Cathy O'Toole (Herbert, Australian Labor Party) Share this | Hansard source

I want to start by acknowledging my thoughts are with the families, friends and loved ones who have had their parents or loved ones affected by some of the stories that I've been hearing today and those we have seen in media over the last few weeks. Aged care is a policy area that needs urgent attention due to the fact that Australia has an ageing population. Around 1.3 million Australians are currently receiving aged-care services provided by approximately 400,000 nurses and carers. It is projected that the aged-care workforce will need to triple by 2056—that is, around one million workers will be required to deliver services for more than 3.5 million voters. Older people will represent one in four Australians. Public expenditure on aged care is expected to double as a share of the economy by the 2050s. Right now, there are over 100,000 people on the in-home-care-package waiting list, including 88,000 people with high needs, and many of those are living with dementia. This demonstrates the high demand and rapid growth of this sector.

When Labor were last in government, we understood the need to act quickly, and we are still aware of the need for urgent attention. Due to the fact that Australia has an ageing population, the ageing-policy area is a rapidly changing environment. Labor made massive reforms to the sector, delivering the Living Longer Living Better reforms in 2012 under the then minister, the Hon. Mark Butler. The Living Longer Living Better reforms were designed to deliver important benefits to older Australians. Those included more support and care at home; better access to residential care; increased recognition of carers—and I pay tribute to carers, as this week is Carers Week—and those from multicultural and diverse backgrounds and also for our First Nations people; more support for those with dementia; and better access to information. The main focus was about consumer-directed care that would give older Australians not only a greater choice about the care they wanted but the independence and support to live in their homes for as long as possible, preferably until they passed away.

There was a clear plan for the Living Longer Living Better reforms, and Labor delivered a massive aged-care reform package that provided $3.7 billion over five years. Labor legislated these reforms, and we funded them. And then something devastating happened for the aged-care sector three months later. The LNP Abbott government was elected, and then the attacks on aged care commenced.

The very worst thing about the current LNP government is that the Minister for Senior Australians and Aged Care is not included in cabinet. Three different aged-care ministers across the Abbott-Turnbull-Morrison governments have had carriage of the Living Longer Living Better reforms over the last five years, and all have failed have to do any real reform across the Ageing portfolio. The former Minister for Health and Aged Care, Sussan Ley, did little or nothing to progress the reforms. The current minister, Ken Wyatt, has also struggled to progress the Living Longer Living Better reforms. More than a dozen reviews and reports, including hundreds of recommendations, still sit on the minister's desk without being actioned. The reports have all been there, sitting on the minister's desk. Instead of responding to them with compassion, they have responded with cuts.

Arguably, the worst thing that this LNP government has done to the aged-care sector is the massive cuts. The LNP have cut billions of dollars from the Aged Care Funding Instrument and have dumped Labor's $1.5 billion workforce compact. Under Scott Morrison's watch as Treasurer, the aged-care budget was used as an ATM to try to prop up the budget. He cut approximately $1.2 billion from the aged-care sector. Now, as Prime Minister, Scott Morrison has tried to say that he hasn't made any cuts. Allow me to enlighten the Prime Minister, who seems to have forgotten that he was Treasurer and apparently cannot read his own budget papers. The budget papers are very clear. Under 'Aged care provider funding' on page 101 of Budget Paper No. 2 from the 2016 budget, it states:

The Government will achieve efficiencies of $1.2 billion over four years through changes to the scoring matrix of the Aged Care Funding Instrument (ACFI) that determines the level of funding paid to aged care providers.

It's there in black and white. How inept can one honestly be? You cannot rip $1.2 billion out of the aged-care system and not have an impact on the quality of services.

The aged-care industry bodies warned at the time of the 2016 budget that the cuts would result in reduced quality of standard of care. And—no surprise to anyone except the LNP—that is exactly what has happened. It was always going to be inevitable that these massive cuts would, sadly, lead to reducing the standard regarding the care of our older Australians.

Care for older Australians is fundamentally a human right. The LNP seem to be too busy fighting amongst themselves instead of focusing on what truly matters. The lack of response in relation to any reform fits a disturbing pattern of cover-ups and inaction on aged care from successive LNP governments. The aged-care workforce is expected to increase by 300 per cent in the next 30 years, underscoring the challenges and opportunities to get this right. But how does the LNP government react to this rapid growth rate? By cutting vital funds to the sector. The current situation in the aged-care sector can be no surprise to this government, and the responsibility for this demise rests solely on its shoulders. But, instead of responding with critical funding, it has responded with denial and a royal commission.

