Louise Markus (Macquarie, Liberal Party) Share this | Hansard source

I rise to speak on the Aged Care (Living Longer Living Better) Bill 2013 and cognate bills. I believe that one of the ways we as a society are judged is the way in which we look after and care for our elderly. Those in aged-care facilities are at a very vulnerable and sometimes difficult stage in life. We have all been in a position where a grandmother, grandfather or parent has had to go into aged care, and as fellow human beings we know that our elderly deserve not only dignity but also respect at this stage of their lives. We have a responsibility to the aged—to our seniors—to provide them with the best services and care available and to support the service providers who engage and respond to their needs.

During the 2010 election campaign the Prime Minister said, 'If re-elected, further aged-care reform will be a second-term priority for my government.' Australians can add that statement to the list of broken promises by this Prime Minister. We have seen a government undertake a litany of reports and reviews, including 20 reviews and three Productivity Commission reports, which are continually ignored or responded to with more inquiries without making any decisions to secure aged care into the future.

Despite promises of reform, five years on there is very little evidence of real change on the ground, where it counts the most. After five years of Labor's neglect our aged-care system needs urgent change to provide viable and effective aged-care services for older Australians. Labor has failed to undertake proper and sustainable reform and to make the hard decisions to give effect to it. It is clear that the Living Longer Living Better package of five bills does not resolve many outstanding viability issues for providers. Under these reforms there have been cuts from the Aged Care Funding Instrument—ACFI—that have placed substantially more pressure on the sector. The bills only cherry pick a few recommendations of the Productivity Commission report Caring for older Australians from August 2011. They add to regulation in what is already a highly regulated sector. The bills establish the framework for the workforce compact, which has created uncertainty, potentially will be costly for providers, relies on cuts to ACFI and appears to be a political mechanism to unionise the sector.

Only the coalition has a clear plan for the future of aged care in this nation. We understand that it is only by working closely with the sector and consulting those who are on the front line that real reform can be achieved. We want to work in partnership with the ageing and aged-care sector to achieve sustainable reform through our first-ever four-year aged-care provider agreement. Older Australians in the sector are no closer to knowing how structural reform would be introduced and how it would affect the care they receive and where they receive it.

The ageing of our population is one of the biggest social issues facing Australians and is an issue that needs to be addressed now, not somewhere down the track or into the future. Australians are living longer, but we have a rapidly ageing population. In its Global ageing 2010: an irreversible truth, Standard & Poor's rating service said that age related spending on health, pensions and aged care in Australia is estimated to rise to 14.4 per cent of gross domestic product in 2050. It is currently 9.6 per cent. Around nine per cent of our population is aged 70 years or older, and this is expected to rise to 13 per cent by 2021 and to 20 per cent—around 5.7 million people—in 2051. As we are ageing we are acquiring more complex health conditions and changing disease patterns, resulting in increasing and changing aged-care needs. With fewer people generating taxation revenue, care options for concessional and assisted aged-care residents—those with the least resources—will be jeopardised.

There is growing and alarming evidence that the aged-care sector cannot provide the care that Australians expect. There are real economic implications for our nation because of our ageing population, and these implications have not been taken seriously by this government. Until there is a proper structural reform of the sector, the care and wellbeing of senior Australians is in jeopardy. Australia has one of the most advanced aged-care systems in the world. However, it can be complex and difficult to navigate. Currently over one million older Australians are receiving aged-care services subsidised by the Australian government. It is expected that by 2050 over 3.5 million Australians will be using aged care each year. Formal aged-care services are delivered through around 8,000 outlets across Australia, including about 3,660 agencies registered as delivering services funded through the HACC program, 2,095 operational community care services delivering community packages, and more than 2,700 operational residential aged-care facilities. The number of over-85-year-olds, which are the main users of aged-care services, will increase from around 400,000, or 1.7 per cent of the total population, in 2007 to 1.6 million by 2047—about 5.6 per cent for the population. The Department of Health and Ageing estimates that by 2050 aged-care expenditure will account for three per cent of GDP and a bit more than 827,000, or five per cent, of the Australian workforce may be engaged in the provision of aged care.

If there was ever a call to action for reform of aged care, this is it. These statistics are alarming and call for careful planning and action. However, at a time when there is increasing demand for services, providers are walking away from the sector because of the lack of viability of providing high-care beds and the increase in compliance demands of the government. It has been reported that up to 60 per cent of aged-care facilities are operating in the red. That is a staggering amount and reflects the economic situation that many providers find themselves in. Providers are handing back licences, and senior Australians are having to wait longer or travel further to find a bed, thereby placing extra pressure on the public hospital system and, most importantly and unfortunately, on their families. This is in contrast with the situation that we would hope to achieve under the coalition.

