Thursday, 5 August 2021
National Health Amendment (Decisions under the Continence Aids Payment Scheme) Bill 2021; Second Reading
The purpose of the National Health Amendment (Decisions under the Continence Aids Payment Scheme) Bill 2021 is to provide express support for the Continence Aids Payment Scheme, CAPS, to confer review functions on the AAT. The bill amends the act to provide that a legislative instrument made under section 12 of the act may provide that applications may be made to the AAT for review of decisions made in exercise of powers conferred by the instrument. The minister may by this instrument formulate a continuance aids payment scheme under which the Commonwealth makes payments as a contribution towards the cost of buying products to help manage incontinence.
Under existing arrangements, the Continence Aids Payment Scheme, an annual or six-monthly payment, is available to people five years of age and over who suffer from permanent and severe incontinence caused by particular kinds of conditions specified in the instrument. These payments help offset the cost of purchasing continence products from the participating person's supplier of choice.
On 16 January 2021, the CAPS instrument was amended to provide that persons and organisations affected by these decisions of the secretary could apply for internal merit review or, following internal review, independent merits review of that initial review decision by the AAT. The bill amends the act to make it clear on the face of the act that the legislative instrument establishing the CAPS can provide the AAT review of decisions provided for in the instrument and that are not already covered by sections 14 and 15 of the act. It's a sensible administrative reform that should improve accountability. As such, Labor commends the bill to the Senate.
[by video link] I would like to make a short contribution to the National Health Amendment (Decisions under the Continence Aids Payment Scheme) Bill 2021. The bill makes important changes to the Continence Aids Payment Scheme, otherwise known as CAPS. CAPS is an annual or six-monthly payment available to people who suffer from permanent and severe incontinence. This bill allows people to apply for an internal review or go to the AAT for decisions made by the secretary under the scheme.
One in four people in our community are affected by incontinence. Incontinence affects women, men and children of all ages; physical ability; and background. The impacts of incontinence are far-reaching and can affect a person's physical, mental and emotional health and wellbeing. People who experience incontinence can suffer from shame, fear and anxiety. Older Australians are particularly impacted by incontinence. Incontinence is intensely and severely personal and often stigmatising condition that requires time and the right skills to manage appropriately.
The Royal Commission into Aged Care Quality and Safety received a range of evidence on the prevalence and management of incontinence in residential aged-care facilities across the country. The commissioners were disturbed to hear that 71 per cent of people in residential aged care have experienced incontinence. Negative effects of incontinence can include increased risk of depression, reduced quality of life and increased risk of pressure injuries and infections. Evidence presented to the royal commission also indicated that some residential aged-care providers unintentionally contribute to incontinence by adopting flawed approaches to its management. The commissioners also heard that aged-care workers often do not have the time needed to assist residents to go to the toilet in a timely manner and incontinence pads are used to manage the workload. This is especially concerning given the number of people in residential aged care with incontinence is expected to almost double from 129,000 to over one-quarter of a million people by 2031. These factors drive up aged-care costs significantly. The estimated direct expenditure on incontinence was $1.6 billion in 2009, with 83 per cent of this on residential aged care.
It is not clear if any of the aged-care funding provided in the 2021-22 budget will be allocated to improving continence care and management as part of the government's aged-care reform agenda. The Continence Foundation of Australia has commissioned the National Ageing Research Institute to develop and test a best practice model for continence care in residential aged care.
We can improve the quality of life for people in aged care significantly and we can do it both now and into the future if people receive the best continence care. Prioritising continence care and support will improve the health, wellbeing and dignity of all people in aged care. I call on the government to implement a best practice model of continence care for residential aged care in Australia and to make sure that the funding that was allocated in this year's budget is also spent on continence care.