Jane Prentice (Ryan, Liberal Party) Share this | Hansard source

I rise to speak on the Aged Care (Living Longer Living Better) Bill 2013, the Australian Aged Care Quality Agency Bill 2013 and associated bills.

The ageing of our population is the biggest social issue facing Australia. We are a rapidly ageing population, acquiring more complex health conditions with changing disease patterns. This social issue is, of course, also a budget issue; an ageing population means fewer people will be generating taxation revenue. The dependency ratio in 2007 was six people of working age for every person aged over 67. By 2047, this will be almost halved to approximately 3.2 people of working age for each person aged over 67. By 2050, over 3½ million Australians are expected to use aged-care services each year.

With greater numbers using aged-care services, there will be greater demands on those services. There will be increased numbers of Australians with dementia requiring these services and the average age of a home-care recipient, which currently stands at 82-years of age, will continue to increase.

As we move from the baby-boomer generation to the next, users of aged-care services will no longer meekly accept what they are given, as many learned to do during the tough economic times of the last century. It is therefore integral to the future care of older Australians that we implement policies which give clients and their families the ability to choose their own provider to deliver government-funded services.

This highlights the fundamental importance of implementing real reform in the aged-care sector. However, the five bills today continue the piecemeal approach from this government rather than a genuine attempt at reforming the sector. They are a response from the Labor government, announced in April 2012, to the Productivity Commission's August 2011, Caring for older Australians report. In many ways, these long-awaited changes are simply too little too late from a government that has ignored the aged-care sector since being elected in 2007.

They have undertaken a litany of reports and reviews—20 reviews and three Productivity Commission reports in total—and have then chosen to ignore the outcomes of these processes, instead, responding with more inquiries without making any real decisions to secure the future of the sector.

Unfortunately, today's measures do not embrace the opportunity for real reform. This Labor government has cherry picked a few recommendations from the Productivity Commission report. Industry sources estimate that about five to eight per cent of its recommendations have actually been adopted from the Productivity Commission's extensive and comprehensive report, which initially received more than 500 submissions with a further 500-plus following the release of the draft report.

After five years of neglect, our aged-care system needs urgent change to provide viable and effective services for older Australians. Instead, year after year, this government has committed itself to taking money out of the aged-care sector. Last year, Labor cut $1.6 billion from the aged-care funding instrument to fund a $1.2 billion workforce compact. The ACFI is the means by which Commonwealth subsidies are allocated to residential aged-care providers. The government justified this by publicly suggesting there was widespread rorting by aged-care providers, although I note there has not been a single prosecution in five years.

As it often does, whether it is 457 skilled migration visas or our national sporting codes, this government makes public allegations that taint an entire sector without providing any evidence for their claims. Furthermore, according to the Grant Thornton report released in June 2012, after the Labor government announced the Living Longer Living Better package, more than $3½ billion in planned aged-care development projects have been shelved. The organisation Leading Age Services Australia also revealed in August 2012 that their industry faces a blackhole of more than $750 million over the next 2½ years.

Aged and Community Services Australia have also reported on the dire situation of the sector. In their 2011-12 budget submission, they reported:

A snapshot of the industry does not depict a sustainable system: that only 40% of aged care providers are operating in the black: hours of service are decreasing; hours of care provided under community aged care packages have fallen; and many providers are not building new residential care beds. The situation is worse in rural and regional areas where providers face higher costs with less ability to manage their income streams.

That is the evidence on the ground. The aged sector industry is suffering. As a result of this Labor government's decisions to cut funding to the sector, providers are facing a huge task in even remaining viable, which will, in turn, have huge impacts on Australians who need their services as well as those employed in the sector.

When speaking to aged-care providers in my electorate, they have told me that they do not disagree with the general direction of the key points of the package, but they want further detail. They are waiting on the detail about what the impact of the regulations placed on providers and consumers will mean for aged-care services. One of the most important areas on which this parliament must focus is implementing real reform to improve customer directed care. This means providing real change. The ability to decide who delivers services should be placed squarely in the hands of the consumer without the very onerous red tape and caveats that currently exist in the sector, not to mention the micromanagement of providers by the Department of Health and Ageing. If we are not able to get this right, if we are not able to genuinely improve this sector, then we undermine the entire philosophy of consumer directed care.

Users of aged-care services must be provided with all the relevant information about what services would be appropriate for them, and not just advising which aged-care organisation has been approved through the government's tendering process. This means moving away from the Canberra based bureaucratic tendering nightmare, which by its very nature will favour those already well embedded within the system. There are a lot of details to cover in these bills, which is why they were referred to the Senate community affairs committee. The committee was due to deliver its final report on 17 June 2013, but has recently ceded to the demands of the government that the parliament consider these bills without full knowledge of their ramifications and will report instead on 31 May—a change the coalition senators strongly oppose.

I am concerned that, without following the appropriate parliamentary processes, all stakeholders in the industry will not have the opportunity to make meaningful submissions on the detail of the bills and their instruments. As Leading Age Services Australia has indicated, they believe that, considering the level of detail and complexity contained in the instruments, it is essential that proper parliamentary processes be adopted. Furthermore, the opportunity to comment on the consultation draft documents for the Home Care Packages Program guidelines has not yet closed, and I expect that providers will have a great deal to say on the direction of those draft guidelines.

