Bernie Ripoll (Oxley, Australian Labor Party) Share this | Hansard source

It is a pleasure to speak on the Aged Care Amendment (2008 Measures No. 2) Bill 2008 in this place and to make some remarks. I will be making some remarks about the member exiting the chamber—the member for Fadden—in relation to some of the comments he made. There are a few truisms that exist in life. There are two that we all know very well, two certainties: one is death and the other one is taxes. But I think there are a few others that we ought to acknowledge in the discussion on this bill, and they are that we are all going to age and not only will we age but we will live longer; not only will we live longer but we will need more care in our older years; not only will we need more care but we will need higher levels of care; and not only that but it will cost the taxpayer a lot more as well.

This bill is really about addressing long-term structural regulatory and funding mechanisms to make sure that as a government and as a nation we are prepared to deal with those issues and to begin the process—and I think it is a continuing process—of ensuring the highest possible standard, the highest levels, of quality care in Australia for all aged and frail people, whether they are in care in a facility or home or whether they are in their own home or under some other mechanism of care.

I have listened to a number of opposition members speaking on this bill, and I did have a look at what the shadow minister said in her contributions in relation to aged care. What I can divine from all those comments is that on the whole we are actually keeping our promises. That is what the opposition are saying: on the whole we are actually delivering on the commitments we made; on the whole it is actually good legislation, it is a good bill. I read through and underlined a number of things Mrs May, the member for McPherson, said. She said that the opposition support the measures in the bill—not one or two of the measures but quite a few of those measures.

There is not so much an argument or a debate across the chamber; we all in the end need to do more. We heard that from the member for Fadden, who said that basically the Labor Party are keeping all of their promises: they have consulted widely. Labor have consulted not only with the sector, residents, contributors, owners and operators; we have also consulted with the unions. There is nothing wrong with that either because they actually represent all the people that work there. Through them we have consulted with all the workers. We have consulted with them directly as well. So, on the whole, the gist of the comments and the debate from the opposition has been quite simple: ‘While we support the bill, while we think it is a great bill and while you are meeting all your commitments and promises, we think you ought to do more.’ What a lovely, lovely thought on this bill from the opposition. If that is the strongest criticism they have of us, I am more than prepared to accept their criticisms on a daily basis. The reality is that all of those things are true. We are meeting our commitments, we are keeping our promises and we are also doing more—the bits that are left over from the previous 12 years of the Howard government, when they did not do more. What they did was more of the same. What we are doing is something a bit more innovative. We are dealing with the structural issues of aged-care provision. We are actually dealing with, at its very core, the principles that underline what will be the strength in the system in the years to come.

I also want to note that the opposition not only do support the principles of the bill but also acknowledge that we are keeping our election commitments and promises. I know that this is probably a bit unusual for them because they were more accustomed to having promises in two categories—the core and non-core promises; some that you kept, some that you did not and some that you completely ignored or forgot. On this side we think that aged care is too important to be merely categorised into core and non-core promises. We need to act and we need to make some substantial changes to ensure that for the next 40 years we actually provide the regulatory legal framework and the funding mechanisms for the future. All of us here need to make sure that as we age we do so with dignity, that there will be care facilities in place and that there will be enough workers in the industry—that we have put forward mechanisms making sure that we not only look after the people that need care but we also look after the people that care for them. I think that that is just as important.

These are not easy issues to deal with. These are complex matters and they are ones that require an awful deal of taxpayers’ dollars. That is not a complaint or some sort of objection; it is just reality that we will need a lot of money in this area.

I want to specifically raise the matter that this year the Productivity Commission released a research paper entitled Trends in aged care services: some implications and I think it is important that people do look at some of those significant issues that are raised in the report. It creates for you an image of the future that is quite startling. If anybody is interested at all in aged care they would understand that the future of aged-care is, I think, quite stark in this country and that we need to do more. I am very pleased to say that this bill is the beginning of us doing more; it sets the right path.

