Senate debates

Thursday, 4 February 2021


Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020; Second Reading

10:52 am

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

The government has taken too long to introduce a Serious Incident Response Scheme that would respond to the cases of assault and abuse in Australia's aged-care system. It has been more than three years since this scheme was first recommended by the Australian Law Reform Commission following its landmark report into elder abuse in Australia. The Carnell-Paterson review commissioned by the government following the Oakden nursing home tragedy also recommended the scheme in 2017. How can Australians trust this government to properly respond to the Royal Commission into Aged Care Quality and Safety when it can't even respond to serious incidents of elder abuse? Labor's been calling for the implementation of this scheme since both reports were released in 2017—understand this: 2017. It is almost four years now since the government was warned about outrageous and shocking incidents of abuse, yet it has done nothing.

Australia's aged-care system was broken before the COVID-19 pandemic, and the delay of this scheme is only putting extra stress on the system. Reported assaults in residential aged care go up every year. Four years the government have wasted. Every year incidents of assault are going up. They reached 5,233 in 2018-19, more than 100 a week. The government should hang their heads in shame. Day after day, the evidence of serious neglect in aged care mounts, and all we see from the Morrison government is running away, passing the buck and not accepting responsibility for their own failures. Neglect is not only the title of the aged-care royal commission's interim report, neglect is the legacy, neglect is the practice and neglect is the policy of the Morrison government when it comes to our aged-care system.

The Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020 amends the existing Commonwealth act to introduce a much-needed Serious Incident Response Scheme for residential aged care and flexible care delivered in a residential aged-care setting. This scheme will replace the current responsibilities of approved providers in relation to reportable assaults and unexplained absences in the Aged Care Act. It will require approved providers to manage incidents and to take reasonable steps to prevent them in the first place. The bill will require approved providers of residential aged care in a residential aged-care setting to report all serious incidents to the Aged Care Quality and Safety Commission.

A wider range of incidents will now be reportable, including unreasonable use of force; unlawful sexual contact or inappropriate sexual contact; psychological or emotional abuse; unexpected death; stealing or financial coercion; neglect; inappropriate physical or chemical restraint; and unexplained absence from care. When you read that list and you think about our parents and grandparents living in aged-care systems for years, this government has neglected to progress this scheme and to put this serious incident response framework in place. They have neglected older Australians. They are not on the side of older Australians and their families.

This scheme is so important in protecting some of our most vulnerable fellow Australians by placing the rigorous safeguards and response processes in place where, until now, they have been deficient under the neglect of the Morrison government. The scheme will remove the existing exemption for reporting assaults where the alleged perpetrator is a residential aged-care recipient with a cognitive or mental impairment and the victim is another care recipient. The bill will strengthen protections for people who disclose incidents of abuse or neglect in aged care and these protections will extend both to existing and former staff members, as well as to current and past residential aged-care recipients. The bill will protect people disclosing such failures against any civil or criminal liability. Again, this is such an important reform. It is beyond time that these changes were made. It is extraordinary how long the government, the Morrison government, has neglected to progress these changes.

We do need to expand the powers of the Aged Care Quality and Safety Commission to enforce the requirements of the new scheme, and this bill does expand those powers. These will include standard regulatory powers which provide the commission with a more graduated suite of powers for ensuring compliance and protecting consumers. An additional information-gathering power will also ensure the commission is able to obtain information and the documents it needs to administer the scheme.

The main concern that Labor brings to this legislation is that it does not include home care. Given that there are about one million older Australians receiving support or care in their own homes there is an equal risk of serious incidents happening in that setting, as well as in a residential aged-care facility. It should be noted that the counsel assisting the royal commission, in its final submission, recommended the government should ensure that a new and expanded serious incident-reporting scheme include all serious incidents, including in home care and regardless of whether the alleged perpetrator has a cognitive or mental impairment.

