Senate debates

Monday, 30 November 2020

Ministerial Statements

Royal Commission into Aged Care Quality and Safety

6:09 pm

Photo of Richard ColbeckRichard Colbeck (Tasmania, Liberal Party, Minister for Aged Care and Senior Australians) Share this | | Hansard source

I table an implementation progress report concerning the special report of the royal commission on aged care and COVID-19. I move:

That the Senate take note of the report.

I am pleased to inform the Senate today that this government is delivering on all the recommendations made by the Royal Commission into Aged Care Quality and Safety in its special COVID-19 report. In Australia 693 people living in aged-care facilities or getting services at home have sadly died. Each loss of life represents someone's mum, dad, grandparent or cherished friend. I offer my condolences to all of those who have been impacted by COVID-19.

Today the government has tabled an implementation progress report in keeping with the royal commission's first recommendation. This implementation report shows every step is being taken to ensure the safety and wellbeing of senior Australians. The Australian government has already delivered four of the six recommendations and progress is well under way on the final two. As previously stated, the lead geriatrician of the Victorian Aged Care Response Centre and a member of the AHPPC aged care clinical advisory committee, Associate Professor Michael Murray, said, 'Australia was as well prepared for a significant aged-care outbreak as any country or jurisdiction in the world, with the probable exception of Hong Kong.' Professor Murray, who is also head of geriatric medicine at Austin Health and an Adjunct Associate Professor at La Trobe University's Centre for Evidence Based Aged Care said, 'Despite being as good or indeed the second best, it was not possible to prevent incursion into the aged-care sector or any other vulnerable community during a mass community outbreak.' Prevention of mass community transmission remains the first and best defence for any community and that was the first line of defence under the Australian government's plan. Importantly, it is worth noting that 97 per cent of residential aged-care facilities in Australia have had no residents with COVID-19 cases.

We have increased our initial investment in the COVID-19 supplement from $205.3 million to a total of $422.9 million, directly responding to recommendation 2, to support aged-care providers with COVID-19 related costs. This means that aged-care facilities can have adequate staff to keep their doors open to family and friends, ensuring that residents don't become isolated. At the same time, revised visitation guidelines, endorsed by the Australian Health Protection Principal Committee, outline how residents can be protected in the least restrictive manner, balancing their health needs with their personal wellbeing. I should also mention the visitation code of conduct, which was developed and led by consumer peaks and the industry. In addition, senior Australians are taking advantage of increased services for advocacy, grief and trauma support. This $19 million investment has produced significant resources, including a dedicated COVID-19 support line for older Australians.

The royal commission's special report outlined barriers for aged-care residents in receiving the allied health and mental health care they need. In response to recommendation 3 we're investing an additional $63.3 million to extend allied and mental health services for aged-care residents. From 10 December, extending these services will mean that aged-care residents can now receive up to 20 Medicare subsidised individual psychological therapy sessions with the practitioner of their choice, in line with the services available to everyone else in the broader community. We're also removing barriers and increasing access to essential allied health services for aged-care residents. This means that residents with a chronic disease management plan will have access to extra Medicare subsidised physiotherapists, occupational therapists and exercise physiologist sessions.

In recognition of the effect COVID-19 outbreaks have had on many residents in aged-care facilities, we are going beyond the recommendations of the royal commission to support group therapy sessions in affected residential aged-care facilities. This is to rebuild muscle strength and to reduce the risk of falls following periods of lockdown and inactivity.

In line with recommendation 4, we have updated the National COVID-19 Aged Care Plan. It is critical to ensure a national approach is taken to protect vulnerable senior Australians. The Australian government has continuously built and adapted the plan since January 2020. As part of that, we have worked side by side with state and territory governments to implement additional infection prevention and control training, and to establish joint approaches to the management of outbreaks. And we stand ready to activate emergency response arrangements when required.

Also as recommended, the Aged Care Advisory Group of the Australian Health Protection Principal Committee, or AHPPC, which is composed of national experts in aged care, geriatric health, infection control and emergency response, has been made permanent. This committee will continue to inform how to address outbreaks and to update advice for providers.

As endorsed by recommendation 5, a robust, well-trained infection prevention control expert workforce is being implemented. This is a $217.6 million investment into residential aged-care providers to employ an infection prevention control lead. And recommendation 6 advocates for the Australian, state and territory governments and infection prevention control experts to work collaboratively. We are continuing to strengthen our preparedness to respond to a rapid escalation of COVID-19 in the aged-care sector, learning from ongoing outbreaks, sharing knowledge and insights and prioritising training and assessments with aged-care providers. To meet this recommendation the Australian government is doubling its contribution under the National Partnership on COVID-19 Response. That means that the Commonwealth government will fund up to 100 per cent of activities undertaken by the states and territories to support aged-care services through infection prevention and control training, preparedness and response.

