Andrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | Hansard source

I rise to speak on the Aged Care (Living Longer Living Better) Bill 2013 and cognate bills. Australia has a proud tradition of fine aged-care services and I think everyone in this chamber who has travelled around this great nation and who has visited an aged-care facility is, by and large, genuinely impressed with the quality of care that is offered, in the context that it is an increasingly challenging space in which to be working. We have of course the demographic shifts that have been alluded to earlier in this debate, with the proportion of Australians over the age of 70 increasing from nine per cent to well over 20 per cent by 2051. But we also have the great challenge that this is fundamentally a private-sector-driven area of health and welfare, so we always need to have the appropriate amount of government support: not too much and not too little.

As I look back over the last five years my observation, with a focus on the health portfolio, is that many of the challenges that beset our health system in 2007 still remain today relatively untouched and unblemished. They are still here today, mostly not addressed. I acknowledge that there has been negotiation around funding agreements but, on the frontline in health care, we have many of the same challenges that we faced five years ago. That, I think, is a significant criticism of the current federal government if for no other reason than that it has been recognised by the COAG Reform Council, which noted just last week in their report that we are fundamentally a less happy population with our health system, with 24 per cent now waiting more than 24 hours to see a GP as compared to just 11 per cent in 2010. We are facing all of those social challenges in our health and welfare system. We are still waiting just as long for operations as we were in 2007. There have been some minor improvements in A&E through some performance payments but, by and large, we have a health system with very little change.

Contrast that with the aged-care sector and you will see a very different story. This has been a sector effectively in suspended animation, desperately in trouble, with only 40 per cent of our providers in the black and most of them holding on desperately by their fingernails, waiting for some kind of reform. When you are in free-fall and facing ground rush, I accept that you will grasp any kind of parachute you can.

With respect to this legislation, it has already been clearly pointed out by speakers from the seat of Wentworth all the way through to the seat of Grey, in some of the most remote parts of Australia, that the challenges are the same. We have seen a tricky shift where we have effectively taken money out of the funding instrument and we have moved it into a union recruitment tool in the guise of higher wages for staff who desperately deserve that. Everyone is smart enough to see that.

In my contribution I want to ensure that some of those observations are read into Hansard for posterity. I have an enormous amount of regard for Minister Butler and his approach to many of his affairs, but I do find this last-minute, rushed arrangement that was rolled out in Western Sydney just a month ago was genuinely beneath him. The minister looked around for an aged-care facility in which he could make the announcement. Not being able to find one he, instead, chose a church in the hope that perhaps some old people behind him might make it look a bit like an aged-care facility. It was patently ridiculous. There is very little support in this sector for the goodwill within this framework of bills; certainly not for the delegated legislation that is to come sometime later but that none of us can yet read. But I acknowledge that many in that sector are desperate for anything. When it is this late in the game, and when services are this close to the bone, I acknowledge that they will grasp at anything. Effectively, we have an offer to increase wages in a context where many services are unable to pay them. More importantly, no matter how much one offers in increased wage deals through union enterprise-bargaining agreements, if you are ripping it out first from the funding tool, then it is almost futile in a negative feedback loop where some centres will simply not be able to survive. I acknowledge that, if you are a centre of less than 60, you are exempted from those EBA arrangements but the majority of our providers in metropolitan Australia are a tick over 60 and are all faced with this reality.

It is a lot of money—$1.6 billion. It amounts to tens of thousands of dollars; in fact some centres on average have to find around $125,000. The most preposterous thing of all is, in a game where we are trying to provide certainty to the private sector and confidence to invest—let's get this right, Deputy Speaker Murphy—aged care is not an area where the government provides the majority of the services; we are utterly reliant on private providers. To provide this 28-day buffer where one can move into an aged-care facility and only after 28 days make a decision on whether you pay upfront or in designated allocations over time is akin to me selling my house, having someone agree to buy it and then 28 days later saying, 'No, I have changed my mind: I am just going to rent it.' That is what you are doing, Mr Acting Deputy Speaker, and I ask you to reflect on that.

The merits of someone who is building for the future and providing services for our seniors having to wait 28 days only to be told, 'Sorry, we've decided to rent and try, not to buy' effectively imperils your entire business model. How do you take that to a bank? How do you convince a bank to lend on those grounds? It is enormously difficult because, believe it or not, when you build an aged-care facility you cannot, 28 days after they finish the completion of a structure, say, 'We've decided to pay it off in allocations over the next five years.'

I would like to include from my own electorate the comments of Paul Mitchell, CEO, from Adventists Aged Care, who said these are the two key issues:

The rest of it is all just machinery of government. Under the proposed changes, a resident can make these decisions 28 days after they move in and in our facility in Victoria Point they are having a series of expansions: 89 new beds to be completed by September. That is part of stage one and that will be completed prior to this legislation applying, but stage 2 is now at risk of not happening at all.

