Julie Collins (Franklin, Australian Labor Party, Shadow Minister for Ageing and Mental Health) Share this | Hansard source

I want to say at the outset that Labor will be supporting the Aged Care (Single Quality Framework) Reform Bill 2018. However, we do have a number of concerns that I will raise through my speech in relation to quality standards for aged care in this country. I thank the minister for arranging a briefing on this bill. The minister talks a lot about trying to have bipartisanship on aged care. This was the first time that I'd actually had a briefing on this issue. I do appreciate it.

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 aged-care providers under the Aged Care Act. The bill also varies the function of the chief executive officer of the Aged Care Quality Agency to reference the aged-care quality standards. Currently, there are standards that cover off on three different areas of care. They include four standards for residential aged care, two standards for home care and two standards for the Aboriginal and Torres Strait Islander Flexible Aged Care Program quality review. The eight standards across all areas of care will be effective from 1 July 2019. I understand that the government wanted a start date of 1 July 2018 but has ceded to concerns raised by the sector that they need time to get ready for the new quality standards and time to do the necessary preparatory work.

The new standards will focus on quality outcomes for consumers rather than provider processes and have been driven by the sector and other stakeholders. These quality standards have been on the drawing board and have been worked on since 2015, so it's great to see the legislation finally come into the parliament. I do want to put on record Labor's support for the people who work in the aged-care sector. When you're talking about quality and standards in aged care, this is of course delivered by aged-care workers and people working in the sector. The quality of care that they provide to residents of residential facilities and the people at home receiving home care is of enormous importance to older Australians, their families and loved ones. The personal care workers—the nurses, the physiotherapist, the occupational therapists, the GPs; all of those people—working in aged care in Australia today are highly valued by this side of the House and by the community.

That is in stark contrast to what we heard from the Prime Minister in question time yesterday, where the Prime Minister said that people working in aged care, an aged-care worker, should aspire to get a better job. Aspire to get a better job! I couldn't believe my ears when I heard that yesterday. Talking to aged-care workers today in an aged-care facility here in Canberra, the aged-care workers themselves couldn't believe that they have a Prime Minister who would say this about aged-care workers. They actually provide a hugely valuable service to our community. Their jobs are hard. They are rewarding, but they are not easy jobs—and they're certainly not well-paid jobs for the hard work that these workers are required to do.

As I said, the government has taken quite a lot of time to get these standards into the parliament. The explanatory memorandum to this bill talks about changes to the Freedom of Information Act 1982 to ensure that documents containing protected information acquired by the agency in the course of its functions are exempt from disclosure. I need to put on the record that, whilst we understand that the agency's investigations might need some protection, I am concerned about the extension of these FOI exemptions in this act. I'm worried that consumers might not be able to get access to the information that they need as part of any quality agency's investigations and I don't want to see important information being kept from consumers. So I'm putting the government on notice that we'll be looking at and closely monitoring this change to make sure there are no incidences of people not getting access to the information that they should because of this exemption.

As I said at the beginning of this speech, we talk about bipartisanship in aged care and the Living Longer Living Better reforms, but we haven't actually had much cooperation from the government as a whole when it comes to aged care. The government seems to want to make aged care a budget issue and an election issue—from what we saw in the budget and what we've seen since from this government—trying to talk up the funding for aged care in this budget when there is not one new single cent over the forward estimates for aged-care services in Australia in the budget. I have never seen a government promise so much to older Australians and deliver so little. It's quite appalling. We've seen billions of dollars ripped out of aged care under this government over the five years. When Labor implemented the Living Longer Living Better reforms, we put in real, new money. We had a 10-year plan for aged care in this country. It'd been worked on, we consulted and we had bipartisanship on it because we worked hard to achieve that and we actually worked with the other side. It's a shame we haven't seen that from this government.

There are a number of reports that the government has sitting on its desk in relation to aged care and the quality and standards that are affected by it. In particular, I want to talk about the University of Wollongong and Applied Aged Care Solutions reports, which the government isn't yet acting on. At last count, there were over a dozen reports sitting on the minister's desk, as I said, from the Living Longer Living Better reforms, and there's some expert advice in the Wollongong report about how to fix the Aged Care Funding Instrument.

