Warren Entsch (Leichhardt, Liberal Party) Share this | Hansard source

It gives me a great deal of pleasure to speak on the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. There is no doubt that Australia has an ageing population and, with advances in medical technologies, together with education about disease prevention and control, it is leading to us living longer lives.

I find in my own electorate that I am sending out more and more 90th and 100th birthday certificates—and even older—to my constituents. However, an ageing population creates challenges in how we best cater for the needs of our elderly community members—there is no-one-size-fits-all solution. We need a modern, adaptable and sustainable aged-care system so we can best help older people maximise their participation in society for longer.

This bill creates the framework for a more flexible, consumer driven aged-care system that will support older people to stay living at home much longer. It puts in place the first stage of the home care reforms that were announced by the government in the 2015-16 budget. These changes are about cutting red tape and giving consumers more choice and control over their aged care.

There are a number of areas where this funding is going to work. I refer to four of those areas. Firstly, funding for home care packages will actually follow the consumer, replacing the current system where home care places are allocated to individual approved providers to deliver service in particular locations or regions. This will give people more choice in selecting their provider and the flexibility to change their provider if they are not happy with the service or if they want to move house, for example. It also gives them the opportunity, should family members offer to support them, to relocate somewhere else. It allows them to be able to have the flexibility of being able to find another closer facility to meet their needs and to be able to maintain that connection with their family.

Secondly, the providers will no longer have to apply for new home care places through the aged care approvals round, significantly reducing red tape and regulations for businesses. Having worked with the Mossman District Nursing Home committee as they completed several ACAR applications, I know how much of a burden it is for any small community organisation in following these guidelines.

Thirdly, there will be a streamlined process for organisations seeking to become approved providers, encouraging new providers to enter the home care market while ensuring the same high standards are met.

Lastly,    there will be a consistent national approach to prioritising access to home care packages through My Aged Care, the government entry point or gateway to the new aged-care system.

In its 2011 inquiry, the Productivity Commission found that the aged-care system was prone to high levels of regulation, lack of timely access to care and very limited consumer choice. The changes being put forward through this bill will address this, with the Productivity Commission making the following points:

… consumer choice improves wellbeing, including higher life satisfaction, greater life expectancy, independence and better continuity of care. In addition, competition amongst providers in a system where consumers can exercise choice leads to a more dynamic system, with enhanced incentives for greater efficiency, innovation and quality. A more flexible system would also enable providers to increase the range and scope of their services, freeing them from the current highly regulated, risk-averse regime.

The total number of home care packages is continuing to increase each year so there is an opportunity for all providers to continue to operate in the market. The challenge is for them to understand their clients' needs and deliver services that tick those boxes.

There was an earlier bill that went through the House and was passed recently which I want to touch on now as it has specific relevance for my electorate. The Aged Care Amendment (Red Tape Reduction in Places Management) Bill 2015 came as a result of a 2013 election commitment to review the administration of aged-care places in a bid to slash red tape in the sector. It makes the business of delivering aged care easier for service providers, and gets rid of unnecessary administrative processes so that service providers can get on with doing what they do best—focusing on delivering high quality care services.

Firstly, approved providers will find it much easier to transfer their places to another approved provider without having to seek approval from the department. The current process will be replaced with a simple notice of transfer.

Secondly, the bill reduces red tape by reducing the number of times that approved providers must apply to extend the period of provisional allocation. This was a major problem in my area. The department accepts that it takes providers, on average, four years to get a bed in place and operational and that 80 per cent are operational within six years. Under the changes, approved providers are now automatically given four years with the possibility of two 12-month extensions. Further extensions can be provided under exceptional circumstances. But, importantly, it means that providers have to explain to the department what the hold-ups are. These places are not just sitting in limbo.

As we see these changes continue to progress through this place, they are very much to the benefit of our community and, of course, to the client, which is very important. We had a situation in Far North Queensland over the past couple of years with aged-care places management being an ongoing and complex issue. There were numerous local media stories blaming hospitals for ambulance ramping and a claim that aged-care patients were taking up too many much-needed beds at Cairns Base Hospital because of a shortage of residential and home care places.

