Emma McBride (Dobell, Australian Labor Party) Share this | Hansard source

I rise to speak on the Aged Care (Single Quality Framework) Reform Bill 2018. This bill amends the Aged Care Act 1997 and the Australian Aged Care Quality Agency Act 2013 to make provision for a single set of aged-care quality standards that will apply to all aged-care providers under the Aged Care Act. The bill will also vary the functions of the chief executive officer of the Aged Care Quality Agency to reference the Aged Care Quality Standards.

In my community on the Central Coast of New South Wales, aged care really matters. We are an older population. One in five of us living on the Central Coast is aged over 65. And one in six of us, or 19,000 people, is employed in health care and social assistance. It's the biggest workforce on the Central Coast and it is the workforce I come from. I'm a pharmacist and have worked in health for almost 20 years. I will never forget my first visit to an aged-care facility. It was 1998 and my first year as a registered pharmacist. I was delivering medications to a psychiatric nursing home in the inner western suburbs of Sydney. I walked in, and it was a picture of misery. I walked out and took some time to pull myself together before going back into the facility, as the week's medications just had to be delivered.

Last week, I spoke at a forum on the Central Coast organised by the Health Services Union—my own union—called 'Our turn to care'. We heard stories from aged-care workers that took me right back to that first visit that will never leave me. I heard that aged-care workers had been told to wait until a person's incontinence pad was 70 per cent wet before it could be changed, that they were only allowed one pair of gloves per shift because the second pair would be too costly, and that the money spent on each person per day in an aged-care facility is sometimes just $6 per day. Older Australians deserve to be cared for with dignity and respect. Aged-care workers deserve support and resources to care for people with dignity and respect. Clearly, we must do more to make sure that all aged care is quality aged care.

Currently, there are standards that cover three different areas of care. They include four standards for residential aged care, two standards for home care and two standards for the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. The eight new standards across all areas of care will be effective from 1 July 2019. This is an amended date as there were concerns from the sector that the original 1 July 2018 start date would give stakeholders and providers little time to do the necessary preparatory work.

The new standards will focus on quality outcomes for consumers rather than provider processes, and they have been driven by the sector and other stakeholders since 2015. The Review of national agedcare quality regulatory processes, also known as the Carnell-Paterson review, handed to government on 25 October last year, had a focus on quality care. The review made 10 recommendations, one of which was to establish an independent aged care quality and safety commission. The government adopted this recommendation back in April but is yet to provide details in relation to this new quality and safety agency. Labor welcomed this announcement by the government, but we are concerned it has not given consideration to the delivery of care across multiple settings.

I have worked across multiple settings in my professional life as a pharmacist, but it was when my father was diagnosed with younger onset dementia that my view of health care was turned upside down. When you're sitting across the consult table as a daughter and a carer, rather than as another allied health professional, your world view shifts. I think we have to be very mindful that there are different demands and different requirements across different settings. Through my late father's experience, I've now had firsthand experience of residential care, in-home care, respite care and day centres, and each setting has different requirements. That is something the government should be really mindful of when this detail is worked through.

The minister's announcement seemed to be focused on those providers delivering care in a residential aged-care environment, and I think it needs to be less narrowly cast. What hasn't been at the forefront of any discussions is the protections for people who choose to age at home. My father passed away in February, and we were very fortunate to the end to be able to care for him within our own home and to have palliative care at home as well. If families are supported properly to do that, it's something that more families may do. It gives people at the end of their life the dignity that we would want for ourselves and for those we love.

The government must give consideration to the growing delivery of care in the homes of older Australians. As I said, I recently lost my dad, who lived with younger onset dementia. In helping my mum care for my dad, with my brothers and sisters, I saw a different side of the health system to what I'd seen in all my years working as a pharmacist in community and hospital settings. Labor is keen to understand how the government will ensure the quality of care delivered in the homes of those who choose to receive part of their care at home, through home care packages, as well as the quality of care delivered in residential aged-care facilities. And Labor looks forward to hearing how the government will integrate home care into the newly established commission. This new agency is due to begin on 1 July 2019, so the government has much work to do to make sure it gets this commission right, and we will do all we can to support them to do this.

Making sure that all aged care is quality aged care is not just a function of standards, although standards really matter. Quality aged care can't be achieved without proper funding. Yet, despite all the rhetoric in the lead-up to the budget, there was not one extra dollar for aged care in this year's budget. What the government has done is pretend to put new money in aged care, but the reality is there isn't any additional funding for aged care. Money has gone from residential care to support home care packages. There's no new money. This is after the Abbott-Turnbull government has cut aged-care funding by billions over the past five years. Every Abbott-Turnbull government's budget has cut aged-care funding. We've seen funding cuts to the Aged Care Funding Instrument and funding cuts to residential aged care, billions of dollars that are no longer supporting older Australians in residential care. It is now clear that the build-up to the budget and the government's rhetoric about aged care did not match what was finally announced, sadly. What the government did in its budget was simply cut money from residential aged care to pay for home care packages.