So it is incumbent upon the government in this debate to explain why millions of Australians, who care deeply about these matters, and over a million Australians who receive residential home care, are not included in this scheme. Don't they matter? Is the Morrison government not on their side? We know the neglect of the Morrison government; it is in the royal commission's report—right there in the title. It is the title of the report and it is the policy of this government. This legislation, unfortunately and tragically, neglects to include those Australians who are receiving home care—aged care in their homes.

Aged care should never be a policy of neglect. If there was one thing that a federal government should get right, it is looking after vulnerable, older Australians—the people who have built this country; the people who have raised families and created businesses, who served in our military and served as volunteers in communities, and who passed on the Australian traditions of a fair go and mateship. We shouldn't neglect them in their older years. Can you really trust the Morrison government to improve the aged-care system at large, given that their legacy, their policy and their practice is neglect? The evidence against them is now condemning in its depth, its breadth and its gravity.

Everyone in this parliament should read the foreword to Neglect, the interim report of the Royal Commission into Aged Care Quality and Safety. I've read it. It is disturbing. Reading the first 12 pages of this report is possibly the most rage inducing, heartbreaking reading you will do of a government report. The interim report describes the experiences of aged-care residents with maggots left in open wounds and left to lie in their own urine and excrement for days. It details that up to half of Australia's frailest aged-care residents are malnourished. This is not some report from a Third World country; this is a report of supposedly one of the best healthcare systems in the world, in Australia. Australia has one of the best aged-care systems in the world? Not so. Neglect—that's what the Morrison government has turned to.

The report describes in detail how 60 per cent of residents are on psychotropic medication but that that medication is estimated to only be justified in 10 per cent of cases. It confirms for all who care to pay attention—I don't think that includes the Morrison government—that there were: 4,000 notifications of alleged or suspected sexual abuse reported in one year; 274,409 self-reported cases of substandard care; and 32,715 calls to the My Aged Care consumer hotline that went unanswered in one year alone. In short, the interim report of the aged-care royal commission is horrifying reading. This is all happening in our aged-care facilities on the Morrison government's watch, and it is a national disgrace. According to the latest population trends, 38 per cent of Australian men and 55 per cent of Australian women will end up in permanent residential aged care. However, for the 240,000 Australians currently in residential aged care, including more than 6,000 younger Australians with disability, it is already a brutal reality.

Not only that; if you are a taxpayer, this is your money. Your money is being misused by the Morrison government to pay for this national scandal. Let's understand this: the Morrison government treats taxpayer money like it is Liberal Party money. Australians want a government that acts in their interests, that is on their side. Instead, what do they get from the Morrison government? Sports rorts, dodgy land deals and secret contracts with Liberal mates to do advertising campaigns to tell us what a great job they're doing. Yet there is this national scandal of neglect of our older, vulnerable Australians in our residential aged-care system and in our home-care system. On those statistics I just read out about people being left in their own urine and excrement, having maggots in their mouths and in their open wounds, being malnourished and being chemically restrained: if the Morrison government weren't so busy looking after themselves and their mates, they might find time to get on the side of older, vulnerable Australians and look after them.

The Prime Minister was our nation's Treasurer when the government cut aged-care funding by $1.7 billion, ensuring services were capped and resources were strangled. Since 2013 the government have spent $1 billion on advertising to tell us what a great job they're doing, yet they cut $1.7 billion from aged care. Mr Morrison was in charge when COVID-19 hit, when aged-care homes were denied personal protective equipment and given an instructional video instead of infection and control training. No wonder Australia has one of the worst records in the world when it comes to residential aged-care deaths as a proportion of total COVID-19 fatalities. No wonder the Grattan Institute has described Australia's centrally controlled, heavily rationed aged-care services as a Soviet style system. That is what this Morrison government is overseeing. This government, elected in 2013, only called a royal commission in 2018 after it was shamed and shamed again by media scandals.

There are 1.3 million Australians in aged care and millions more who will need aged care—dare I say some of us in this chamber will. Of course we will. All of us will at some point have to contemplate going into residential aged care. We all need real policies backed up by real funding, from more home-care packages to more workforce development training and more oversight of quality and safety standards. We need to be cynical of any talk about how the so-called industry has learned its lessons and will now put the customer at the centre of everything it does. After all, the Australian government is the only customer the sector cares about, because the Commonwealth provides more than 80 per cent of its revenues and, as we know, the Commonwealth has been cutting that funding.