In total, the Australian government has invested more than $1.7 billion in the aged-care sector since the start of the COVID-19 pandemic, specifically to deal with COVID-19. While we hope there isn't another COVID outbreak in aged-care facilities, or in home care, we are dedicated to putting everything in place quickly to ensure our senior Australians are protected throughout the pandemic and the COVID recovery phase. This was evident in the rapid and effective response to the recent cluster event in South Australia. We know, and we've seen it so many times, that where there is community transmission there is a risk to aged-care residents in local facilities. The loss of lives in Australia has underlined our fierce determination to ensure that every effort is made to ensure that it doesn't happen again. I'm delighted to report that there have been no active cases of COVID-19 in aged-care recipients in Australia since 28 October. One South Australian residential aged-care facility does have four staff with COVID-19, and they are appropriately in isolation and being cared for. The facility is being monitored closely, with a regular testing regime.

The successful shift in the tide for Australia comes as the battle against this virus continues around the globe. That is why we must not become complacent. The Australian government is leading a systematic change in the nation's aged-care sector to deliver an aged-care system that meets senior Australians' needs and expectations. We are committed to building on the work underway and to elevating the key focus of improving the health, safety and wellbeing of aged-care residents, home-care recipients and their families. We will continue to work with our state and territory colleagues, aged-care providers, peak bodies and industry partners to transform aged care and provide Australians with choice and control over the care and services they need as they age.

We look forward to receiving the royal commission's final report in February and we will carefully consider all its recommendations, just as we have carefully considered and responded rapidly to the commission's special report on COVID-19. The report tabled today shows holistic, coordinated and considered actions to tackle a critical threat to the health and wellbeing of our senior Australians. I thank the Senate.

6:21 pm

Photo of Kristina KeneallyKristina Keneally (NSW, Australian Labor Party, Deputy Leader of the Opposition in the Senate) Share this | | Hansard source

I rise to take note of the ministerial statement from Minister Colbeck. I start by making clear that the Labor Party's capacity to respond to the substance of the minister's statement to the Senate is limited. It's limited because the minister has displayed a high degree, an unusual degree, of secrecy around this statement. It is the usual practice, the usual courtesy displayed by ministers in the Senate, to provide a copy of a ministerial statement to the shadow minister in advance of tabling it. I can advise the Senate—and thereby advise the workers in aged care, and the residents in aged care and the families that care for them—that that did not happen. The shadow minister for aged care received a copy of this report at 6 pm by email. In fact, it's been incredibly hard even to work out the purpose of the ministerial statement from the minister today. So allergic are the Morrison government to scrutiny, so fearful are they of scrutiny of their custodianship of the aged-care portfolio and the care provided to our parents and grandparents in aged care, that they couldn't even bother to provide adequate, usual courtesies of giving the statement to the shadow minister prior to giving it here in the Senate today.

But why should we be surprised? This is a minister who has turned his back on the scrutiny of this place, a minister who persists in his role despite being censured by this Senate for his mishandling of the COVID-19 pandemic in aged care. It demonstrates he's learned nothing. The aged-care royal commission's special report provided the scrutiny that the government clearly needed. Really, it's not just the government that needed it; it's the residents of aged care in Australia who desperately needed it. The staff who work tirelessly in aged care, underpaid and overworked, needed this scrutiny too. And the government's response is important for the families and loved ones of the 685 people, older Australians, who died from COVID in aged care. The government's response will be scrutinised by the opposition. We'll look to see what they've learned, to see if their mistakes will be repeated. The minister and the Morrison government ignored warning after warning and failed to protect for COVID-19 in aged care. They displayed the pretence of a plan. Who could forget the Prime Minister standing up and waving around the Australian health sector emergency response plan for aged care, or what he said. There it is in paragraph 4.1.4: 'The Australian government will also be responsible for residential aged-care facilities'—black and white!

The government said they had a plan. The government said they were responsible for aged-care facilities and the maintenance of PPE, of infection control, of workforce protection, of looking after our parents and grandparents in the middle of a global pandemic. They said, in this document, that they were responsible. And then, when we had an outbreak, what did they do? They found someone else to blame.