I've been visiting aged-care facilities around the country in the last few months and weeks, as shadow minister, and I'm hearing from aged-care providers that the government's cuts, in the 2015 MYEFO and the 2016 budget, of the Aged Care Funding Instrument are having a real impact on quality of service and resourcing in residential facilities right across the country. The Wollongong report, which considers changes to the ACFI, was made public by the government a year or so ago. I've been very clear, from Labor's side, that we think the ACFI is broken and the government needs to act. To date, the government doesn't seem to have made any formal response to the ACFI, and a separate review by Applied Aged Care Solutions about the ACFI seems to have been shelved. It would be good if the government would clarify where it is in terms of changing the ACFI, because the ACFI relates to funding for residential aged care, and funding is related to quality and standards. You can't deal with one in isolation from the other. On 19 April 2017, the minister said:

These two separate but important pieces of work will help inform the Government's deliberations over the future direction for funding reform.

But, as I said, we have seen very little action, and providers are reporting that these cuts are impacting on them.

The other significant review that the government is sitting on at the moment is the Carnell-Paterson review, which of course talks about quality and standards and was initiated by the government after the Oakden situation that occurred in South Australia. We've seen numerous media reports since that time of other incidents around Australia in other residential aged-care facilities. We welcomed the review and we welcome the government adopting the recommendation to establish a joint agency to merge the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner into one. We're curious, though, about where this is at. We haven't seen or heard anything from the government about legislating to merge these two agencies. I'm hoping that the government will update us and provide some briefing on what is happening with this merger.

I am particularly concerned about the new agency and what it's going to do in relation to not just residential care but home care. I'm receiving increased reports about older Australians who are not getting the home care that they need and deserve. I'm not talking here about the massive waiting list for home care, which I'm happy to talk about a bit further on; I'm talking about people in their home who have a home care package, one that has been allocated to them. I am hearing reports of older Australians who may be on the end of elder abuse at home from some of the workers, so I want to make sure that the government has the standards right and that we are protecting older Australians in their homes as well as older Australians in residential care. There are a lot of regulations and standards around residential care; there are fewer around home care. I want to make sure the government is doing what it needs to do in relation to older Australians who are receiving home care. Particularly as we're expanding home care and wanting to give Australians more options to stay at home, it is very important that the standards and the quality that people receive at home are no less than the quality and standards people receive in residential care. I want to make sure that these announcements and changes that the government is talking about are focused not just on residential care but also on the growing sector of home care. I'm looking forward to hearing about how the new commission will deal with this.

The other review that is very significant is the Tune review—that is, the legislated five-year review of the Living Longer Living Better reforms. The Legislated review of aged care 2017 was tabled last September, and the government said that it would respond to Tune in the budget. We've seen some response to some of the recommendations, but, again, we don't know what the government is doing on at least 20 of those recommendations. The government did immediately reject two of the 38 recommendations. The government is now claiming that it has responded in full or in part to another 18, which leaves 20 recommendations—or 18, I suppose, by the time you take off the other two recommendations—not yet dealt with, so I'm curious as to when the government is actually going to respond to the other recommendations in Tune, because these also impact on quality and standards of care.

It is interesting that the government, in the budget, tried to claim that it was doing something about aged care when what we actually saw was the government take money from residential care and provide it to home care and an additional 14,000 home care places. Of course, we are happy there are more home care places. What we're not happy about is the government not telling Australians the truth about what it's done. It should be honest about what it has done. It should be honest about the previous cuts from MYEFO 2015 and budget 2016 and the impacts that these are having on quality and standards of care, the impact these are having on the resources available to provide care to older Australians in residential care. It's not good enough that we continue to hear excuses from the minister. We continue to have the minister say that our side of politics is not telling the truth. Well, the truth about the cuts that they have made is in their own budget papers and in their own MYEFO papers. They have made cuts to aged care worth billions of dollars over the last five years. That is the truth, they are the facts, and the government needs to stop pretending that that's not the case.

When it comes to home care packages, we have the government's own website saying that as at December last year more than 100,000 older Australians were waiting for home care. More than 100,000 older people are currently waiting for home care. We don't know how many are waiting today, because that figure is as at December. The March quarter figures were due to be released, but we haven't seen them yet. I don't know what the government's sitting on or why the minister won't tell us how many Australians today are waiting for a homecare package. Perhaps he's hiding something, or perhaps he's sitting in his office trying to cobble together something for those hundreds of thousands of people who are waiting for home care today.

