Zed Seselja (ACT, Liberal Party, Minister for International Development and the Pacific) Share this | Link to this | Hansard source

SESELJA (—) (): I table a revised explanatory memorandum relating to the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021, and an addendum to the explanatory memorandum relating to the Social Security Legislation Amendment (Remote Engagement Program) Bill 2021, and move:

That these bills be now read a second time.

I seek leave to have the second reading speeches incorporated in Hansard.

Leave granted.

The speeches read as follows—

AGED CARE AND OTHER LEGISLATION AMENDMENT (ROYAL COMMISSION RESPONSE NO. 2) BILL 2021

Today I introduce the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill of 2021. This is the second stage of aged care legislative reform to deliver the high quality and safe aged care that our senior Australians deserve.

This Bill responds to a number of Recommendations of the Royal Commission into Aged Care Quality and Safety, ahead of further reforms that have been committed to by this Government.

Australian National Aged Care Classification (AN-ACC)

This Bill implements significant structural reform of funding for residential aged care. It replaces the outdated Aged Care Funding Instrument with a new model for calculating aged care subsidies. The Australian National Aged Care Classification (AN-ACC) model has been developed in consultation with the aged care sector and consumer groups over several years and it will encourage innovation and investment in the sector.

The AN-ACC was developed following an extensive research project, and the Government has taken a staged approach to implementation. From April 2021, residential aged care recipients have been progressively assessed and classified under the AN-ACC, and this classification will now be linked, through this Bill, to the subsidy calculation for residential aged care providers. This Bill will finalise implementation of the AN-ACC model from 1 October 2022.

Aged Care and Support Worker Regulation

The Royal Commission recommended strengthening regulation of the personal care workforce and increasing protections for senior Australians from workers who pose an unacceptable risk of harm.

This Bill responds in part to Recommendation 77 of the Royal Commission by establishing authority for nationally consistent pre-employment screening for aged care workers and governing persons of approved providers. It also establishes a Code of Conduct, which will ensure poor behaviour of approved providers, workers and governing persons is held to account.

A national database of cleared and excluded individuals will support employment decisions in aged care and, through mutual recognition arrangements with the National Disability Insurance Scheme, across the care and support sector more broadly.

The Aged Care Quality and Safety Commissioner will have powers to make and enforce a Code of Conduct. The Commissioner will have a range of powers to deal with breaches including civil penalties, and, significantly, new banning orders for individuals, in line with recommendation 103 of the Royal Commission.

These new regulatory arrangements are designed to work together, to effectively manage and prevent unsuitable workers from entering or remaining in aged care.

Extending the Serious Incident Response Scheme to home care

The Bill extends the Serious Incident Response Scheme to home care and flexible care delivered in a home or community care setting from 1 July 2022. These amendment give effect to Royal Commission Recommendation 100.

The new requirements seek to build provider capacity to identify risk, respond to incidents, and drive learning and improvements that will reduce the number of preventable incidents in the future. Under the scheme, providers of in-home aged care services will be required to identify, record, manage and resolve all incidents that occur.

By extending the definition of reportable incident, this Bill will ensure the most serious incidents occurring in home and community care settings are reported to the Aged Care Quality and Safety Commission. Expanding the Serious Incident Response Scheme will reduce the risk of abuse and neglect, and protect vulnerable senior Australians receiving aged care services in their home and the community.

Strengthening Provider Governance

This Bill improves the governance of approved providers from 1 March 2022. The amendments align with recommendations 88 to 90 of the Royal Commission, which note that good provider governance arrangements result in high quality care.

A number of new governance responsibilities for approved providers and their governing bodies will be introduced, as well as new reporting requirements to assist senior Australians and their families to understand the operations of providers.

Approved providers will be required to notify changes to key personnel, and the Bill will replace the current disqualified individual arrangements with a suitability test. The new governance arrangements will improve the transparency and accountability of providers, and will change the culture from the top down.

