Graham Perrett (Moreton, Australian Labor Party) Share this | Hansard source

I rise to speak on two bills, the Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018. The purpose of these two bills is to establish a new aged-care quality and safety commission from 1 January next year. The establishment of the commission was one of ten recommendations included in the Carnell-Paterson review. Whilst Labor supports these bills—I say that up front—I would just like to make the comment that it is almost one year since the Carnell-Paterson Review was handed to government. Why has the Morrison government taken so long to action this review, when the aged-care sector is clearly in crisis? Labor has known for a long time that the aged-care system is in a state of national crisis, but this shambolic government has been too busy dealing with their own internal crises to notice.

It is hardly surprising that the sector is in a mess when they've had three different aged-care ministers across the Abbott-Turnbull-Morrison governments—the ATM governments. The aged-care minister is not in cabinet, and the coalition does not even have a minister for ageing. There have been dozens of reports and reviews into the aged-care sector, but none of them have been actioned. The only action the coalition government has taken in aged care is to cut. Let's have a look at it. When Prime Minister Morrison was Treasurer, the member for Cook was responsible for ripping out almost $2 billion from the care of older Australians at a time when the number of older Australians was increasing. Is it any wonder older Australians are suffering with ever-decreasing levels of care? In 2012 under a Labor government, Labor introduced the Living Longer Living Better reforms. These reforms were designed to deliver important benefits to older Australians, such as: more support and care at home, better access to residential care, increased recognition of carers, recognition of those from culturally diverse backgrounds, more support for those with dementia, and better access to information. The main focus of Labor's reforms was to give older Australians a choice and to provide them with the support to live independently in their homes for as long as possible. These reforms were accompanied by a funding package of $3.7 billion over five years.

Sadly for the elderly of this nation, just three month after those historic Labor reforms were legislated, the Abbott government was elected. Since then, the coalition government has shown almost a complete lack of commitment to Australia's aged-care system. They've cut billions from the aged-care system and they've ignored dozens of reviews and reports, including hundreds of recommendations that were all about improving the aged-care sector.

Aged-care policy is not something that can be kicked down the road. It's in crisis already and every demographer—and anyone who goes out in their community—knows that it is only going to get worse in the years to come. There are around 1.3 million Australians currently receiving some form of aged care. There are around 400,000 nurses and carers administering the care to these Australians. By 2056, just 38 years away, the aged-care workforce will need to triple. One in four Australians will require aged care by 2056. That's around 3½ million older Australians. We need to get this mess fixed now.

So I support the Royal Commission into Aged Care Quality and Safety. The horrors of abuse we have seen documented on Four Corners and elsewhere really are a national shame. Sadly, these are not just one-off incidents. We know that abuse is occurring widely and is still happening today.

When the Minister for Senior Australians and Aged Care announced the royal commission, he asked members of parliament to engage with their communities and report what issues should be included in the terms of reference for the royal commission. Unfortunately, he only gave us a very short time frame—in fact, just one weekend—but I emailed my constituents on the Friday afternoon and asked them to report back to me on the Monday.

I was overwhelmed with the response just in that one weekend. Many Moreton constituents told me of their own experiences with their loved ones in aged-care facilities, and this was heart-wrenching information. The same issues came out in emails and phone calls and letters over and over again: staffing levels; the qualifications of staff; the standard of care; appropriate care for those living with dementia; the provision of medical care in residential aged care; the needs of the culturally and linguistically diverse residents; the affordability of aged care and funding arrangements; the transparency of provider performance and regular inspections of residential facilities; information about the choices available in aged care; and responsiveness to the allocation of home care packages and transitions between levels of aged care.

This is a sector in deep crisis. A royal commission is welcome, but older Australians deserve this crisis to be fixed, not just recognised. The Morrison government needs to do its job and look after older Australians who need to access aged care. The Prime Minister has a particular responsibility because he was responsible for those deep cuts into this sector. The waitlist for home care packages has now blown out to 121,000. These are older Australians who want to stay in their own homes, thus saving money—people like my father. They are capable of staying in their home with some support, but the longer they stay on the waiting list without the support they need, the more likely it is that they will need residential aged care. Many older Australians are waiting more than two years for the home care package they've been approved for. This is disgraceful.

It is with great reluctance by the government that these figures were even revealed at all. The release of each set of data has been delayed by months. The most recent data was released under cover of—guess what?—the grand final weekend. It was released late on the Friday afternoon right before the NRL and AFL grand finals kicked off. Labor has written to the Prime Minister and the Minister for Senior Australians and Aged Care, calling on the government to do more to fix this crisis in the home care package waiting list.