Finally, the economics of aged care speak to one of the most tragic elements of our experience of the COVID-19 pandemic: 655 people died in Victorian residential aged care during the crisis last year, entirely on the Morrison government's watch. Aged care is a federal responsibility, not a state government one. In fact, their own plan said they would be responsible for the management of COVID in aged-care facilities. Australia has one of the highest rates in the world of deaths in residential aged care as a proportion of the total COVID-19 deaths. A Senate inquiry has noted that deaths in aged-care homes account for nearly 75 per cent of all the deaths from COVID-19 in Australia. When more than 1,500 aged-care homes requested masks, gloves and gowns from the National Medical Stockpile last year, they were refused. Staff in aged-care homes also needed comprehensive infection control training; instead they got a 10-minute video.

The royal commission has found that the federal government did not have a specific pandemic plan for the aged-care sector. Neglect again. Neglect systemically, neglect before COVID-19, neglect during COVID-19. When is the Morrison government ever on the side of vulnerable older Australians? When this evidence from the royal commission was put to the government, what did the minister for aged care say? Minister Colbeck said, 'The government maintains its position that it has a plan in place.'

We have had eight years of despicable neglect—neglect from the point of view of funding, neglect in the priorities, neglect for the care of vulnerable older Australians, neglect of home care and neglect of residential aged care. This bill is important; make no mistake. This bill is necessary; make no mistake. The tragedy is that this bill is so long in coming to this parliament, and the tragedy is that it does not do anything to assist those Australians who receive home care, aged care in their home. We will continue to fight for them because we are on their side.

11:07 am

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

I rise to speak on the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020. This bill represents a reform by at least establishing a serious incident response scheme that mandates providers to report an alleged, suspected or actual serious incident. The Greens support the bill in principle; however, we have some concerns about the bill, which I will articulate now. I've also circulated amendments to seek to address those serious concerns. I will also articulate that the Greens very strongly believe we need to also have such a scheme for home care, and I will ask some questions in Committee of the Whole around that.

In this bill, a serious incident is defined as:

(a) unreasonable use of force …

(b) unlawful sexual contact, or inappropriate sexual conduct …

(c) psychological or emotional abuse …

(d) unexpected death …

(e) stealing from, or financial coercion of, the residential care recipient by a staff member of the provider;

(f) neglect …

(g) use of physical restraint or chemical restraint … (other than in circumstances set out in the Quality of Care Principles);

(h) unexplained absence … from the residential care services of the provider

Aged care providers are required to not only report incidents but also provide support to residents, conduct investigations, monitor actions taken and use data to drive continuous improvement to prevent similar incidents from occurring. This bill also offers protections to people who disclose serious incidents, including providers, staff, residents, family members, carers and advocates. The Aged Care Quality and Safety Commission will be responsible for regulating the scheme. The commission will assess a provider's compliance with incident management obligations, receive reports on serious incidents and respond to incidents using the full range of regulatory actions available.

This scheme represents a significant departure from the existing reportable assaults scheme. We have all seen the failures in aged care over the years. There's a long list of them, quite clearly showing the current system has not been working appropriately. At the moment, aged-care providers are only required to report incidents involving unlawful sexual contact or unreasonable use of force against a resident, and we know that they haven't even been doing that. There are also exemptions under the current scheme around reporting assaults if they are committed by residents with cognitive impairment. This has been a serious barrier to preventing and dealing with the sexual abuse of older people in residential aged care. Sexual abuse by a person who is cognitively impaired is still, actually, sexual abuse. I am pleased to see that the new scheme will be expanded to include the reporting of assaults by residents with cognitive impairment.

