Ross Hart (Bass, Australian Labor Party) Share this | Hansard source

Around 1.3 million Australians are currently receiving some form of aged care provided by around 400,000 nurses and carers. The statistics show that it's projected that by 2056 the aged-care workforce will need to triple. That is, there will be nearly one million workers required to deliver services for more than 3.5 million older Australians, and older people will represent as much as one in four Australians.

Any of us can trot out those statistics in this place, but what we need to consider is the personal aspect of this area of policy. It is absolutely true that each of us will, at some stage, require some measure of assistance if we live to an age that requires aged care. Every Australian who requires aged care should receive an appropriate level of service that is safe and clinically appropriate. We shouldn't have the circumstances which have been recently identified on Four Corners and other public controversies with respect to the quality of aged care. This is something that needs to be addressed as a matter of urgency, and it's something that really does move beyond us as the people's representatives standing here in parliament. There needs to be concrete action to ensure that safety, quality and dignity in aged care is maintained.

Public expenditure on aged care as a share of the economy is expected to double by the 2050s. It is obvious to me that the aged-care system is in crisis. The fact that the aged-care system is in crisis should be obvious to any reasonable observer. But, when Labor first raised this issue, when we pressed the issue, as I might say we must when calling any government to account, we were heavily criticised by the minister. Now, as I said earlier today, this crisis is recognised implicitly with the calling of a royal commission. Billions of dollars have been cut from aged care in the last five years by this government. The present Prime Minister, Mr Morrison, cut almost $2 billion in his first year as Treasurer. There are now 121,000 people on the home-care package waiting list. It is telling that when I first wrote this speech I included the figure of 108,000 people. Between when I drafted this speech and now there are a further nearly 15,000 people that are now added to waiting list. The list include 88,000 people with high needs, many of them living with dementia and other high-care requirements.

More than a dozen reviews and reports, including hundreds of recommendations, still sit on the minister's desk without being actioned. Three different aged-care ministers across the governments of Prime Minister Abbott, Prime Minister Turnbull and now Prime Minister Morrison have had the responsibility for this for the last five years, but in my submission they have failed to undertake any real reform across this vitally important ageing portfolio. As I indicated earlier today, I've spoken on a number of occasions on motions moved by my good friend and colleague, the shadow minister for ageing and mental health, Julie Collins, the member for Franklin. Those motions criticised the government for its delay in releasing important information on the government's progress in addressing the home care waiting list. As I said earlier, in my opening, each of us should have a real interest in this policy area. This has a direct impact upon the dignity of vulnerable older Australians.

The purpose of the Aged Care Quality and Safety Commission Bill 2018 is to establish a new Aged Care Quality and Safety Commission from 1 January 2019. The commission will be responsible for the accreditation, assessment and monitoring of aged-care services and Commonwealth funded aged-care services, and for complaints handling. The role of the commission is to protect and enhance the safety, health, wellbeing and, importantly, quality of life of aged-care consumers and also to promote confidence and trust in the provision of aged care and to promote engagement with aged-care consumers about the quality of care and services.

This is all particularly timely, given the appalling vision that we saw on the Four Corners reports over two weeks. It's appropriate for us to ask: what is the government's record with respect to this important area of public policy? And, more broadly, what is the government's record in supporting and funding regulators? I say that this government's record in supporting and funding regulators is bleak.

This is a government that called the Australian Securities and Investments Commission the 'tough cop on the beat'. We now have a royal commission highlighting every day failures not just in regulation but in general law enforcement. This government's unfortunate record of incompetence extends across multiple portfolio areas. What use is a philosophy that drives to cut what is described as 'red tape' when that regulation is properly required to maintain public trust and confidence, public trust in safety and consumer protection in multiple areas, whether it's finance or it's aged care? The undeniable fact is that the Aged Care Quality and Safety Commission will have a significant task in restoring confidence and trust in the provision of aged care—and this is before any evidence is taken with respect to the proposed royal commission and indeed before any terms of reference are agreed or published.

Aged care has been a policy area which, in the past, has attracted a significant level of bipartisanship. Labor introduced welcome reform with its Living Longer Living Better reforms. Those reforms were designed to deliver important benefits to older Australians, reforms that included more support and care at home; better access to residential care; increased recognition of carers, particularly those from culturally diverse backgrounds; more support for those who suffer from dementia; and, of course, better access to information to assist in the planning and delivery of care. It's important for all of us to understand that the central philosophy driving policy was that of consumer-directed care not just providing greater choice for older Australians as to the care they wanted but also delivering independence and support to live at home for as long as possible.