Sadly, there is a significant, growing crisis inside the aged-care sector, and that concerns dementia. Dementia is the second-leading cause of death for Australians, but for women it is actually the leading cause of death. Dementia is not a normal part of growing old. It is an insidious, terminal illness that impacts on and eventually takes the lives of more and more Australians each year. This is an urgent issue, one that has a serious impact on the aged-care sector.

Labor fully understands how urgent the issue is. At the last election, Labor made a commitment to raise awareness of the growing dementia crisis and build community capacity towards a dementia-friendly nation. We must continue to invest in research to find a cure, but, until we have that cure, we need to do more to make our communities livable places for people with dementia. We need to make sure that government gives families and carers of people living with dementia the support they need and that aged-care providers are giving their residents who are living with dementia the care and the dignity that all older Australians deserve.

It is not good enough that older Australians are continuing to endure the suffering that we've seen on our TV screens, on that Four Corners program and in other programs. Older Australians living in residential aged-care facilities include some of the most frail and vulnerable in our community. Many are unable to communicate to raise the alarm if their care is not as it should be. They often literally have no voice—and please note that correct use of the word 'literally'. We often hear the phrase, 'It's your word against theirs,' but, for our most vulnerable in aged care, many have no words. When there are unexplained bruises or other injuries, the families have no choice but to accept the explanation given by the aged-care provider, even when that explanation just does not sit right.

They could make a complaint to the Aged Care Complaints Commission. Many of those have been made—more than 5,000 last year. But, as I will come to in a minute, those complaints often go nowhere. Imagine the fear of those vulnerable, frail residents—not able to move, not able to raise any alarm at all and day after day subjected to treatment that no Australian should be subjected to. We must ensure there are safeguards in place for these Australians to protect them from harm.

I must stress that the overwhelming majority of carers in the aged-care sector are great, or good. They are hardworking and caring professionals. We're not talking about the majority; it's just the occasional rogue. But, sadly, sometimes there are not enough of the best-hearted people. There are not enough staff, or not enough trained staff, to properly care for the needs of those dependent on their care.

The Australian Medical Association's submission to the Senate Community Affairs Legislation Committee said that the current system has failed older Australians—strong words from the AMA. They said that the current:

… lack of coordination and information-sharing can result in the inexcusable, continuous neglect of older people …

The AMA quoted the 2017 Review of the Commonwealth's aged care quality regulatory processes, that said in its report:

Serious complaints about medication mismanagement and unexplained bruising on a resident at Oakden were raised with the Principal Community Visitor in June 2016 and then with Northern Adelaide Local Health Network (NALHN). This led the CEO of the NALHN to request South Australia's Chief Psychiatrist to undertake an extensive review of clinical care within the Oakden facility in December 2016 and appoint a senior nurse manager on 9 January 2017 to oversee the delivery of clinical care. Inexplicably, the Commonwealth aged care quality regulators were not advised of these issues and instead found out about them through a media report on 18 January 2017.

The Aged Care Complaints Commissioner communicates fewer than 15 per cent of complaints received by it to the Australian Aged Care Quality Agency—15 per cent! That cannot be right! The AMA continued:

There is no overarching regulatory body for the whole aged care sector. This be confusing for aged care providers and consumers, as well as create inefficiencies and a lack of communication between the existing regulatory bodies.

So this bill will create an Aged Care Quality and Safety Commission which will be led by a statutory-appointed Aged Care Quality and Safety Commissioner. The commissioner will be appointed for a term of five years.

The task of the commission is to help restore the confidence of aged-care consumers in the delivery of aged-care services. There will be a single point of contact for aged-care consumers and providers of aged care in relation to quality of care and regulation. The commission will be responsible for accreditation, assessment and monitoring of and complaints-handling for aged-care services and Commonwealth funded aged-care services. All areas of aged care will be included: residential aged care, home care, flexible care services, the Commonwealth Home Support Program and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. The functions and operation of existing authorities will be transferred into the new commission. Members of the existing Aged Care Quality Advisory Council will continue for their current term of appointment as new members of the Aged Care Quality and Safety Advisory Council.

As I said at the start, Labor supports these bills, and I support these bills, because these bills will create this new statutory commission. However, I remain concerned about the time it has taken this government—in their 6th year of governing; I guess we can call it governing!—to introduce this legislation, and they've had this recommendation for almost a year. There were 5,779 complaints about aged-care services submitted to the current Aged Care Complaints Commissioner in just the last 12 months. That was an increase of 23 per cent on the previous year. So there is much work to be done to improve the lives of older Australians. As a nation, we should judge ourselves by how we treat our elderly—this generation that has done so much for us. We can't call ourselves a fair and generous country until we give all elderly Australians the love, care and respect that they deserve.

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