The introduction of the Serious Incident Response Scheme is a welcome change, but I ask the government: why has it taken so long? The new scheme was recommended by the Australian Law Reform Commission all the way back in May 2017 in its final report Elder abuse—a national legal response. This recommendation was then endorsed by the Carnell-Paterson review of October 2017 following investigation of the terrible failures in Oakden. A committee of this very chamber, the Senate Community Affairs References Committee, had an inquiry into Oakden as well and also highlighted the massive failures in the system at the time. And yet it is in 2021, just before the royal commission comes out with its report, that we are now discussing these particular amendments, and they don't go far enough. So the government is still squibbing it. Older Australians and their families have had to wait four years for action. This is just not good enough. The Australian Greens support this bill in principle; however, we have concerns about the bill—that it doesn't go far enough. We've circulated a series of what I think are substantive amendments which would strengthen the proposed scheme.

Falls are missing from the definition of serious incidents. I'm extremely disappointed to see that falls are not included under the definition of serious incidents. In the government's implementation guide, falls are mentioned only once, where they are used as an example of an unexpected death. Aged-care residents are at a high risk of falls that can cause serious injuries, result in a sudden decline in health and, we know, lead even to death. Data from Monash University shows that 15 per cent of all deaths in residential aged-care facilities have preventable causes and, of these, 90 per cent are from falls and choking. An avoidable death rate of 15 per cent would be cause for outrage in other sectors. Why is aged care treated differently? Falls are often the result of systemic failures, such as insufficient staff and inadequate clinical care. Recent data shows that 10.5 per cent of residents were admitted to hospital in 2018-19 because of a fall, which is up from 8.5 per cent in 2014-15. So we know this issue is getting worse. They should be reported and investigated to identify case-specific and systemic issues that can be changed. I'm not saying that we need to wrap people in aged care in cotton wool. I'm not saying that at all. We shouldn't be doing that. But we should be using this scheme to identify falls, investigate them and see what happened.

I was on a community affairs committee delegation a couple of years ago to New Zealand where we looked at aged care. It was part of the reason we were there. I discussed with people in New Zealand this issue around falls. In their processes, although it's not part of a legislative response, they have been reporting and looking into the impact of serious falls and requiring them to be notified of them so that they can actually look at whether they can have the benefit of improving the system. My understanding, from my discussions over there, is that they have in fact been improving the procedures around serious falls. So I ask the minister, and I'll be asking in the Committee of the Whole: why haven't falls been included in the scheme? If the purpose of this scheme is to encourage providers to continuously improve and to reduce the likelihood of incidents reoccurring, surely falls, one of the leading causes of preventable death, should be included in the scheme. I will be moving an amendment to add falls under the definition of 'serious incidents'. To pre-empt the answer 'the royal commission is coming': we know the royal commission is coming, and we know this is an issue. We don't need the royal commission to tell us that falls are an issue.

Related to this, I'll also be moving an amendment that stops the use of physical and chemical restraints from not being reported as a serious incident when they are used in line with the circumstances in the quality-of-care principles. We think all use of restraints should be reported. We have to start treating the use of chemical and physical restraints as a serious incident. As this chamber knows, I've been pursuing this issue for a long time. We shouldn't be using chemical and physical restraints; we should be eliminating the use of chemical and physical restraints. That is why we need to be using this scheme to treat them as serious incidents when they occur and to report all of them. We know the current instrument on the use of chemical and physical restraints falls short of the standards and falls short of moving to eliminate the use of these restraints. If we are serious about phasing out, ending and eliminating the use of these restraints, we need to treat it seriously and get serious about using these mechanisms to ensure that happens. I strongly believe that, if we require providers to report and publish data on restraints, we will see a significant reduction in their use, as has been the case in the United States.