Enhanced Information Sharing

Along with improving regulatory protections in aged care, the Australian Government is taking a first step towards aligning the regulation of providers across the broader care and support sector. This sector covers aged care, disability support and veterans' care. Regulatory alignment will improve the consistency of quality and safety protections across the care and support sector while reducing the overall regulatory burden on cross-sector providers.

The Bill facilitates increased information sharing by the Commission, Department of Health and Department of Veterans' Affairs with specified Commonwealth bodies. It will facilitate information sharing about providers and workers operating across the care and support sector who are not complying with their obligations, are failing to provide quality care or whose conduct might be putting senior Australians at risk. The amendments seek to address aspects of the existing legislation that make it difficult to share information in a way that responds effectively to such risks.

I note that reciprocal sharing of information about provider and worker conduct in the National Disability Insurance Scheme will be facilitated by proposed information sharing powers in the National Disability Insurance Scheme Amendment (Improving Supports for At Risk Participants) Bill 2021.

Increased Financial and Prudential Oversight

The Government is implementing a new financial and prudential monitoring, compliance and intervention framework for the aged care sector. Its purpose is to build the sector's financial resilience and improve its accountability. It will enable the Government to identify at risk providers earlier, and help ensure providers meet their obligations to refund deposits to residents.

This Bill introduces the second phase of a three-phase reform by:

These changes implement the Government's commitment to enhancing the transparency of the aged care sector and supporting continuity of care for senior Australians. They also respond to the Royal Commission's recommendations for more stringent financial reporting requirements and strengthened monitoring powers.

Independent Health and Aged Care Pri cing Authority

Finally, the Bill expands the functions of a renamed Independent Health and Aged Care Pricing Authority to also include the provision of advice on health care and aged care pricing and costing, and to perform functions conferred on it by the Aged Care Act.

New governance and appointments arrangements will streamline administration and reflect the enhanced responsibilities and integrated functions of the Pricing Authority. Information used and disclosed to perform the new functions will be appropriately protected.

Establishing an independent aged care pricing and costing advice function will support transparent and evidence-based assessment of the costs involved in delivering care to senior Australians who use aged care. This builds on our existing work to improve transparency in the aged care sector and fosters community confidence that the care they receive is cost-effective and sustainable. Transferring functions performed by the Aged Care Pricing Commissioner to the Pricing Authority will further streamline administration and enhance industry confidence.

Collectively, these amendments form the second step in the Government's five year reform agenda through the five reform pillars: home care, residential aged care services and sustainability, residential aged care quality and safety, workforce, and governance.

The health, safety and wellbeing of senior Australians is of the utmost importance to the Government, and is driving our plan for generational change of the aged care system.

HEALTH INSUR ANCE AMENDMENT (ENHANCING THE BONDED MEDICAL PROGRAM AND OTHER MEASURES) BILL 2021

The Australian Government recognises the unique challenges facing the health system in the regions and is focused on improving the capacity, quality, distribution and services to meet the needs of families and communities

The 2018-19 Budget $550 million ten-year Stronger Rural Health Strategy continues to give doctors more opportunities to train and practise in regional, rural and remote Australia, and incentivises nurses and allied health professionals to participate in multidisciplinary, team based primary care. After the first two years, more than 700 additional GPs and 700 additional nurses are now working in regional and remote areas.

Building on and supporting the implementation of the Stronger Rural Health Strategy, the Government has announced a further $123.0 million Health Workforce Reform package in the 2021-22 Budget to ensure the health workforce is available to improve the health and wellbeing of all Australians.

The Government funds a broad range of programs to train, attract and retain medical professionals in rural communities. This includes the statutory Bonded Medical Program - the Program - which commenced on 1 January 2020.

The Program provides a Commonwealth-supported place in a medical course at an Australian university in exchange for participants completing a Return of Service Obligation (RoSO) working as a medical practitioner in a regional, rural or remote community. The Program aims to deliver high numbers of vocationally recognised GPs and specialists to areas of workforce shortage.