The Productivity Commission's final report, Caring for older Australians, was publicly released by the Prime Minister and minister on 8 August 2011. This report focuses on a shift from the current ration system based on licences and packages to an entitlement based system whereby aged care would become part of the health system. Other key features of the report include the creation of a single Australian seniors gateway agency and the recommendation that funding be replaced by a single national care co-contribution regime, which would apply across the aged-care system, whether services are delivered in the community or in a residential aged-care facility. It took the Australian government over 250 days to respond to 58 recommendations within the Productivity Commission's report. When that response finally came it was announced with great fanfare as supposedly extensive reform of the aged-care system. Whilst the headline figure of $3.7 billion over five years sounded impressive, the actual amount of new money to be spent was $577 million. Furthermore, many of the changes will not start until 1 July 2014, so the effect will not be felt until well after the next federal election. The coalition and I acknowledge that one of the failures in the aged-care reform package is the missed opportunity to reduce red tape. This is something that the sector has been urgently demanding. In a sector already wallowing in red tape, this package will heap on them more red tape and more bureaucracies to deal with. The coalition has been advised that aged-care nurses spend on average a third of their time on paperwork. Under this package, things are only going to get worse.

This is not real reform; this is another case of Labor talking but not doing anything. Some key issues have caused major concern to stakeholders: the decision to rip $1.6 billion out of the ACFI, the $1.2 billion workforce compact, and the establishment of the Aged Care Financing Authority. One critical need to be addressed is the almost 321,600 Australians living with dementia. When in government, the coalition committed $320 million in the 2005 budget to help fund the Dementia Initiative, making dementia a national health priority. Despite this initiative proving invaluable to help dementia sufferers, and a government evaluation of October 2009 finding the initiative successful, Labor deliberately dropped funding for this program. It was pleasing to see that at a subsequent meeting of health ministers dementia has now been made a national health priority. The coalition is committed to delivering a high quality, affordable and accessible aged-care scheme that meets the needs and preferences of older Australians.

At the last federal election, the coalition outlined its plan for the first ever four-year agreement and we set out some areas which we believe ought to be included in any agreement. We undertook to provide certainty of care through the first ever four-year aged-care provider agreement with the aged-care sector, and as part of that process we outlined various areas for inclusion in such an agreement. There was a very positive response. Since the last federal election, the coalition has continued to listen to the aged-care sector. We will be revising our policy before the next federal election. The fundamental framework—the first ever aged-care provider agreement framework—will be retained. It is important to stress that this is the first ever aged-care provider agreement. It would ensure certainty and engagement for the aged-care sector. In much the same way as the pharmacy agreement shapes that sector, this agreement would set the framework for aged care in Australia for the next four years.

The coalition plan to reduce red tape as an important component of our four-year agreement. Providing flexibility and certainty, we want to work with the sector to cut red tape in ways which will provide efficiencies without compromising the quality of care. The agreement will deliver better and more affordable aged care by: reducing red tape and enabling nurses to get back to nursing residents; providing certainty for aged care for older Australians, underpinned by a high quality framework; delivering value for money through revised subsidy arrangements; ensuring certainty for the aged-care workforce; establishing a more flexible and viable aged-care provider network to meet care needs now and in the future; and ensuring that the comfort and safety of older Australians is maximised.

The coalition want reform in partnership with the aged-care sector. We do not believe that fundamental reform should be imposed from above. Given the opportunity to govern following the next federal election, we will immediately commence consultation with stakeholders in the ageing and aged-care sector on the framework for the aged-care provider agreement, including consideration of the recommendations of the Productivity Commission. The coalition want an agreement in place within a year of taking office.

The coalition does not want to pre-empt the contents of any negotiated agreement. The agreement framework establishes a formal pathway for future dialogue between the minister, the government and stakeholders to more effectively consider ongoing issues regarding timely and appropriate access to aged care. It will guarantee flexibility and much needed certainty in the sector. Principal Endeavour aged-care facility, in the electorate of Macquarie, have the following statement in their mission statement:

Our aim is not just to provide a home, but to provide a lifestyle surrounded by a caring, active, wholesome community.

I too believe that this should be the aim of every aged-care facility, but this can only happen by real change and reform and through the government partnering with the sector to allow them to do what they do best. I support the amendment moved by the shadow minister today and commend it to the House.

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