Another serious omission from this scheme is the public reporting of incident data. I understand that the commission will be responsible for the publication of sector trends and key risks to support quality improvement and capacity building in the sector. However, this falls short of the recommendation by counsel assisting the royal commission that the new incident reporting scheme require the quality regulator to publish the number of serious incident reports on a quarterly basis at a global level, a provider level and a service or facility level. This recommendation goes to the heart of this issue. These incidents need to be reported at a provider level and a service or facility level to really drive improvements. You can look at what's just happened in Western Australia, at Regis, to see why we need to be reporting these incidents at a provider and facility level. If there is no public reporting on which providers and facilities are experiencing serious incidents, how can we drive continuous improvements across the sector? How can consumers compare providers and make informed decisions if that information isn't publicly available?

I also strongly believe that consumers and their families should have access to this information so that they can make informed choices about aged-care services. The public has a right to know which facilities are of concern and which are managing quality risks well. Public reporting of information across the aged-care sector is fundamentally missing, and I think we need to address that if we are to build transparency and accountability and improve performance throughout the sector. We need to have public reporting of serious incidents on a quarterly basis at global, provider and facility levels if we are going to achieve improvement in quality care, and I'll be moving amendments to address these issues.

I want to move to the next lot of amendments that we'll be moving and articulate the issue. Under the new Serious Incident Response Scheme, providers are responsible for supporting consumers and families if an incident occurs. They are expected to go further than under the current scheme and work to prevent similar events from occurring. This is, of course, a welcome reform. However, there is no guidance for providers on how they should support older people who have been involved in an incident.

I'll be moving an amendment today that ensures that everyone who has experienced a serious incident will be automatically referred to an independent advisory service, such as the national aged care advisory program. Whether the consumer chooses to take this up is up to them, but at least they'll be required to be provided with that information. Many people will actually want to go to an independent person rather than be supported by the provider, who potentially has been responsible for the incident. This amendment will ensure that older Australians have guaranteed access to that independent support if they experience sexual abuse, emotional abuse, neglect or any other serious incident defined in the bill.

Despite the merits of this strengthened scheme, serious incidents won't tell us everything. The government must not use this scheme as an excuse to delay reforms in other areas that will prevent serious incidents occurring in the first place—reforms like ensuring that every resident receives four hours and 18 minutes of care, which is the recommended level of care, or ensuring that nurses are on 24/7 and that the right ratio and skills mix is available at all times for residents. If we are really going to reduce the number of falls and incidences of neglect, we need to ensure that we have enough qualified staff to care for residents in the first place.

I hope that the government will seriously consider the amendments that I've circulated in the chamber. I encourage all senators to look at and support those amendments, which will strengthen this scheme. I also hope providers will see that the new scheme is an opportunity to fix issues and provide better care to older Australians and their families. We should not lose sight of the purpose of the Serious Incident Response Scheme, which is to protect the safety and wellbeing of residents and to drive changes in the way care is provided across all these facilities. We no longer want to see the shocking incidents we have been seeing in aged care for years and years. This scheme is well past due. It needs to be in place, it needs to be strengthened and then it needs to be funded and staffed enough to ensure that it has its desired effects.

11:22 am

Photo of Helen PolleyHelen Polley (Tasmania, Australian Labor Party) Share this | | Hansard source

I rise to speak on the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020. This legislation is long overdue. It's implementing some of the key recommendations of the Australian Law Reform Commission's report into elder abuse, which was tabled in 2017, so it's been almost four years before we've seen the Liberal government finally starting to act. In the report the Australian Law Reform Commission said that its 43 recommendations were timely, and its cornerstone recommendation was a national plan to develop and combat elder abuse.

To reinforce the need for a Serious Incident Response Scheme, a separate review—again, commissioned by those sitting opposite—followed the Oakden nursing home tragedy and also recommended introducing the scheme in 2017. How can we trust that this government will act upon the recommendations of their royal commission into aged care, whose report is expected to be handed down this month, if they've taken four long years to respond to elder abuse? That is four long years of abuse of older Australians. The Liberal government then waited two years and commissioned KPMG to undertake a prevalence study of serious incident report schemes, and the findings of that report were handed down by the government in November 2019 but not made public until June 2020. This report revealed that there were more than 50,000 cases of assault and abuse in aged care across the country that were going unreported each year. They sat on this information for months and let tens of thousands of vulnerable people be subject to undue harm before they started to do anything about it. Under this government, reported assaults in residential aged care have gone up every year, reaching 5,233 in 2018-19. That's more than 100 a week—100 of some of the most vulnerable members of our society were assaulted each day and every week.