In addition to accepting new student participants every year, the Program allows participants of legacy schemes - the Medical Rural Bonded Scholarship (MRBS) Scheme and the Bonded Medical Places Scheme - to opt in to the Program. Participants from these legacy schemes are attracted to opt in to the Program because it provides more flexible options to undertake and complete their Return of Service Obligation. In addition, the Return of Service Obligation - generally three years - is less than what would otherwise be required under the legacy schemes.

The Health Insurance Amendment (Enhancing the Bonded Medical Program and Other Measures) Bill 2021 (the Bill) provides additional flexibility to support the ongoing administration of the Program. The proposed amendments will address unintended consequences in the interests of participants and will also support achievement of the Program's objectives.

The proposed amendments to the Health Insurance Act 1973 will introduce additional administrative flexibility into the Program. Amendments will allow a person to cease to be a bonded participant - and effectively exit the Program - in the event of their death or if the Secretary determines that exceptional circumstances apply to the person.

The amendments also provide greater flexibility to provide some long-term legacy scheme participants - who would otherwise not be able to complete their Return of Service Obligation in the 18 year period allowed - an extension of time to complete their Return of Service Obligation under the Program, if needed.

The Bill will also ensure that the administrative penalty applied under the Program - when bonded participants fail to give information or documents to the Department within prescribed timeframes - is appropriate and proportionate in the circumstances.

The Bill also provides for the more appropriate administration of breaches of legacy Medical Rural Bonded Scholarship contracts.

It will allow for the waiving of amounts owing to the Commonwealth accrued by Medical Rural Bonded Scholarship Scheme participants due to minor or inadvertent breaches of their contractual arrangements.

It will also establish discretionary authority as to whether a person - having breached their Medical Rural Bonded Scholarship contract with the Commonwealth - should be subject to a ban period during which a medicare benefit is not payable in respect of a professional service rendered by, or on behalf of, the person as a medical practitioner.

Overall, the Bill enhances the Bonded Medical Program in the interests of participants. It allows for more appropriate and efficient administration of bonded programs and above all, to meet and support the needs of a modern workforce - a workforce of medical professionals providing crucial health services in regional, rural and remote Australia, at this critical time.

SOCIAL SECURITY LEGISLATION AMENDMENT (REMOTE ENGAGEMENT PROGRAM) BILL 2021

The Government is reforming remote employment services in 2023. The reforms will be co-designed and piloted in partnership with a number of remote communities ahead of implementing the new program.

The Social Security Legislation Amendment (Remote Engagement Program) Bill 2021creates a new supplementary payment for job seekers in remote engagement program pilot communities who volunteer to participate in a placement that is like having a job. The placements will build participants' skills in roles that will deliver goods or services to benefit local communities and provide a pathway for job seekers to find a job. The new payment will be one aspect that communities can trial alongside other approaches to training, skills development and non-vocational support as part of the co-design of the remote employment program.

Over many decades, governments have tried different approaches to delivering employment services in remote Australia. We have learned that what works in our cities and more densely populated regions may not work in remote areas. We have also learned that we have to continuously adapt and evolve to better meet new and existing challenges.

There is more to be done to continue to develop an approach that empowers the people, many of them Indigenous people, living in our remote communities to develop their skills and engage in economic opportunities in a way that is both tailored to their specific needs and beneficial to their communities.

This Bill supports collaboration with communities to develop an appropriately flexible program that will build the skills and vocational capabilities of people in remote communities. Many of the more detailed aspects of the approach will be set out in legislative instruments and policy guidance, allowing the flexibility to adjust as lessons are learnt and communities' ideas change over the course of the pilots.

Achieving sustainable change in remote communities can only be done by working together, including by listening to Indigenous experience and expertise to develop a new approach. Working in partnership to pilot innovative approaches, learn and review, and develop the new program will be key to our future shared success.

Rewarding and sustainable employment opportunities are transformational for individuals, families and communities. Jobs contribute to financial and economic security and to self-determination and wellbeing.