Ultimately, the actual details of the bills mean more bureaucracy and more regulation in what is already a highly regulated sector. The Aged Care (Living Longer Living Better) Bill 2012 implements changes in four key areas, including: changes to residential care; changes to establish a new type of care—home care; changes relating to governance and administration; and further minor administrative or consequential changes. The Australian Aged Care Quality Agency Bill 2013 establishes a new agency to replace the existing Aged Care Standards and Accreditation Agency from 1 January 2014, as prescribed under the Financial Management and Accountability Act 1997. The new agency will be responsible for approved providers of home and residential care to deal with quality assurance of their services. There will also be other new bodies, including the aged-care pricing commissioner, which will be yet another layer of regulation on pricing and will place further burdens on providers and consumers. There will be some changes to home care, including replacing community care and some forms of flexible care delivered in a person's home, such as Extended Aged Care at Home and Extended Aged Care at Home Dementia.

From July 2014, there will be changes to the way that homecare subsidy and fees are calculated for care recipients who enter home care on or after 1 July 2014. Key changes will include requiring some care recipients to contribute more to the cost of their care through an income tested care fee, that no full rate pensioner will pay an income tested care fee and that new annual and lifetime caps will apply to income tested care fees. In the changes to residential care, the government has proposed that care recipients who can afford to can contribute to their accommodation costs through a fully refundable lump sum, a rental style periodic payment, or a combination of both. The periodic daily accommodation payment is the implied preference of the government, despite the evidence given during the Senate committee's inquiry that the lump sum option provides greater stability to the sector.

Furthermore, the minister has also announced a $1.2 billion workforce supplement, which imposes further regulation and red tape on providers. Minister Butler first intended to negotiate a workforce compact with both unions and employees with consultation and the support of aged-care providers. That did not happen, because providers were forced to boycott the process when they discovered that the true intention of the minister was to increase union membership without any real attempt to actually improve services in the industry. Such was the level of disgust by the providers at this abuse of process that the minister could not even find one aged-care facility to host his announcement.

Under the proposed workforce compact, providers with more than 50 beds will have to enter into an enterprise bargaining agreement and meet certain so-called workforce obligations to access funding under the compact. Providers with less than 50 beds would be required to meet the workforce obligations but will not be required to enter into an EBA to access the funding.

However, there is no guarantee that this supposed increase will actually reach workers. The minister has previously admitted that he does not know how many of the nation's 350,000 aged-care workers will benefit. What we do know is that with only 40 per cent of providers operating in the black, many of them will simply be unable to pay the wage increases and the associated ongoing costs such as in administration and superannuation. The cost pressures will further erode their viability, especially for smaller providers in rural and regional areas, as identified by the previous speaker, the member for Maranoa.

Forcing providers to enter into EBAs mean that more aged-care workers will be forced to join a union. Unfortunately, they do not have much to choose from: there is United Voice, the Australian Nursing Federation and, of course, the notorious Health Services Union. United Voice, Minister Butler's former union, has recently put out a publication, using this new workforce compact as a call to arms for workers to join the union. It states:

Most employees on award wages need to negotiate an Enterprise Agreement to get the pay rise. To win a good agreement, all potential members are urged to join United Voice to speak with one voice in negotiations.

This compact—negotiated only with unions, not providers—is a backdoor way to coerce more aged-care workers to join a union, including the HSU. It is an industrial mechanism to unionise the sector dressed up as an administrative change.

The coalition have a real plan to take real action for older Australians and the aged-care sector. We will provide certainty of care through the first ever four-year aged-care provider agreement with the aged-care sector. We will establish an aged-care bed incentive program to provide $335 million over four years to convert up to 3,000 of the allocated bed licences to operational residential aged-care beds in the first term. We will provide convalescent care to assist up to 20,000 older people waiting in hospital to return home. We will ensure a high standard of quality care and less red tape, and we will support the continuing contribution of senior Australians through dementia programs and other community based programs.

Given the increasing difficulties the industry faces, we simply cannot continue with piecemeal approaches to the aged-care sector. We simply cannot allow this Labor government to rush incomplete legislation through the parliament without giving all relevant stakeholders the opportunity to have their say. Today's measures will only add further regulation to an already highly regulated sector.

On Tuesday night we listened to yet another deficit ridden budget speech from the member for Lilley. The Treasurer spoke—at length—about his 'Budget for the Future'. But nowhere did he mention the future of aged care; nowhere did he mention the future of older Australians. Australia needs a government willing to listen and a government with the determination to invest in genuine reforms for the aged-care sector for the benefit of providers and consumers. The coalition has been listening, and will continue to listen. Only the coalition will restore hope, reward and opportunity and give a real future for older Australians who deserve our support. I would also take this opportunity to remind the chamber that next week is National Palliative Care Week and I hope that everyone will promote that very important event in their own electorates.

See this speech in context