Tony Zappia (Makin, Australian Labor Party, Shadow Assistant Minister for Medicare) Share this | Hansard source

My analysis of the aged-care sector was clearly outlined in my contribution to the Aged Care Quality and Safety Commission Bill 2018 debate in this place last week. The sector is in crisis. It has been for some time. The victims of the crisis are mainly the vulnerable elderly, although they do include some of the staff who work within the sector as well. The government has now announced a royal commission, which Labor supports. However, I repeat what I said last week: the royal commission should not be an excuse to delay changes that are needed immediately about matters that are well-known and have been for some time.

This report of the House of Representatives Standing Committee on Health, Aged Care and Sport is one of many over recent years that have focused on the aged-care sector. Many of the other reports came to similar conclusions as this committee report did. Indeed, the Australian Law Reform Commission report of only a couple of years ago addressed many of the matters that the committee addressed and came to similar conclusions on many of those matters as the House standing committee did.

We have reached a point where we see that this sector, which has been exposed for its shortfalls and deficiencies over many years, continues to deteriorate rather than improve. We have reached a point where there are inadequate staffing levels, fewer allied health professional visits, less social activity within centres, deteriorating food quality, GPs cutting back or cutting out their residential aged-care facility visits, long waiting lists for home care packages, too much of the home care package funding being chewed up in administrative costs and other problems within the sector. All of those matters are known and have been known for some time. What I see from this government is simply more talk about the problems and more promises to do things in the future but no real change taking place right now.

Even today we have announcements about increased unannounced visits to aged-care facilities in the future—beginning some time next year. The reality is that those matters could be addressed right now and should be addressed right now. They don't require legislative changes. They could simply be administrative changes that the government implements. Those matters are well known. I have often asked the question: why did we not introduce unannounced visits in years gone by? Why was there a need to announce the visits in the first place? Regardless of whether we increased the number of visits, the fact that the visits were taking place with an announcement being made in advance seemed to me to defeat their very purpose. Again, the government claims that it will respond and act in that matter—but when?

In the course of the inquiry the committee heard considerable evidence. There were some 123 submissions, many of them confidential because they were made by people that work within and had very personal insight about the industry or by family members who, equally, had personal experience of how the facilities were operating. For fear either for their future employment within the centre or of retribution against the family member that was in those facilities they didn't want their submissions to be made public. I suspect that was simply the tip of the iceberg with respect to the number of people that would have loved to have come forward and talked about their experience within this sector but for one reason or another chose not to.

We have a royal commission now. One of my other concerns about the royal commission is that the government will effectively sideline the committee's report and defer any meaningful response until the royal commission findings are in. My understanding is that will be some 18 months to two years away, which effectively means that, again, matters that need to be dealt with immediately will simply be pushed into the future and, in this particular case, beyond the next federal election. I say to the government: if the royal commission is being called for no better motive than to defer action then I believe that the public will simply not wear it. I think it would be fair to say, certainly from the numerous people I've spoken to about this matter, that the public are looking for a response right here and now.

The committee came forward with some 13 recommendations. There are other matters that perhaps could have been dealt with, but I think the 13 recommendations are appropriate and in most cases should not be ignored and should be supported by the government now—and not wait for the findings of the royal commission. I won't speak about all of them; I want to talk about just half a dozen. The first is recommendation 2, which talks about penalties. To date the penalties imposed on providers of aged-care services that have breached their obligations is generally to have their accreditation or their licence to operate suspended for a period of time until they rectify the problems. To my mind no other types of penalties have ever been imposed. I believe the issue of penalties needs to be reviewed. The penalties imposed where serious breaches occur should be more than just a suspension and a 'please explain' letter from the department but, rather, a real penalty.

The second is with respect to the comment I made earlier about GPs not visiting centres as much as they used to and many others now saying that they will cut out or cut back on their visits in the future. That is an issue that goes to the heart of the Medicare Benefits Schedule payments the GPs receive, and that matter needs to be reviewed. If it's not and GPs don't visit people within these facilities then it is not good for the resident and it is not good for the public health system, because the resident ultimately ends up in a public hospital.

The third is the unannounced visits which I spoke about earlier. In my view unannounced visits are a no-brainer, but in addition to visits being unannounced, they need to also take place in the out-of-business-hours time periods: after 5 pm, on weekends and perhaps even on public holidays. My understanding from the feedback I've received is that's where most of the problems are likely to occur, and most of the criticisms made arise from the care provided during those out-of-hours times.

The other matter of real concern to the committee is the use of restrictive practices, whether it's the use of medication or other more direct restraint methods. I can accept in some cases the need to do that but in all cases where restrictive practices are used, two conditions should apply. Firstly, there should be the approval of a medical professional before a restrictive practice is used. Secondly, the family or carer of the person should be notified.

Lastly, I go to the issue of the My Aged Care website, where it ought to clearly highlight the complaints that have been received by a particular facility so that the public, which has the right to know, know how that facility stacks up in comparison to the others. I'm aware that the committee's inquiry will continue with respect to staff ratios. That's a very important matter. I look forward to the evidence and to the report of that inquiry when it's presented to parliament.

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