of COVID-19. We have seen quite graphically, though, how devastating and how tragic it can be when a significant outbreak does take hold.
The government has not limited the resources that are available to a facility that has an outbreak of COVID-19. We've worked closely with each facility from the time we found out that they had an outbreak within the facility. We've had both state and Commonwealth medical experts and the Aged Care Quality and Safety Commission, working closely with each facility to ensure that they have the resources that they need, whether that be staffing, PPE or advice, acknowledging that the states have oversight of clinical care responses within these circumstances. We've been working closely with all of the jurisdictions to provide the resources that are required to ensure that quality care is being provided but also acknowledging the requirement for communication. In certain circumstances we've provided additional resources, particularly for communication with residents' families so that they understand what's happening within the facilities.
I acknowledge the calls that have been made for the royal commission to consider the events, particularly at Newmarch, and I understand that the opposition has written to the royal commission in that context. I acknowledge, though, that the royal commission has said that they will be looking at aged care in the context of COVID-19 and I believe that's appropriate. But I also believe it's appropriate that they look at all circumstances of COVID-19 in aged-care facilities, because it's not just about Newmarch. Newmarch is a particular case that deserves attention, I agree; but I believe that the royal commission should be looking at all of the aged-care facilities and how each of them has managed COVID-19, because some of them have done a brilliant job. Also, it's not just about the things that have gone wrong. We also ought, through this process, be understanding what has been done well and acknowledging that and congratulating the sector for that, and I do congratulate the sector for that.
I congratulate the staff at the front line who are turning up every day in a very difficult circumstance and dealing with the residents who have been unfortunate enough to be infected with COVID-19, staff who have put themselves at risk and, in some circumstances, have themselves caught the virus. It's a very difficult circumstance for everyone. It's very stressful for everybody involved in all of those circumstances, and I acknowledge the efforts of the industry, the sector more broadly, and the staff, in particular on the front line And I acknowledge the concern quite rightly being expressed by the families, particularly by those who have loved ones within facilities that have had an infection within the site. I thank senators for their contributions to this piece of legislation and commend the bill to the Senate.
I just wanted to indicate Labor's position in relation to the second reading amendment. I don't believe we've done that so far. There are a number of points raised in the Greens' second reading amendment that, of course, Labor has been calling on the government to fix urgently for some time. This includes the home care package waiting list: more than 104,000 older Australians are waiting for their package and, frankly, this is not good enough. Labor will continue to put pressure on the government to fix the home care package wait list. This is urgent. It should not be ignored during the COVID-19 pandemic.
With regard to the other issues raised in the Greens amendment, it is our strong view that the Royal Commission into Aged Care Quality and Safety should be given the opportunity to put forward its final report as it considers many of the significant issues that impact on the aged-care system. This bill is about supporting families and their loved ones at a very difficult and challenging time, and we don't want to hold this bill up, of course. The Greens have failed to consult with Labor on their second reading amendment and we will not be supporting it.
The Acting Deputy President:
The question is that the second reading amendment on sheet 8964 as circulated and moved by Senator Siewert be agreed to. Those of that opinion say aye and against say no. I think the noes have it. I'm assuming the Australian Greens would like their support for these amendments noted, so we will do that. The question now is that the bill be read a second time.
Question agreed to.
Bill read a second time.