Australians living in remote communities face complex employment challenges, different from those experienced in regional and urban areas. Remote areas cover 75 per cent of the Australian land mass however there are fewer jobs available in remote areas, with less than two per cent of actively trading businesses located there.

The measures in this Bill recognise the lack of employment opportunities people, including Indigenous Australians, face in some of the most remote parts of Australia. The opportunities and circumstances in remote Australia are unique and different from urban areas, and this will continue to be the case. We have heard what communities and stakeholders have said about current and previous remote employment services. We know remote communities want changes so that future employment services better match place-based economic circumstances and labour market opportunities.

This Bill supports the reforms to the Government's suite of employment services and programs to ensure they remain fit-for-purpose, make the most of technological advances and support Australia's economic recovery from COVID-19.

These reforms include the Government's 2021-22 Budget announcement to pilot a new remote engagement program to trial approaches in advance of replacing the Community Development Program (CDP) in 2023. Initially, we estimate around 200 eligible job seekers across the pilot sites will volunteer to participate in placements in work-like roles across their community and receive the payment.

We want to collaborate with stakeholders to develop a new remote engagement program that will better enable job seekers to contribute to goods and services that will strengthen the economic, social and cultural life of communities and build in-demand skills. And at the same time, create a pathway for these job seekers to build skills to find local jobs.

When implemented, the new program will contribute to the National Agreement on Closing the Gap, which includes targets to close the gap on employment outcomes between Indigenous and non-Indigenous Australians.

The new payment is one possible design element of the new program we would like to co-design with communities as part of the pilots. We will also work with communities during the pilot phase to explore:

This Bill makes changes to the Social Security Act 1991 and the Social Security (Administration) Act 1999 to create a new supplementary payment that will be paid at a fixed rate between $100 and $190 per fortnight. The new payment will be paid in addition to an eligible job seeker's primary income support payment and other supplements. The new payment will not be subject to the income test.

This Bill proposes an eligible job seeker's income support plus the new supplementary payment will be approximately equivalent to the minimum wage for the hours participating in work like activities. Eligible job seekers will voluntarily participate in a role in government services or community organisations between 15 and 18 hours per week building important skills and experience. The payment will be designed not to discourage people from taking up paid employment opportunities. The pilots provide an opportunity to test the level of incentives.

The Bill defines an eligible job seeker as someone receiving a qualifying income support payment, who receives employment services from a Remote Engagement Program service provider and who has agreed to participate and is participating in an eligible placement, with a host organisation, for at least 15 hours per week.

Eligible job seekers will be considered to be fully meeting all their Mutual Obligation Requirements by participating in the scheme. Eligible job seekers can voluntarily choose to leave the placement at any time.

To give effect to this commitment of working in partnership, this Bill proposes further detail about qualification criteria and the rate of the payment be set out in legislative instruments. These legislative instruments will be informed by the outcomes of a co-design process with communities in the pilot sites. We will take the time to work together and listen to communities in the pilot sites about what they think could work in relation to the amount of payment to be provided, the hours of engagement to be undertaken in return and what eligible job seekers are required to do to continue to receive the payment. This approach will also enable adjustments during the pilots as lessons are learned.

This Bill provides that the payment will not be payable after 30 June 2024.

While the Bill will have no impact on arrangements for current CDP participants outside the pilot sites, learnings from the pilots will inform the design of the new program.

The Bill also proposes amendments to repeal or omit provisions of the Social Security Act 1991 and the Social Security (Administration) Act 1999 relating to the former Community Development Employment Projects (CDEP) Scheme. Removing these obsolete provisions will assist with modernising and streamlining the social security legislation.

It is important that we take this opportunity to work with Indigenous and non-Indigenous Australians in remote communities. Sustainable change can only be done by working together, including by listening to Indigenous experience and expertise to develop a new approach. An approach that empowers individuals to gain skills and find a job. And an approach that enhances employment pathways for job seekers in remote Australia to realise aspirations. For themselves. For their families. And for their communities.

Debate adjourned.

Ordered that the bills be listed on the Notice Paper as separate orders of the day.