So there you have it from the front line. How do you go back to a bank and explain to them that you want to receive millions of dollars in borrowings only to not be able to pay it back until you receive allocations or contributions over years? This facility in my electorate will simply have to face refinancing and the risk of not being able to proceed at all.

What we have here is a very, very clever recruitment tool for the unions and it is very clearly included in union propaganda, even from the minister's own union. There was an effort to modify the scoring tool so that less money could be given to providers, only to see more money given to workers, and hope that that somehow balances out. It is a murky approach, and some of the most senior aged-care experts in the country have said it is not the way to do business.

The other great criticism that was mounted in the defence of this legislation was a very serious accusation of rorting. I do not know whether this government has a preoccupation with singling out professions and claiming that there is a problem with rorting, and then never providing that evidence, but using that as the basis to proceed with often significantly flawed or biased legislation. We saw it in the cataract rebate debate in 2009 when an entire profession was traduced on the grounds that they were rorting the system—for goodness sake, providing more vision to Australians by doing cataract rebates and this was rorting.

We had the same claims made against the dental profession in an effort to bring down the CDDS and effectively close out 96 per cent of Australia's dentists from being able to deliver care to the sickest of Australians with chronic disease—all based on this claim of rorting. We saw threats to the dental profession to scare them into not providing dental care with the possibility that they would never be reimbursed. Ultimately, the CDDS, which could have been easily refined and improved, was instead terminated: September, no new entrants; November, all work to be completed. The result of that is that, right now, we see Indigenous Australians having to scavenge for $300 dental vouchers from public hospitals to get urgent dental work done. That is another health outcome in 2013 under this Prime Minister, all based on the proposition of rorting by professionals.

We do not have to do it that way. We can work with the profession. We can work with the sector, and of course there will be elements of rorting everywhere one goes. That is the job of the legal system. That is the job of a department doing appropriate audits to address those providers and those examples. What is the first thing that happens when a minister talks about rorting in the aged-care sector? Mr Acting Deputy Speaker, I put to you that my parents, and others who might some day be in an aged-care facility, say: 'I wonder if I'm being rorted. I wonder if this place is rorting me. I wonder if I'm being ripped off.'

I think that the blackening of our wonderful aged-care sector is not only regrettable but patently avoidable. We do not need to do that to get legislation through this place, nor to advance the interests of our aged-care sector. It does not need to be divisive. It does not need to attack the providers and it does not need to set up these envy based attacks between the tenant and the builder; the aged-care provider and the resident; and the provider of a health service and the recipient of one. There is another way, but in five short years this has been a recurring pattern of behaviour from a government that should know better and could do better but instead has chosen the low road of traducing providers.

I would like to make an observation about union recruitment, because this has been picked up by many providers. It is very obvious that this funding instrument has been linked to these supplements. The amounts are comparable. The first thing that aged-care providers say is: 'What is taken from one hand and provided to the other leaves me how much more worse off?'

It is clearly a case of a simple transfer. What we have is an obligation to enter into these enterprise-bargaining agreements and, as I alluded to a little bit earlier, I wanted to read out exactly what appears in the minister's union's own propaganda. It simply says:

Most employees on award wages need to negotiate an Enterprise Agreement to get the pay rise.

And it continues:

To win a good agreement, all potential members are urged to join United Voice to speak with one voice in negotiations.

It could not be any simpler than that. I think the obvious observation is that the money that is being provided from government coffers, through union-negotiated wage increases, is in turn paid as union fees to unions. What is it spent on? Let us reflect on where that money is spent. It is a fairly obvious assertion of mine that the money is effectively being diverted for political purposes. I think that too is regrettable. We do not need to draw the fine aged-care sector into those kind of murky dealings. It is not just me saying that; I did want to include the comments from Ray Glickman, who said we are effectively:

… stripping money from the care of our frail older people. Not only that, but the only way to re-access these care funds will be via deals with unions.

Our frail elderly are being sold short, and this redirection of existing funding, by adding further pressure to an industry at breaking point, will inevitably impact on the wellbeing of the most vulnerable in our society.

Leading Age Services, LASA, say that the compact is strikingly similar to aged-care reforms, and is 'tinkering at the edges and will not address the real issues faced by the industry'. They say that 'older Australians have been shunted off to one side' and:

… This government is not providing care based on need it is delivering a system of aged services with an imposed fiscal limit. This is why every 73 minutes another Australian is denied access to aged care.

Lastly, I wanted to quote this comment, from Catholic Health Australia's CEO, Martin Laverty—who, I concede, made balanced comments:

A government contract for services should not in our view stipulate an industrial outcome. Aged care providers and their staff should be free to determine above award employment arrangements at a local level, reflecting the circumstances in their workplace.

And it could not come any clearer than that.

These should be way more than just administrative changes; they should be way more than shunting money into the pockets of our unions. Our aged-care services are without doubt the finest in the world. They have waited for five years for this and they should have received far better.

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