A research paper from the aged care royal commission has revealed the shocking rates of elder abuse in aged-care homes under the Morrison government. It's estimated that almost 40 per cent of people living in Australian aged-care homes experience elder abuse in the form of neglect, emotional abuse or physical abuse, but this doesn't include financial, social and sexual abuse. It has found that the prevalence of neglect is over 30 per cent. How shameful is that! These are statistics that we should not be comfortable with. They confirm just how broken the aged-care system is under the Morrison government. We have had almost eight years of this government, and that's the shameful neglect of the aged-care system under the watch of Scott Morrison.

Let's go back to the bill. It amends the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018 to introduce a Serious Incident Response Scheme for residential aged care and flexible care delivered in a residential aged-care setting. Labor has been calling for the implementation of this scheme since both reports were released in 2017. We again called out the government's inaction on the development of a scheme on the eve of Elder Abuse Awareness Day last year. We will support this legislation, but we fear it may be insufficient in its current form. The bill will require approved providers to manage incidents and take responsible steps to prevent incidents, including through implementing and maintaining effective organisation-wide governance systems for management and reporting of incidents of abuse and neglect.

The bill will also require approved providers of residential care and flexible care delivered in a residential aged-care setting to report all serious incidents to the Aged Care Quality and Safety Commission. A wider range of incidents will also now be reportable under these amendments. Currently, aged-care facilities only need to report unlawful sexual contact and unreasonable use of force. They don't have to report other types of harm or assaults by elderly residents with dementia or mental illness. Under the amendments, psychological or emotional abuse, unexpected death, stealing or financial coercion by a staff member, neglect, inappropriate physical or chemical restraint, and unexplained absence from care will be reportable. The government's watchdog will also be given additional powers under the amendments to punish providers for failing to keep residents safe. Some aged-care experts are critical of the government's scheme, fearing it will be insufficient in its current form. Counsel assisting's final submissions to the commissioners recommended that the government should, in developing a new and expanded serious incident reporting scheme, ensure that it also includes all serious incidents, including those that occur in in-home care. As more and more Australians are electing to stay home as long as possible, it's important that they too are provided with protection by this scheme. In its current form, they are not. Again, the government is not only failing to deliver home-care packages to older Australians in their own home but also failing to protect them.

Additionally, this scheme does not have the proactive mechanisms to prevent elder abuse. Whilst reacting to elder abuse when it occurs is an important step, this scheme must do more to prevent it from happening in the first place. There needs to be reform relating to the suitability of people working in aged care by enhancing employment screening processes and ensuring that staff are subject to a national code of conduct. I have been calling for that, as has Labor, for such a long time. There should be regulations governing the use of restrictive practices and there should be national guidelines in place for the treatment of care recipients. Not only are older Australians more vulnerable because of their age, but they face other factors, such as increased rates of isolation, disability and cognitive impairment, that make them more vulnerable to abuse.

Elder abuse undermines dignity and autonomy. Abuse and living with fear can inhibit a person's ability to make choices about their own lives to pursue what they value. We must protect older Australians from abuse so that they can support themselves to live good, dignified lives. They should not be subject to abuse. We owe it to them to ensure that they are protected, whether they are still living at home or whether they are residing in residential aged-care homes. Australians have rights which should not diminish with age. We all have a right to a dignified existence, free from exploitation, violence and abuse.

