Mike Freelander (Macarthur, Australian Labor Party) Share this | Hansard source

I'd like to commend the member for Grayndler for his comments. It's probably salient to say that I am 65, and this was brought home to me the other day when I was shopping with my wife and, while we were waiting to have the bill paid, the shop assistant asked me for my Seniors Card. But this demonstrates that our population is ageing and that our aged-care needs are increasing, and many people, as they get older, do suffer from chronic illness and require quite significant treatment, even in aged-care facilities.

Parliament, however, as you can see, Mr Deputy Speaker, can do some very strange things to people, and we see evidence in this place every day. It does certainly seem strange to me that, after 40 years practising as a paediatrician, I have finally graduated to aged care. In my role as the member for Macarthur, I have visited a number of retirement living and aged-care facilities in my electorate, and I must say I've been very impressed and very pleasantly surprised.

I rise today to talk on this bill, but first I would like to commend the many aged-care workers who live and indeed work in my electorate and some of the aged-care facilities in my electorate, of both for-profit and not-for-profit organisations, for their ongoing care of the older Australians in my electorate. In particular, I'd like to commend Estia Health, the Mount Gilead retirement living complex, the IRT aged-care facilities and the Frank Whiddon homes for providing excellent care to older Australians in my electorate.

So I rise today to speak about Australia's aged-care arrangements and, more specifically, about the Aged Care (Single Quality Framework) Reform Bill 2018.

This bill was tabled in this House on Thursday, 24 May 2018 and has been brought on for debate today before the Parliamentary Joint Committee on Human Rights, the Senate Standing Committee on the Scrutiny of Bills or the House of Representatives Standing Committee on Health have discharged their respective inquiries on how the bill may affect individual rights and liberties and standards of care. This is both unfortunate and not a practice that I would generally think should be encouraged in debating bills in this House. I'm not here to disparage this bill or unduly delay its passage, but I do have concerns about at least one of the measures proposed and the timing of today's debate.

This is a short bill, but one which has taken the best part of three years to prepare. Streamlined accreditation and quality control arrangements applying to the provision of aged care were first announced on budget night in May 2015, a long time ago. The bill deals with incredibly important and increasingly pressing issues, as we've seen with some of the press reports of elder abuse et cetera in aged care. It's a bit of an overreach, however, by the minister to suggest this bill lays the foundation for the introduction of a single set of aged-care standards. If it has taken three years to lay the foundation, one wonders how long it might take to raise the superstructure, because this is less a case of laying the foundations and more like just locking the front door before the adequate measures have been developed.

The bill neither sets out new quality standards nor puts them into effect. Those are the hard bits and they are apparently still under consideration—or else they ought to have been sent to us in time for this debate, which they haven't been. I'm also concerned and unclear as to the scope of and the precise effect of the provisions in the bill limiting access under the Freedom of Information Act to protected information, including information provided by aged-care providers under the quality agency act to government officials. It is very unclear. I am keen to know what sort of information this Freedom of Information Act exclusion contemplates. Does the bill, for instance, target inhibited access to the accreditation records of aged-care providers? We don't know. I would be grateful to the minister if he could address that question on the proposed scope of the freedom of information exclusion later in this debate.

Having said all that, let me explain why I think it is worth giving this bill a second reading, notwithstanding the criticisms I've just got off my chest. First, by the time this bill finds its way to the Senate, some of the defects in process that I've identified may well have been addressed—for example, the Parliamentary Joint Committee on Human Rights and the Senate Standing Committee on the Scrutiny of Bills will have reported and, hopefully, will have given the bill a clean bill of health and a tick. If not, then the Senate will no doubt take the appropriate steps—we hope. With luck, any lingering concerns about freedom of information access issues will have been addressed by then as well.

Next, to be fair to the minister, and the department as well, I recognise that they are striving to have the new quality assurance arrangements fully phased in by 1 July 2019. I must say, the minister is trying his best with limited resources to do the right thing. From what I can gather, the arrangements and the new single set of aged-care quality standards have been subject to extensive and multiple rounds of consultation and testing, but we really don't have all the information. The draft proposed standards released for comment in early 2018 attracted support from both providers and some user bodies; although some user bodies were very critical of the arrangements. I note also that the government has allocated $50 million in the 2018-19 budget to residential care services to help to transition to the new standards; although how it's going to be used is still again unclear.

The new quality standards will be enacted through amendments to the quality care principles developed initially in 2014, and will therefore be subject to direct parliamentary scrutiny and possible disallowance. More government can be good.