What does Scott Morrison do when he's under scrutiny and pressure? He finds someone else to blame. He tried to pretend all of a sudden that aged care had nothing to do with him; it wasn't a federal government responsibility. Lo and behold, it's a public health responsibility. It's all the states. Just like quarantine, just like the Ruby Princess, just like everything else to do with this pandemic—Scott Morrison has looked for someone else to blame. It's usually a state government, because apparently all the things the Commonwealth is supposed to be doing, under our Constitution and our federal system—border control, aged care, quarantine—are suddenly no longer federal responsibilities. They sit with the states. When it goes right, Scott Morrison is there to take the credit, and when it goes wrong he avoids the blame and finds someone else to blame for his failure.

I want to point out to those who might be watching this debate that this week the government tabled another report, the 2019-20 Report on the operation of the Aged Care Act 1997. This goes to the hubris of this government when it comes to aged care. That report failed to acknowledge a single death from COVID-19 in aged-care facilities. We've got an aged-care report on the Aged Care Act 2019-20 and not one acknowledgement of the fact that 685 people died in residential aged care. Perversely, this report congratulates the government on its achievements in infection control, minimising transmission and maintaining a safe environment in aged-care facilities. Talk about patting yourself on the back. That's going to be really cold comfort to the almost 700 families with a loved one who contracted COVID-19 and died in an aged-care facility this year.

The Royal Commission into Aged Care Quality and Safety's special report into COVID-19 stated that the Morrison government did not have a plan for COVID-19 in aged care. I noticed the minister got up for his statement today and began with a whole lot of laudatory comments from supposed experts—they may be experts; I don't know them personally. I do know one expert, and that is the royal commission, staffed with experts who were appointed by this government. They're experts in aged care and they've been studying the problem. What did they say? They said the statement in this document—this plan—was no plan at all, and that the Morrison government did not have a plan for COVID when it came to aged care.

By the way, let me just acknowledge the remarks of Senator Steele-John earlier, when he said the government didn't have a plan for disability when it came to COVID. He's right. He's absolutely right. Aged care, disability, the vulnerable—the government is leaving people behind, just like stranded Australians. This government is leaving people behind. It is shameful when they're leaving behind our grandparents and our parents—vulnerable older Australians who cared for their children, who built their businesses, who contributed to their community, who fought in wars. These are the people this government is leaving behind to fend for themselves.

The royal commission's report into aged care for COVID-19, this special report, stated that there was difficulty for aged-care workers in accessing PPE, there was insufficient infection control training for aged-care workers and there was no surge workforce strategy document. It's not like they didn't have warning. They've had Earle Haven in Queensland; Dorothy Henderson Lodge in New South Wales and Newmarch House. These were all warnings that they didn't heed. To listen to this government and this minister, you'd think they couldn't have possibly imagined ever having to replace an entire workforce in an aged-care facility, but it had already happened a year earlier, and yet they had no plan for it. They did not have any idea how many aged-care staff were working across multiple sites. If there's one thing this COVID pandemic has exposed, it's not just the shocking neglect of the Morrison government when it comes to aged care but also the shocking impact of insecure work—that is, people who do not have job security and who have to work multiple casual jobs. When it comes to aged care, that happens. We know it happens, yet this government had no plan to try and understand the extent to which it was happening—again, a failure to imagine, to anticipate and to plan when it comes to the impact of COVID on aged care.

The lessons learnt from the early mistakes in aged care were kept secret for too long. They were not made public in a timely manner for the entire sector to learn and adjust. By the way, I'm tired of hearing how much we are 'learning'—700 dead people later. We should have learnt a lot earlier. I'm also tired of hearing the government say that they've put $1.7 billion into the aged-care sector to deal with COVID-19. Do you know how much they cut out of aged care when Scott Morrison was Treasurer? It was $1.7 billion—the exact same amount. Don't pat yourselves on the back over there that you put $1.7 billion in, when you took $1.7 billion out under this Prime Minister when he was Treasurer. That is the neglect. The aged-care royal commission has an interim report into this government's handling of the aged-care sector, and it is titled Neglect. It talks about people starving in their beds, soiled in their bedclothes with ants and maggots in their wounds. That is what we went into COVID with: an aged-care system in neglect, and 700 people died. For the government to continue to pat themselves on the back is a shame. Neglect is the shame of our aged-care system.

6:31 pm

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

I also rise to take note of the ministerial response and the ministerial statement in response to the Royal Commission into Aged Care Quality and Safety's report Aged care and COVID-19: a special report.