The federal government has a responsibility. They are responsible for the laws and the framework in a legal sense and to ensure that they're put in place to protect older Australians. For far too long older Australians have been left out, and the Morrison government have no excuse, as they have commissioned inquiry after inquiry into the shortcomings of the aged-care sector. We on this side of the Senate chamber have known, just like those opposite—who have been responsible for aged care as ministers—that minister after minister has called for and sought reports into the aged-care sector. They have been well aware of the issues that this sector has faced. They know that there is an issue around abuse in aged care. They know there are issues around the workforce and the lack of workers in this sector. They know that the workers in aged care are underpaid. They know that the majority of workers in this sector do a very, very good job. But they know the failings of this sector and they have failed to act. Then what they have been doing in recent years is putting everything on hold until the royal commission brings down its final report. We never had to wait to have a royal commission to know the failings that are happening on a day-to-day basis in the aged-care sector, but those on the government benches have been very happy to just put their hair down and pretend that they didn't know what was going on.

This bill goes some way to ensuring that older Australians are going to be protected when they live in residential aged care, but the government still haven't protected those who are still living at home. Let's be quite frank about this. It is far cheaper for the government to support people living in their own home for longer rather than going into the residential home sector. But those on the government benches for the last eight years have failed to deliver the quality of care that is needed to ensure that those living at home are going to be safe and can have a dignified life and receive the home care packages that they need—not a level 1 when they've been assessed to have a level 4 package. No more excuses, Mr Morrison. It's time you delivered.

Those opposite have well and truly dropped the ball when it comes to aged care and our vulnerable older Australians, and older Australians have suffered as a result of that. As we know, tens of thousands of older Australians have died waiting for the level of home care that they had been assessed for but that this government failed to deliver. We know the final report into aged-care will be handed down this month, but I want to put on the record once again that we have never had to wait for the royal commission to bring down either its interim report or the final report. We know of the neglect.

I want to concur with the comments of Senator Keneally here today. She went back and again painted the picture of maggots and of the abuse and neglect that older Australians have had to endure with an undignified existence in residential care.

I also concur with many of the comments that Senator Siewert has made today in her speech. Both of us have been on many inquiries. We were on the Oakden inquiry, in particular, and inquiry after inquiry looking into other aged-care issues. We know the neglect. We are embarrassed about the neglect in aged care, just as Australians should be. It is a shame and it is a blight on the Morrison government, and in particular on Mr Morrison himself who, before the last election, said he was going to make aged care a national priority. If this is what he calls a national priority under his watch, God help us if he wasn't interested in aged care! God help us, and God help those older Australians who are being neglected and those families who have lost their loved ones. Minister after minister has neglected older Australians in this country.

I want to put on record my thanks to Julie Collins, the former shadow minister for aged care and the member for Franklin in Tasmania, in my home state, who knew about and understood these issues. She fought, along with myself, Shayne Newman and Mark Butler, to give older Australians the dignified and high-quality care that they deserve. I also want to put on record my appreciation for Clare O'Neil, as the new shadow minister for aged services. I'm looking forward to continuing to work with Labor's team to hold this government to account, to ensure older Australians get the care that they need and they deserve to have a dignified life, whether they're in a residential homecare sector or whether they're living at home with their homecare packages that they deserve. I know that the senators on this side will never ever give up fighting for the dignity that older Australians deserve in this country, each and every day.

11:37 am

Photo of Stirling GriffStirling Griff (SA, Centre Alliance) Share this | | Hansard source

I rise to speak in support of the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020. It must be noted that whilst this bill is welcome, the government has taken far too long to bring this legislation before the parliament. This bill seeks to implement the recommendations for a serious incident response scheme, made by the Australian Law Reform Commission three years ago. The 2017 Carnell-Paterson review, following the terrible abuses at the Oakden aged-care facility in South Australia, also made recommendations for a fit-for-purpose serious incident response scheme.

Oakden was a tragic and disgraceful blight on the aged-care sector in South Australia, and a sad and reprehensible chapter in the state's history. Shocking abuses have occurred and do occur in aged-care homes throughout Australia. Abuse of the elderly, whether a deliberate act or just through gross negligence, is a stain on our society and we must do what we can now to stop it. The Royal Commission into Aged Care Quality and Safety interim report, titled Neglect, underscored how serious the problem is. It is a scathing interim report. The inquiry found the system had failed to care for our older and often very vulnerable citizens. The commissioners wrote:

It does not deliver uniformly safe and quality care for older people. It is unkind and uncaring towards them. In too many instances, it simply neglects them.