What those opposite should do is be honest with Australians about the issues, be honest with Australians about how long we're going to have to wait for home care. People who are waiting for level 3 and 4 packages are still having to wait for more than 12 months for care. They were waiting 12 months prior to the budget, according to the government's website, and post the budget they're still waiting for more than 12 months. Indeed, as I said yesterday, we are actually getting reports about this from people all over the country. In particular, children of older Australians are saying: 'I can't get my mum and dad a package. How long do we have to wait?' That is what they are saying. They are crying out for assistance for their parents, for their loved ones, to get home care because this government promised something in the budget and people thought things were going to change. But they aren't. I think it's pretty cruel to try to pretend to older Australians, their families and their loved ones that you've done something rather than be honest and tell the truth about what is actually going on in aged care in this country today.

Given the numerous reports, given the fact that the government is still sitting on well over a dozen of them and not acting on recommendations, and given that progress in aged-care reform in this country has been very slow in the last five years, I'm pleased to finally see some legislation in this place to do something positive. But, as I've said, I do have some concerns. I do have some concerns about whether or not these standards are going to be achieved; whether or not this government is going to be able to implement it; whether or not the government will be able to implement the things that it has already agreed to do, let alone actually deal with the other recommendations from all the other aged-care reports still sitting on its desk.

We've had the Minister for Aged Care admit what we already know about the aged-care packages in the budget—that is, it's not enough. We know that he knows and that everybody in this place knows that what the government has done in the budget won't even come close to solving Australia's aged-care crisis. There's a crisis in aged care, there's a crisis in residential care, there's a crisis in the aged-care workforce, there's a crisis in home care—and this government has created it. It has been in government for five years, and to try and blame Labor for the last five years of inaction and cuts is an outrageous thing to do.

We had the Prime Minister come in here yesterday and tell us what he thinks about aged-care workers. As I've said, the aged-care workers that I met today were insulted by what they heard from the Prime Minister yesterday. For the Prime Minister to say to those workers, 'You should aspire to get a better job,' when we need to triple the aged-care workforce over the coming decades is outrageous. We've even had the sector put out media releases after what the Prime Minister said yesterday saying that this will discourage people from taking up a job in the aged-care sector. The government should be respecting and encouraging people to work in the aged-care sector. It is a valuable thing to do. It is a necessary thing. We are going to need more workers in aged care, not fewer, and we need a government that respects them, a government that's willing to invest in them and a government that's willing to understand the issues in aged care and be honest with the Australian public about the situation that we're going to have in aged care with the changing demographic.

We need to be up-front and honest with Australians about what this will mean going forward. We need to know in 10 years time how many home-care packages we're going to need. The government hasn't done any modelling on it. I asked, 'What will the wait list be at the end of the forward estimates after the funding in the new packages?' The government won't tell me or can't tell me. I think it's a bit of both: (a) it doesn't know and (b) it doesn't want to know. It does not want to know, and it does not want to plan for the changing demographic—that is the truth of it—because they don't want to be up-front and honest with Australians about what is happening in the sector. They should be ashamed that they are perpetuating untruths and mistruths and pulling a cruel hoax on older Australians when it comes to what they have or haven't done in this budget and previous budgets in the last five years. We can clearly see that the government's poor implementation of any reforms—the slowness of it and the funding cuts—is now hurting older Australians. That is clearly evident from what this government has done. I am really concerned that older Australians, their loved ones, their carers and their families are not able to get the care that they need and deserve. I'm also very concerned that this government doesn't seem to want to act fast enough to deal with it.

We really only have to look at how the government has been acting over the last five years to get an indication of where it will go. I am prepared to talk to older Australians. I am prepared to work with the government on how we deal with this situation going forward. I have been up-front with the government about sitting down and talking about the issues in aged care—talking about the issues with regard to a future workforce that we need to plan for and talking about the future funding issues in relation to providing enough services for those who need it. Instead, what we got from this government was a promise to consult, a promise to brief, and nothing before the budget. We now know why, because there was nothing in it, despite what the government's pretending.

This cannot go on. If the government is serious about improving quality and standards in aged care and if it's serious about providing services for older Australians, we need to work together on it. We need a bipartisan position when it comes to dealing with aged care. This should not be a three-year election cycle. This should not be political point scoring from the government, trying to pretend it's done things when it hasn't. This should be about older Australians, and, sadly, it has not been. To say that I'm disappointed in this government and this minister is an understatement. I think older Australians are disappointed in this government. The workers are disappointed in this government, and the workers are certainly disappointed in this Prime Minister after what we heard yesterday.

We heard from the senior minister, the Minister for Health, Greg Hunt, prior to the budget—I am trying to remember his seat, Deputy Speaker Vasta, but I can't, so I will say the Minister for Health.

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