Over the past five years, the Abbott-Turnbull government has slashed billions of dollars from aged care, and it is solely responsible for the growing waiting list that exists for in-home care. We know that across Australia there are over 100,000 people currently waiting for home care packages. We know that many of those people have accepted packages below the level that ACAT has assessed that they require. We know that in my community of the Central Coast there are currently 750 people waiting for home care packages—a third of those people with high needs, dementia or those type of conditions. How can the government find $80 billion in tax cuts for big business, including $17 billion for the big banks, but not find one extra dollar to invest in the care of older Australians, of our mums, our dads, our grandmas and our grandpas? It is extremely disappointing that the Turnbull government did not use this year's budget to invest in the care that older Australians deserve.

Older Australians need the government to act now. What I haven't seen from the government is any sense of urgency. There doesn't seem to be an understanding that this is something that can't wait, that people that need this care aren't able to wait, that their families can't wait and that they are under enormous strain. Funding just 14,000 new home care packages over four years—it was a hoax; it really was, because 3,500 places a year isn't even enough to keep pace with demand. The waiting list grew by 20,000 in the last six months of 2017 alone. It's particularly cruel after promising older Australians that they would address the wait list. The people that I have met through my dad's experience, particularly people living with younger onset dementia—there's a particular set of circumstances when you're caring for somebody with this type of diagnosis in their 50s or in their 60s, when their primary carer is typically someone who is still in the workforce and still paying a mortgage. There are particular demands on these people that other people perhaps don't have, and it's something that we really need to shine a light on.

Even the Minister for Aged Care was forced to admit what we already knew, that the home care packages announced in last month's budget wouldn't come close to solving Australia's aged-care crisis. Responding to whether the new home care packages announced in the budget would be enough to solve the crisis, the minister could only say that the Turnbull government would have to consider new measures. They need to act now. This is urgent. I really look forward to hearing what these new measures will be and when they'll be delivered, and so do many of my constituents.

In my community on the Central Coast of New South Wales there are 30,000 people who care for someone else every day. That would be mirrored in electorates across the country. Just one example from my electorate is a man in his mid-70s who lives alone. He lives with mental health and has difficulty navigating the aged-care system, which for anybody is difficult to navigate—it's overly complex and it's not straightforward. If you were in a situation of crisis, it's not something that you would have the capacity to do. He had been assessed by ACAT as requiring a level 4 package. He had been waiting three months in April, and his condition is deteriorating rapidly. He receives just one hour of cleaning per week. That is all the support that this person receives at the moment.

What is of further concern is that the government is now delaying the public release of the next quarterly data wait list for home care packages. The last package of data revealed that almost 105,000 older Australians are waiting for home care packages right now, with the average wait time for a high-level package now more than a year. As I've said, people who are assessed as needing a level 4 package aren't people that can wait a year; they're someone with complex needs, someone with end-stage dementia or someone at risk of a fall which would end up having them hospitalised and then going straight into residential care. These are the sorts of people that are assessed as level 4.

As we know, the demand for home care packages grew by 20,000 older Australians in the last six months of last year. The Minister for Aged Care must be honest with older Australians and immediately release the latest round of data on the wait list for home care packages. People need to know where they are in the queue. People need to have certainty. People need to be able to make decisions based on reliable and up-to-date information. As you would expect, most people go into residential care within 10 kilometres of their home. People want to be able to stay near their GP, they want to be able to go to the pharmacist that they've been going to for decades, they wants to be able to be visited by their family and they want to visit people who they know, their friends and family. But they need certainty, particularly people with complex needs, who know that the wait lists are longer for them because of the types of needs that they have.

With the latest quarter ending in March, this data is now well overdue. The questions Labor are asking this minister are: where is the data, why is there a delay, is there something that the minister is hiding, is there something that the public deserve to know and is there something that families and individuals need to know now?

If the Turnbull government is confident that its baby boomer budget will deliver for these older Australians, it should release the latest data on home-care packages immediately. It must be released to the public. People deserve to know. Families deserve to know. People waiting in limbo need to know. The Turnbull government created this aged-care crisis, the Turnbull government is ignoring this aged-care crisis and it's budget fails to fix the aged-care crisis. With some older Australians waiting years for the care they need, the government must take action now.

In conclusion, I know the experience in my community would be the experience of many communities across Australia. We have an ageing population. People are living longer. What that means is that we have a different set of circumstances to what we've had in our society before. What it means is we need to plan better to support people to be able to, firstly, live better at home, because that's what most people want to do. Most people want to be able to live at home with dignity and respect. That was my father's choice. He wanted to be able to live in his own home, the home that he designed and built. My dad was an engineer and a builder. That, to him, meant more than anything else. I think that's something that we need to do. We need to respect the wishes of older Australians. We need to give them dignity and we need to treat them with care. In order to do that, aged care must be properly funded. The people who work in aged care must be properly paid. They need better support to be able to care for people.

People who work in aged care do so because it's a vocation and they really want to help and support other people. All that people working in aged care are asking for is to be properly paid. All they're asking for is to have the resources to be able to care for people who are within their care. That's what this government is not allowing them to do. The government doesn't see the urgency, it hasn't properly seen the crisis and it really needs to act now. I implore everybody in this House to make proper funding of aged care and proper support for people who work in aged care a priority and to act now.

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