Government make a lot of the $1.7 billion that has been, they claim, invested in the sector for dealing with the pandemic. Of course, if the sector had been running effectively we wouldn't have needed to inject $1.7 billion. It was quite obvious the sector was not ready to handle a pandemic. It had multiple issues, as is evident from the fact that we've got a royal commission in the first place. Here we have the government saying that they've got an updated plan in response to recommendation 4, which is to 'establish a national aged-care plan for COVID-19 through the national cabinet in consultation with the aged-care sector'. What the government says in the report that has just been tabled, which we've all just laid eyes on, is that there's an updated national COVID aged-care plan. The royal commission clearly knew that in fact there wasn't an aged-care plan, but the government continues with the myth that there was an aged-care plan—that in fact they didn't just rip the cover off the general plan and put on a new cover that said 'aged care'. They've updated that. I hope it's more than just changing the report's title page.

The funding that's allocated here, which of course is welcome, is for investment in mental health care and allied health care. The very interesting thing to note here is that the government have now decided they can invest in better access in aged-care facilities. Some of us who have been around this joint for quite a long time have advocated and advocated to extend better access to aged care. First off I'll say: thank goodness it's now been extended. But why, for all these years, have we had the flawed approach of allocating a bit of separate money—which was better than nothing, I will admit—for mental health in aged care, which had to be diverted and then delivered through the different PHNs all around the country and which meant that somebody in an aged-care facility could not get the same mental health support that anybody else in the community could get? Now, all of a sudden—from 10 December—they can get it. But it's only for six months. It finishes in June next year. Then aged-care residents will have to go back to the same-old, same-old where they do not get adequate mental health support.

When we look at allied health—and I will preface this by saying I've only had a chance to have a brief look at it—the funding will be targeted to aged-care residents living in facilities which experienced outbreaks, and it will fund initial assessment and an allied health consultation for a six-month period. Again, it's only for six months. My reading of this is it's only for those that had an outbreak. We know many, many aged-care facilities around this country have been in lockdown and they haven't been able to receive visits, supports and the sorts of allied health that they need. On top of that, they don't get proper access to allied health services in any case. Again, it's only for six months. So while the government's making much of all this so-called new money—as was articulated earlier, there's been a whole lot of money taken out of aged care over the years—it's only available for six months.

I know the government are going to say, 'The royal commission is reporting in February and therefore we'll be rolling out new services.' But they won't be rolling them out that quickly, folks, because they didn't adequately cover this in the last budget. And, of course, the next budget's not until May next year. What will people do in the interim? They will not have access to mental health services. They will not have access to allied health services.

In terms of staffing, we all know that aged care is understaffed. The staff absolutely go above and beyond. They've had to work across multiple facilities, and they will have to continue to do that across Australia. That, again, will be a perfect tsunami, potentially, if we get further waves or outbreaks of coronavirus in our states. We're going to be back to the same-old, same-old situation where we had inadequate levels of staffing and where staff didn't get adequately paid. We could well end up in those same circumstances. We need to make sure that we have a staffing system that ensures that we have four hours and 18 minutes worth of care for residents. We need to make sure that we have the staffing expertise that can deliver clinical care. That is not being delivered in residential aged-care facilities right now.

Also in the report is the fact that the AHPPC has set up a subcommittee for aged care. We have been up hill and down dale through the COVID committee trying to get the advice that AHPPC provides. Do you think we could get that? No. Senator Gallagher will tell you very clearly how much we have been pushing in the COVID committee to get access to that advice. It also claims to have consumer advocacy. But the last time I asked about this there were no residents on that committee, nobody with actual lived experience. That is not to cast aspersions on the consumer advocate that's there, but they don't have lived experience. What about, 'Nothing for us without us'? People in residential aged care deserve a voice and deserve to have input into that committee. Just this morning we were talking about transparency when Senator Griff was moving amendments to a bill to actually try and get better transparency for the aged-care sector, yet here we have a body providing advice to the AHPPC that's not transparent and the community can't see that advice. Residents in aged care expect the best-quality care and families expect the best-quality care, not more ad hoc decision-making with bits of money being dripped in here and dripped in there and only going for short periods of time.

I'll come back to the issues around mental health services. All the experts are talking about it. Across the board, we have a mental health pandemic. Aged-care residents are right up there in suffering from the effects of the pandemic, particularly in Victoria, but across the country. They haven't been able to see their loved ones, or they've had to see their loved ones through glass, holding up their hands. They've missed birthdays. They've missed so many family occasions. They need ongoing mental health services that aren't limited. They need better access—whatever that looks like after the review—and they need guaranteed access to mental health services, allied health services, clinical care and a staffing level that's guaranteed to provide the best quality care.

I seek leave to continue my remarks later.

Leave granted; debate adjourned.