My second reason for supporting a further reading of the bill is that I really do think this is an area where government needs to take the lead and really get cracking on the substantive issues. This is a role for government. We have seen already how laissez-faire approaches to aged care have led to damage and even to the deaths of older Australians. At the present time, there does not appear to be a great deal of transparency to some of the aged-care quality standards involved.

If we're lucky, we'll all make it to an age where, as individuals, we cannot care for ourselves and will have to call on relatives, family and friends to provide care for us. This may well be one role where government needs to take overall responsibility for scrutiny. Government or independent third-party involvement later in life is necessary sometimes. However, life expectancy and quality of life in retirement are determined by the opportunities we've had when we were young. Access to education and access to good early health care can often prevent or delay access to residential aged care. However, for many of us, it still will be required, and we must trust in our government to provide adequate standards of care for us.

When we're young, we seldom seem to think about a plan for a time when we can't care for ourselves, and most of us operate on the maxim that God and fate often laugh at those who make plans too long into the future. Nevertheless, many of us will require residential aged care, and sometimes we reach an age where we can't make those decisions for ourselves and we rely on government to provide supervision of our residential or in-home aged care. It's one reason we've now got compulsory superannuation. That is a role for government, as is aged care.

Government has a role in redressing the imbalances in the lives of many of us as we end up in residential aged care, so it is very important that aged care is fair and equitable. Predominantly, our retirement choices are made in much the same way that we make our choice of doctor. It is rarely an exercise of informed choice and often not entirely of our own free will. We rely on hearsay at the present time and we rely on the help of our relatives. As economists often say, health information is often very asymmetrical in that there are power differences. It's very important in residential aged care that we have a more transparent ability to choose the facilities that would best suit our needs and provide the best standards of care. That is why this bill is so important.

In the medical field, the recent Four Corners program on out-of-pocket charges in health fees and hidden doctors' fees demonstrates that there is a role for government in the regulation and oversight of these important health decisions. The same is true in aged care. We know that there are huge levels of community concern about the quality of residential health care, and I think that will always be the case. But this bill can help allay some of those concerns by having a transparent way of assessing quality and making it available to not only the providers of aged care but also the consumers of residential aged care and in-home aged care and their relatives.

Regarding community concerns, there are also areas of little comfort when we see the types of things that have been happening with elder abuse that have been presented in the press before our regulatory agencies have had the opportunity to present this information to the public. These are sometimes matters of life and death. When it comes to these matters, the community rightly won't be placing its faith in what some people would say is a light-touch form of regulation. If we do have oversight of residential aged care, it is very important that the information that is presented to the public is freely available, transparent and of the highest quality. These are indeed matters of life and death, and many of us will face a time when, as we age, we will need to be cared for in aged care, and it is very important that we have the information freely available to us and our relatives.

Aged care is heavily regulated because it is heavily funded by the taxpayer, and the taxpayer wants, deserves and has a right to know that they're getting value for money. The Commonwealth government provides close to 95 per cent of public aged-care funding for all Australians aged over 65 and for Indigenous Australians aged over 50 who can no longer live without support or care in their own home. Overall spending on aged-care services currently stands at $18 billion for the 2018-19 budget and is set to rise steeply over the next four years to over $22 billion in 2021-2022, largely reflecting demographic factors, including increasingly large numbers of baby boomers, like myself, entering some form of residential or in-home aged care.

The government is in the field because people need to know that adequate regulation is in place, and they want it to be there. The government is there to make sure that the myriad rational decisions that work for the majority of individuals don't oppress the minority, or aggregate the poor or the disadvantaged into a collective decision that is against their best interests.

I'm also keen to have this bill go forward as soon as practicable because we are running out of time to get changes made as our population ages. If you want a parallel in other policies, just think about climate change. This government won't be helping if it turns aged-care policy into an ideological battleground. That would be a real pity, because over the last decade we have fallen significantly behind in our provisions for aged care—and we only have to look at the waiting lists to see this. Politics has the potential to derail good aged-care policy, and both the major parties need to work together to get the best results for our older Australians.

The House of Representatives Standing Committee on Health, Aged Care and Sport, of which I am a member, has been inquiring into aged care and the effectiveness of quality arrangements. We've taken many, many submissions and we are still to make our final findings known. This was prompted by reports of poor care in residential aged care in particular, and it means that this bill is urgently needed. We need to get a formal policy and appropriate guidelines as soon as possible to provide for the care of some of our most vulnerable Australians.

So I do commend this bill, with the reservations that I've stated, and I thank the members for their statements. (Time expired)

See this speech in context