The demand for aged care over the next 40 years will be enormous. People aged over 85 are expected to increase fourfold in number by the year 2047. If you can imagine what that means in terms of government funding and government budgets, given the current systems that we have got in place, the figures are frightening: how many more people will be in need of care, of funding; how many residential aged-care beds will be required and the facilities that will be required. And all of this is at the same time that there is a lifting the standard of quality provision—very much like health. The conundrum that we all face is that while people are generally living longer, their health is not necessarily becoming better and their expectations of health provision, as in aged care, are growing exponentially as well. So we have got a lot of work in front of us. Approximately one in seven Australians aged 65 years or older will be in that group. They will make up 13.4 per cent of the population. By 2050, those people who are 65 or over will, let us assume, by that stage no longer be working and therefore no longer necessarily be contributing directly to the tax system. Yet, while we have fewer people contributing to the tax system, at the same time we are going to have more people needing it.

This bill is about setting forward a regulatory framework for Commonwealth funded aged care and at its core, as I said earlier, it is about the protection of the health, the wellbeing and the interests of care residents. That has to be the core; it has to be the principle that we apply. The bill is designed to ensure that the one quarter of a million, approximately, frail and older Australians who are either already in residential care or receive some sort of community care service in their homes receive high-quality care—the sort of care that we would expect for our own parents or for ourselves. For me that is the line that I draw; it is the frightening thought that one day I am going to need these services and I do not want to end up in a facility somewhere that ends up on the front page of a newspaper because of abuse, or poor services or some other issue.

We have already heard about some of those things from other speakers so I will not dwell on that, but that is the reality. While the majority of the aged-care sector is hardworking, caring, responsible and doing the right thing, properly managing their responsibilities in terms of the services they have to provide and the government funding and the funds of their residents, there are unfortunately some in the sector who, because of the open nature of the sector, can abuse their position. We have seen some horrible cases over the years, but I will not dwell on that. I just mention it in passing because it is important that we continue to improve the regulations and that we do not run away from the hard things that the government needs to do to ensure the community has confidence in our aged-care sector. I believe that on the whole there is confidence out there, but the horror stories that appear do undermine and weaken community confidence, so we need to make sure we are on top of those things. By putting this bill through the House, I understand with the support of the opposition, we will be on the road to continued improvement.

The industry has changed significantly over the past decade, as has been noted. It is very different from the way it was when the Aged Care Act 1997 first came into play. We have seen since then a change in the structural make-up of aged-care facilities, in the way they are owned and operated. What was once an environment of fairly small, cottage industry type service providers has turned into multisite, multistate, multiservice operations using complex financial and legal arrangements. There is nothing wrong with that. That is the evolution that occurs in any sector when perhaps better financial systems or ways of operating are found to improve efficiency and deliver better services. But as a government we need to ensure that our regulations keep pace with what is happening in the sector. Again, that is what this legislation is about. Often those sorts of complex arrangements create unintended consequences. We are setting out to make sure that we keep pace with the consequences that arose in the 10 years since the Aged Care Act was passed and with further industry developments.

The bill also amends the Aged Care Act and the Aged Care (Bond Security) Act in relation to bond security. Because of a number of legislative inadequacies, the amendments are to maintain an effective regulatory safeguard for older Australians. There is something like $6.3 billion being held in trust through these bonds from care residents. It is a lot of money, it is other people’s money and it needs to be properly administered. There needs to be confidence about this in the wider community and by the people who are literally putting their houses on the line to provide these bonds. The funds have to be managed in a proper, fair and equitable way, and they have to be protected in case of the liquidation, insolvency or collapse of a particular provider. I can speak from some experience, having been involved with some segments of the Queensland aged-care sector. I applaud their contribution and I am very satisfied with the level of involvement they have had in trying to work with the government to make sure we understand directly what the issues are for the providers and owners in the sector. We need to understand the complexities of the structures for those in the sector and the costs involved not only in maintaining aged-care facilities but also in building new facilities and the interaction between what the government provides, what they can provide through private funds and what they hold in bonds.