The system is very much broken and is in need of a major overhaul.

Since 2018 the Royal Commission into Aged Care Quality and Safety has uncovered widespread elder abuse and mistreatment. We learnt that an estimated 50 sexual assaults occur each week across Australia's aged-care sector—50 sexual assaults a week!—affecting around 13 to 18 per cent of residents. That is sickening and very much a national shame. The abuse is perpetrated by care workers as well as other residents. This bill ensures providers will have to report incidents of abuse and aggression between care residents, including where the resident who commits the incident has a cognitive or mental impairment. This type of abuse is currently exempted.

A broader range of incidents will now be reported under the provisions, including unreasonable use of force, unlawful or inappropriate sexual contact, psychological or emotional abuse, unexpected death, stealing or financial coercion by a staff member, neglect, inappropriate physical or chemical restraint and unexplained absence of care. This bill will improve oversight and transparency in addition to expanding the powers of the Aged Care Quality and Safety Commission.

I note recently circulated amendments from Senator Patrick that deal with the publication of staffing ratios and the implementation of CCTV cameras in aged-care settings. The amendments on sheet 1186 that deal with staffing ratio disclosures mirror similar amendments moved by me previously in this place and a bill introduced in the other place by my colleague the member for Mayo, Rebekha Sharkie. Ms Sharkie introduced a private member's bill calling for transparency on staffing ratios back in August 2018 and again in July 2019. A government led committee that reviewed the bill even recommended that that legislation be passed, but the government still hasn't acted. So we will support that amendment.

However, we will not be supporting at this time the amendments on sheet 1191 that seek to implement a mandatory CCTV requirement in aged-care facilities. Implementing a mandatory CCTV requirement in aged-care homes will not fix the underlying and systemic issues facing the sector—the chronic understaffing and the deskilling of staff in aged-care settings. Installing CCTV cameras simply avoids the problems that lead to abuse. What is needed are dedicated carers who have been given the proper training for their care role and who are supported by sufficient numbers of colleagues. We need mandatory minimum training requirements. We need legally enforceable staffing ratios with the appropriate skill mix and to make it mandatory to have a registered nurse on each shift.

The aged-care royal commission will issue its final report by 26 February. Once it does, we expect the government to introduce legislation that acts decisively on all of its recommendations. No more excuses.

11:42 am

Photo of Jess WalshJess Walsh (Victoria, Australian Labor Party) Share this | | Hansard source

Australia's aged-care system is broken. It is a national shame. In too many cases, it is delivering neglect and harm instead of care and compassion. Australia's aged-care system is in crisis. It has been in crisis for years, since well before COVID-19 hit. So what have the government done to take action on this crisis? Where is their response? Where is their plan? The government's inaction on aged care has been absolutely tragic—tragic for aged-care residents, tragic for their families and tragic for the staff that work so hard to care for those residents, because they've all been let down. They've all been let down by the Morrison government, a government that takes far too long on urgent issues and far too long to take life-saving action on issues that the government have known about for years.

This bill is no exception. The Serious Incident Response Scheme is no exception. This is a scheme that we need. It's a scheme that we've known that we've needed for years. The government have taken far too long to implement it. The elder abuse figures in Australia are absolutely shocking. We know that research from the aged care royal commission has shown that almost 40 per cent of those living in Australian aged-care facilities experience elder abuse in the form of neglect, emotional abuse or physical abuse. This is a national shame.

This research was released at the end of last year and this wasn't the first time that elder abuse was raised as an absolutely urgent issue to this government. Three years ago the Australian Law Reform Commission released the findings from their investigation into elder abuse in Australia and they recommended the implementation of a serious incident response scheme then—just like the one included in this bill.

Photo of Sue LinesSue Lines (WA, Deputy-President) Share this | | Hansard source

Thank you, Senator Walsh. The time for this debate has expired and you will be in continuation.