Shayne Neumann (Blair, Australian Labor Party, Shadow Minister for Veterans' Affairs and Defence Personnel) Share this | Hansard source

I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. Why this bill? More specifically, why now? There is nothing in this bill that needs to be done now before the royal commission hands down its final report in February 2021. This bill was introduced back in February this year, so we've waited eight months already. It seems far more responsible to wait until after the royal commissioners have handed down their final report. I think it's fair to assume there are serious recommendations coming for major reform to aged care. This legislation seems to be tweaking a system that's failing older Australians. They're tweaks to adjust how or when we pay service providers. They're tweaks that will do nothing to provide better services or release new packages.

Two years ago, when the Prime Minister announced the royal commission, he admitted it was likely to be a bruising outcome. Let's face it, he called the royal commission to get ahead of the bruising reports by the ABC's Four Corners program—a program on which his own minister appeared saying there was no need for a royal commission—how embarrassing.

The royal commission has been far more than bruising. The response of this royal commission was referred to as an opportunity of a lifetime. The stories we have heard from older Australians and their families have been appalling and heartbreaking. When senior counsel assisting, Peter Rozen QC, wrapped up last week he labelled this the most in-depth and thorough examination of Australia's aged-care systems that has ever been undertaken.

The senior counsel presented 124 suggested recommendations to the royal commissioners. There are no guarantees that all the suggested recommendations will be accepted. The fact is they deal with issues that will make this legislation before the chamber either redundant or irrelevant. Regardless of what the commissioners agree upon, there are changes coming and there will be many.

Let's look at a few of the suggested recommendations by senior counsel. Recommendation No. 8 suggested a new aged-care program combining all the existing aged-care programs into a more comprehensive continuum of care of older people. Why tweak a system that may be completely overhauled after the recommendations are handed down?

Suggested recommendation No. 9 is about meeting preferences to age and place. This suggested recommendation includes a requirement to clear the home-care package waiting list and immediately increase the home-care packages available, allocating a package to all those on waiting lists by 31 December 2021. Why tweak a payment system when what we really need is to clear the backlog?

Suggested recommendation No. 14 is about approved providers responsibility for care management. This would see an approved care provider assign a care manager to each individual. In the instance where there are more than one provider, the leading provider must assign a care manager. Why make life harder for aged-care providers when an overhaul is on the way?

Suggested recommendation No. 16 is about assistive technology and the home modifications category. This would provide aids, appliances and services to promote independence in daily living and reduce risks to live safely at home. Why tweak the system when what people need is more than what's being offered anyway? Older Australians simply want to age well, safely and securely at home.

The Darling Downs and West Moreton Primary Health Network, so ably led by CEO Merrilyn Strohfeldt, asked older residents in my community what they thought about services that provided care for older Australians. Among the things they wanted to see was more support to continue living at home as they aged. They wanted: more focus on prevention, such as exercise, balance and nutrition; more help to manage their health needs; and more services closer to home, such as visiting professionals and telehealth options. This is exactly what the royal commissioners found in their interim report so infamously called Neglect, and that's what the evidence that has been adduced before the royal commission shows since the interim report. It's what we want for our parents, our grandparents and for ourselves as we age. It's what home care is all about, or, rather, it's what home care should be all about.

Given there are more than 100,000 Australians still waiting for home-care packages, given we are just four months away from the final report of the aged-care royal commission and given there's a strong likelihood of major reform to aged care coming, why are we debating this legislation now? Is this the time to be tweaking a system, which isn't working, about how the government pays providers of aged care—tweaks that would put pressure on smaller providers? When we know we need more packages, is this the time that this legislation before the chamber is so important? If people are not being supported to live independently at home then they are more likely to require more expansive and expensive health and residential aged-care services. Do we want the see more Australians languishing and dying while waiting for home-care packages?

This legislation does nothing to address the current crisis. The legislation does nothing to address the challenges, the blessings and the burdens of our ageing population. The government hasn't even considered the issues of an ageing population. This is a government with a track record of ignoring the ageing population and the impact of longevity on our economy and our lifestyles and on jobs and on services.

I hear backbenchers in the government waxing on about their proud record on ageing. They must have political amnesia. A bit of history is really important. Back in November 2013—this is a third-term government—one of the first acts of this government was to scrap the Advisory Panel on Positive Ageing, just six months away from delivering their final report, their blueprint. But it shouldn't have come as a surprise to anyone, because the coalition parties, going into the 2013 election, had a seven-page pamphlet—seven pages in total—that they devoted to aged care. That was their total policy commitment on the area of aged care. They said things like they were going to get rid of antiquated regulatory processes. How's that going? They thought this would put at risk standards in the industry. If they got rid of regulations, they thought it would also help, because people would be less susceptible to potential abuse and neglect. That's really gone down fantastically well, hasn't it? Honestly, what a joke that policy was.