The issue of the cost of employment, of wages, is a very serious and real one, and it is something that I do not believe that any of us can shirk or get away from. We need to understand that one of the crisis areas of aged care is aged carers themselves—their remuneration and the conditions that they have to work under. We need to strike the balance between responsibility, assessments and the quality assurance that we want aged-care facilities to have. At the same time, we need to make sure that there is the right care environment, because it is about care. In the end, we are talking about people; we are not just talking about a commodity. We are talking about our parents, our grandparents and, one day, ourselves. We expect a high level of care. We want people who are looking after us to actually feel something and to understand that when you become a frail, older Australian it is a very difficult time. I think we need to balance all of those issues. Having and maintaining an effective regulatory regime with safeguards is all about doing that, and that is what we are setting out to do.

There are also changes in the way that providers deliver quality services. The suitability of some providers may have changed over past decades. What was once a cottage industry type provider may, over the years, in a much more complex environment with higher demands, higher assessments and higher quality expectations and standards, no longer be capable of providing that level of care. Therefore, there needs to be a review of the way that we assess those providers. This legislation does that. I am also very appreciative of the way that the minister has dealt with making sure that the security extends to not just the operators of these facilities but also the owners, because there can be a real disconnect between those who are the structural, board-type owners, such as those who work through managed funds and trusts, and those who are actually the operators. The existing legislation does not cater for that occurrence. The decision makers, who are often pulling the financial strings and making, therefore, very important decisions, do not come under the present legislation. This amendment will rectify that. This amendment will mean that not only operators and owners but also those that are involved through trusts and boards are considered to be key personnel.

There are a broad range of issues being dealt with in this legislation. It is about making sure that, in the end, we clarify a number of services. Retirement villages and other different set-ups may now have multilevel care. You may find that a provider that once just delivered a particular type of service now has multiple services on site, such as aged care, frail aged care, care for people with disabilities and care for young people with disabilities. This legislation deals with understanding and acknowledging that the act must be regulated specifically to those in aged care so that it does not rope in other people in the one facility and create unintended consequences. I am very pleased that we have been able to do that.

As of 30 June 2007, there were around 970 approved providers, and 75 per cent of all approved providers held accommodation bonds. As I said earlier, those total around $6.3 billion—a substantial amount of money. We want to maintain consumer confidence and maintain and increase the level of corporate investment. We want to ensure that, by putting the right frameworks in place, we give confidence to the private sector, to the corporations that want to be involved and invest. For them to put their money on the table, the right regulations have to be in place. That is what we are doing through this legislation.

The bill also clarifies a number of key responsibilities for the Secretary of the Department of Health and Ageing when considering the imposition of sanctions against aged-care providers, with the core principle being the protection of health, welfare and the interests of current and future care recipients. It is the way the responsibilities of the secretary of the department ought to be. We have made sure we have gone out to the sector. We have made sure that we have consulted with the community. We have made sure that we have consulted with those people who are involved, because we cannot do this alone. We cannot just do this from the perspective of government. We have to take an approach of working with the industry and the sector to understand what their issues are.

This bill does all of those things. It also makes some minor operational changes, improving the administration of the legislation so that it operates more efficiently and effectively. This is about cutting away red tape, simplifying processes, ensuring that you get the right mix between the demands and the responsibilities you place on aged-care providers, as opposed to the demands you make on them in providing care for the people for whom they are responsible.

I am proud to say that the government have been working closely with everyone in the sector. This is a very important and essential area of services that are provided in the community. The government ought to continually review our own operations and the effectiveness of the regulation and ensure that the taxpayers’ dollars that we put into that area are efficiently and properly expended and, at the same time, ensure that we provide the right sort of care for people. I want to be able to confidently walk out into my community and talk to those providers and ensure that they understand why we are putting this measure in place. So far, the feedback that we have had from them is good. It is quality feedback and it supports the principles that the government have set forth in this legislation.

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