There was a growing wave of outcry from the public about the quality of care that older Australians have received, particularly with respect to residential aged-care facilities, even before the revelations from the Four Corners story. This was first highlighted by the investigations around elder abuse and neglect at the South Australian Oakden facility. In response to Oakden, there was a Senate inquiry. This in turn triggered the government to commission a review which is better known as the Carnell-Paterson review. The review was then handed to the then Turnbull government in October 2017.

Labor supports the Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018. They should be considered non-controversial, but there are a number of concerns. Firstly, it's taken nearly a year for the government to introduce legislation into parliament in response to the Carnell-Paterson review. The bills are, in my view, a missed opportunity for the government to give the new commission stronger arbitrary powers, particularly given the level of public concern in relation to service providers. Although the advisory council is set to continue, the government has yet to fill vacancies on the advisory council. Labor will put the government on notice that there must be no change to the cost-recovery process and/or fees to ensure the ongoing support which is necessary for smaller providers, in particular in regional Australia, which is where I represent. The government has also not addressed the policy area with any success, which is evident from the significant level of public concern about the aged-care sector.

As I said earlier, more than a dozen reviews and reports, including hundreds of recommendations, still sit within government and on the minister's desk without being actioned. It might be said that the government has proceeded to cherry-pick rather than deal with the reports and the reviews in an holistic manner. The lack of response in relation to the reviews and reports in relation to any reform fits a disturbing pattern of inaction, incompetence and cover-ups by successive governments.

The Abbott-Turnbull-Morrison governments have shown a complete lack of commitment to the Australian aged-care system by cutting billions of dollars from the aged-care system. The aged-care system has been used as an ATM to try and prop up the budget, with significant cuts in support to the industry, and there have been denials that there was a cut in the first place. That is what this government does: it consistently argues that it is delivering additional funding year after year—that is, in raw dollar terms—and it says it can't be accused of cutting health, education or the funding available to aged care. In this particular case, they've been caught out with their hands in the till. The aged-care funding instrument was cut by $1.2 billion. This means a cut to services to vulnerable, older Australians. It's absolutely obvious to me that standards in the care of older Australians have slipped under the weight of these cuts, in particular with the lack of supervision and attention to standard.

I, like every other representative in this place, I'm sure, receive many complaints and requests for assistance from constituents who are attempting to navigate the aged-care system. My constituent Estelle came into the electorate office to express her frustration at the system. She lives with her elderly mother and provides care to her. Her mother cannot get into a nursing home because she owns a small farm. To make matters worse, Estelle has been told that there is no palliative care available to her mother 'because of funding constraints'. Estelle told my office that she's looking forward to a change of government and a better approach to aged care.

I've also been speaking to Malcolm, who regularly visits a friend, Neil, in an aged-care facility in Launceston. Neil is recovering from a broken hip and requires physiotherapy as part of his recovery. Malcolm was horrified to learn that the only way Neil could get access to this treatment was to pay $75 per hour to a private physiotherapist. That is because the facility where Neil is a resident no longer has the funding to offer physiotherapy and other allied health services to its residents—a direct result of this government's $2 billion worth of cuts to aged care funding.

I've previously brought to the attention of the House concerns raised by Diana, who lives in a small town, Bridport, within my electorate. She despairs at the state of the My Aged Care website, saying that it should be a 'research tool for older Australians, not an advertising platform for providers'. She pointed out that, despite the fact that she lives in a remote seaside village and the fact that she finally received an aged-care package after an extended wait, according to the My Aged Care website, she has in excess of 80 providers who might provide services to her in Bridport. This is more than are available to a potential consumer in Hobart or Canberra. The reality, of course, is that there are few providers available to her, despite what that website reports. I also spoke to Michael from Launceston after the facility where his mother is a resident tried to increase her accommodation fees by 60 per cent following a refurbishment.

Clearly, there are real concerns with respect to safety and quality within the aged-care sector. There are many services that are doing very, very well, but we need to ensure that there's not just the rhetoric of being a tough cop on the beat and that the government actually follows through.

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