'Ageing' wasn't a dirty word to former Treasurer Wayne Swan, who established this panel of pre-eminent Australians to lead the nation forward. At the same time this government was sacking Everald Compton and his panel, they axed the Aged Care Workforce Supplement—$1.2 billion designed in accordance with the sector to assist aged-care providers to pay and train their staff appropriately. Then, a few months later, in June 2014, they axed the dementia supplement. That was just fantastic! As we know, ACFI, the Aged Care Funding Instrument, doesn't cover severe behavioural issues and issues for those people suffering from severe dementia. It doesn't fully catch them, so the funding doesn't cover everything.

The previous Labor government designed a dementia supplement, providing 10 per cent extra, and a veterans supplement, also providing 10 per cent extra, for home-care packages and a daily payment for people living in residential premises who were living with dementia and severe behaviours. But what did this government do? One of its first acts was to get rid of dementia supplement, which was affecting, at that time, 330,000 Australians. So don't come into this place and tell us about your proud record. There's barely been a MYEFO and a budget that this government has brought forward that hasn't resulted in a mismanagement of the aged-care sector or a cut, particularly in their first three years under Prime Minister Abbott and Prime Minister Turnbull, to funding in the aged-care sector. I might add, the current Prime Minister was the Treasurer during a lot of that period.

Because those opposite are so excited and happy about what their record is, let's have a bit of a look at what they've done. On September 2017, there were 6,000 home-care packages. This was their first relief. They were all exhausted by December 2017, so, in the budget in 2017-18, there was no funding for 14,000 home-care places. They took them all away by reducing the 26,000 residential aged-care places. That was really a brilliant move! In the MYEFO in 2018, there was supposedly another 10,000 places. They brought forward some funding. That's all they did. They didn't put forward new funding; they just brought it forward.

In February 2019, they announced another 10,000 places on the eve of the royal commission hearings beginning over five years. It was because they wanted a little bit of an accounting trick. They are really good at it if you watch Senate estimates. They also reannounced that in the budget in 2018-19. Then in November 2019, prior to MYEFO and in response to the royal commission's interim report titled Neglect, they announced for one year from 1 December another 5,500 places. You can't really work out when you look at it whether that was new money or just rehashed or recycled money. So don't give us lectures about how good you are in terms of aged care when you have a royal commission damning you at the moment and you can't find a budget or MYEFO you don't want to cut the funding for. The government are obsessed with aged-care funding cuts.

This government has moved 'ageing' out of the departments of health and human services. It stuck it initially in the department of social security, where it got lost. Ageing became a government service without any consideration of how to address the ongoing health and active ageing policy agenda. Eventually aged care was moved back to the Department of Health after Labor campaigned for that to happen, and so many people in the sector did also. But the government remains focused on aged-care services rather than ageing policies. There is a distinction, but you wouldn't know it. I remember a former coalition minister for rural health telling a Senate estimates inquiry she considered 'ageing' and 'aged care' to be precisely the same thing. I can assure you they are not. I encourage anyone to have a look at the Department of Health website and look at it's 'health topics'. There's 'aged care' but no topic for 'ageing'.

Come to think of it, 'dementia' doesn't rate as a topic either. Dementia is the second leading cause of death for men and the leading cause of death for women. In 2016 it became the leading cause of death for women and the greatest cause of disability for older Australians. Dementia Australia tells us there are close to 500,000 Australians living with dementia at this moment and a further 1.6 million Australians are involved in the care of someone living with dementia. We recently buried my mother-in-law, who was living with dementia for many years. In the next 30 to 40 years, there will over one million Australians living with dementia. How does dementia not rate as a major health topic on the Department of Health's website? Dementia isn't an ageing issue. It is true that over half of the residents in residential aged-care facilities are living with dementia, but it is a disease that affects young people as well as older. Almost 30,000 younger Australians are living with dementia.

The research is vital. But where is the government's agenda on active ageing and dementia-friendly communities? We hear nothing from the government about positive ageing or age-friendly communities. A large part of the demographics of our country is getting older. The community that plans for this with appropriate infrastructure and public places, safe and stable walking services, plenty of seating and conveniently located restrooms is the community I want to live in and that Australians want to live in. It is a community that appreciates playgrounds are not just for kids but to provide exercise and recreational facilities as well. It is a community that employs older people and utilises their wisdom and their experience to mentor and train young people. It is a community that values and appreciates older people, rather than isolating and neglecting them. It is a community informed about dementia and aging, respecting and caring for those people living with those challenges. It's a community that provides appropriate housing options, age-friendly transport options and health, consumer and social services. This is a community that provides services and support for carers.

Labor took these policies to the last election, and I anticipate that we will do so again. On this side of the chamber, we want to wrestle with these options and develop comprehensive plans with stakeholders. We're a party that believe that the ageing of our population can be a positive thing, a blessing rather than a burden. It is a tremendous achievement in Australia that our population is ageing. It is something that we should celebrate. It is a good outcome for our health services and an achievement we can take pride in.

When I see all the challenges we face in the health and ageing sectors in terms of dementia and getting our communities ready for the demographic changes that will happen and I see legislation that tweaks things like this, I see that the government have utterly failed older Australians. They are languishing at home. This is an unacceptable performance by the government, and they should be ashamed of themselves.

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