Personally, I back the royal commission, as does Labor. After all, it is Labor that has been saying for some time that the system is in crisis. It was only in May that the Leader of the Opposition, Bill Shorten, said this in the parliament, and the government likened it to committing elder abuse. So it is a positive step that the LNP have changed their minds and are finally listening to people who use aged-care services, and workers, because the issues are blatantly obviously.

In Townsville I have set up an aged-care reference group, and that group and members of the wider community have raised a number of issues. Firstly, the staff don't get paid properly. Secondly, the ratios of nurses and support workers to patients, and the skill mix of staff, need to be addressed. I think there needs to be a discussion about the ratio of qualified people to residents, and about the care that those residents need in the aged-care facilities. Are there enough nurses? Are there enough doctors? Do we have the local pharmacist involved? Can we get GPs to visit aged-care facilities? These are all questions that need answering.

Thirdly, regarding Prime Minister Scott Morrison's cuts to aged care, you can't cut billions of dollars in funding to residential aged-care facilities—supporting people with high needs and complex conditions, like high-care dementia—and expect a better result. Fourthly, is the cost of access. I am hearing lots of stories about people feeling ripped off in retirement villages.

Fifthly, is, importantly, My Aged Care. Accessing My Aged Care is simply a traumatising experience for many elderly people—apart from the fact that many elderly people are not computer literate or do not even own a computer. When my father was extremely unwell and living in a residential aged-care facility, he was being transferred to hospital and my mother had a fall and broke her pelvis whilst walking with him to the ambulance. If that was not traumatic enough, when she was eventually discharged from hospital, she also needed a visit from the aged-care assessment team, because she needed an assessment for support services. The nurse visited and spent five hours with my mother, doing the assessment on line. At the conclusion, she hit the 'submit' button, and the entire assessment disappeared from the screen.

The long and the short of this story is that she had to redo the assessment at a very traumatic time in her life. The only reason she had a nurse visit was because she had just been discharged from hospital and she needed immediate support. My mother had family to support her in this process. The question for me is: what happens to older Australians who do not have someone to support them? My mother-in-law got her appointment for her assessment after she died. The My Aged Care process needs immediate attention.

There have been several inquiries into the problems in the aged-care sector, which the LNP government has not acted upon. If we are going to be serious about a royal commission, then the entire system must be included—the cuts, the reports, the inaction, everything. The royal commission must look at all aspects of aged care. It must look at the long-term sustainability of the sector, the workforce and the quality of care. It all must be investigated.

The workers in the aged-care sector work really hard every day. They are on very low wages. Sometimes they are low-skilled workers, and sometimes they are highly skilled individuals who are not receiving the remuneration they should because they are working in the aged-care sector. They need to have their say as well. The workers I have spoken to want to feel proud they work in the aged-care sector. They want to go home feeling they have done a good job and have had the time to properly care for the older Australians in their care. As a nation we want to encourage people to work in the aged-care sector and we want to ensure that this royal commission takes a long-term view, and not just a rushed short-term look at some systemic issues.

Most importantly, the royal commission must allow for and encourage older Australians to have their say—as well as their loved ones and their families. They must feel safe to make complaints without fear of repercussions. If the government is ever to rebuild faith through the royal commission process, then it is vital that older Australians and their families have their say.

But it is also critical that we do not wait until the end of the royal commission before we take action, because we know what action needs to be taken. The LNP government cannot use the excuse of a royal commission before they commit to take the necessary action to fix the sector in its immediate crisis. Older Australians and families cannot wait. The LNP government must act now on the things we know are wrong with the system. The reports are available and the reports say that the cuts are having a detrimental impact on the quality of care offered in aged-care facilities. Now it is time for the government to step up, say they are sorry and restore the funding that has been cut. You don't fixed aged care by cutting funding. You don't fix aged care by not funding it. You certainly don't fix aged care by delaying action. That is really at the heart of what has happened to the aged-care system.

That brings me to the bill at hand. The Carnell-Paterson review recommended bringing together the functions of the Aged Care Quality Agency and the Aged Care Complaints Commissioner. There are 10 recommendations in the Carnell-Paterson review. The purpose of the Aged Care Quality and Safety Commission Bill 2018 is to establish a new Aged Care Quality and Safety Commission from January 2019.

Debate interrupted.

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