It was very, very difficult to get an accurate state of play as to how many beds and packages we actually were short. As a result, I asked then Minister Fifield for an audit of aged-care places in Far North Queensland that had been previously allocated but had not yet become available. As at 30 June last year, there were 386 provisionally allocated residential care places, of which over 80 were six years old or older. It concerned me that those places had been allowed to stagnate, given the demand in our region.

I recall one very sad case where a husband and wife had been separated because there were not beds available. The wife was living in residential care in Cairns, and her husband was placed in residential care in Herberton, on the Atherton Tableland, because they were not able to be placed together. In a regional area with no public transport and at that age, when they were requiring high care, it was impossible for one partner to travel the 1½ hours necessary to see the other. Sadly, by the time we managed to get it resolved, the husband had passed away. Actually we had got him a place in Cairns, and in the process of the transfer he passed away. Fortunately, with this new legislation, there will be greater accountability as to why beds have not come online. If an approved provider after four, five or six years decides not to proceed with these beds, they can be easily transferred to another operator who may be in a better position to act swiftly.

With a meaningful focus on aged care, we are now starting to see some remarkable developments in Far North Queensland. In the 2015 Aged Care Approvals Round, we will benefit from around 416 new residential aged-care places and around 109 new home care packages. In the second half of 2015, two facilities, with 338 additional places, became available, and a further 30 beds are due online in the first part of 2016.

There was a great community atmosphere at the opening of the Bupa Cairns aged-care facility in September, which brought 144 beds online, including 36 that are dedicated for dementia patients. Already, the facility has 102 residents, and it is a beautiful set-up. Anybody interested in finding out about a place there should get in touch with Bupa in Cairns, because there is still potential there for them to be able to take additional people.

One that has been very close to my heart is in Mossman. The Mossman and Port Douglas nursing care committee have been working for many years. The Douglas Shire Council have been working closely with them. They have paved the way for construction of stage 1 of the Mossman and District Aged Care precinct in Johnston Road. This is an incredible outcome, a result of over 20 years of advocacy by the Mossman District Nursing Home Committee, the council and, recently, The Salvation Army Aged Care Plus, who have come on board and will build and operate this facility. My congratulations to the founding and executive members, Marj Norris, Shirley Vico and Joan Gray. The trio were recognised as Douglas Shire Council's 2016 Citizens of the Year, and rightfully so. They have done an absolutely fantastic job over the last 20 years. We have gone from this being just a dream to something that will be a reality in the very near future. The preliminary approvals, which have just been given, include a development permit for the 42-bed aged-care facility and a preliminary approval for the balance portion of the land and reconfiguration of one lot into two lots to facilitate stage 1 of the precinct. Stage 2 is earmarked for a retirement facility that features an activities building, a community wellness centre, approximately 60 private suites and a low-care and independent living precinct over the balance of that land. It is certainly an exciting time. The Salvation Army Aged Care Plus is now free to start building this vital community asset.

Up in the Torres Strait, the Star of the Sea Elders Village is another example where flexibility is really going to make a huge difference. This is a facility that over the years had deteriorated to a point where it was in appalling condition a couple of years ago. I had been very strongly advocating to have it refurbished. It is the only facility of its kind in the world, focusing on Torres Strait people and their needs. As a result of that advocacy, I managed to get the Torres Strait and Northern Peninsula Aged Care Master Plan developed. Through that, it was fantastic to get a $19 million injection into a long-overdue refurbishment plan and redesign and a further $5.8 million for construction of new staff facilities. It has worked out very well. Sue Boisen from Blue Care tells me that the project is progressing exceptionally well and they are now applying for development approval for the refurbishment and the new staff accommodation in the near future. It was fantastic to see that come to fruition.

At the end of the day, we have got some big changes coming through in the aged-care sector, with more to come. But we are absolutely committed to the consultative approach with the sector, because their input is critical in program design and implementation. Since the budget, we have worked closely with stakeholders, and we will continue to do so through 2016, with an increasing focus on communication and transition activities to support consumers, carers, providers, ACATs, health professionals and other stakeholders. I am also very happy to hear that our new Assistant Minister for Health and Aged Care, my good friend Ken Wyatt, will be visiting Cairns later this month to hold an aged-care roundtable. I am looking forward to bringing together stakeholders from around the region. We will certainly be having some robust conversations about future changes in this sector. I commend the bill to the House.

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