Clare O'Neil (Hotham, Australian Labor Party, Shadow Minister for Senior Australians and Aged Care Services) Share this | Hansard source

Thank you so much, Speaker, for the opportunity to make a statement on behalf of the Australian Labor Party in this second reading debate on the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Bill 2020 that is before the House. It's very unfortunate that we're dealing with this bill far, far later than we should be. The government has taken much too long to respond to serious incident abuses that have been happening in our aged-care system. The bill that's before us will implement the recommendations for a scheme that were put before the government more than three years ago by the Australian Law Reform Commission. Soon after that, the Carnell-Paterson review, commissioned by the government following the Oakden nursing home tragedy, also recommended introducing the scheme—back in 2017. Here it is—an issue as critical as how a nursing home manages a sexual or physical assault on a vulnerable elderly person, and it has taken the government years to take action. As I'll explain, the bill that's before us is deficient in some very profound ways, including the fact that it actually leaves the majority of users of our aged-care system completely out of this scheme.

The way in which the government has dealt with this issue—this lumbering, delayed, lack of urgent prioritisation—is unfortunately emblematic of what we see of the government's entire approach to the aged-care crisis which confronts our country. It is obvious to every Australian that changes need to be made to this system. We have a royal commission's report titled Neglectthis is how obvious the problems in this system are—and yet we see that time and time again these reports are given to the government, and it takes them years to do anything, if at all. In fact, when the Prime Minister was Treasurer of this country, we saw him try not to solve the problems in aged care but to cut $1.7 billion out of this system in crisis. We see again that when the government attempts to make changes it does so in a slow fashion, in a way that shows that this is not an urgent priority for the Morrison government and in a way that, frankly, introduces a sub-standard system like the one we'll be debating today.

I make these points because it's really important for Australians to see the pattern that's in place here. We've got a royal commission on foot which tells us that this system is profoundly failing hundreds of thousands of users of the aged-care system, profoundly failing millions of people who will in future use that system, and we have a government that just drags its feet when it comes to reform and to appropriately fixing the problems that are discussed here.

Neglect is the title of the royal commission's report into aged care. That doesn't just describe the way in which the aged-care system operates; it describes the way in which the government has dealt with this critical area of policy for its almost eight years in office, and it needs to be held to account for that. Ultimately, I see the government's handling of this issue and so many others as its own form of cruelty.

Let me talk a little bit about the specifics of this bill, because it's an area that I think hasn't seen the kind of light and transparency that I think it deserves. So I want to talk a little bit about the problem that's trying to be solved. The scheme that's before us is trying to bring more transparency into the issue of serious incidents that occur in aged care. Serious incidents in aged care are actually very common, and we saw reported assaults, for example, in aged care have gone up every year in recent years and reached 5,233 in 2018-19. So let's think about the cohort of Australians that we're talking about here against whom these serious assaults or incidents are occurring—the most vulnerable, the most frail and, in many ways, the most important Australians that this parliament gathers in this chamber to protect, and yet we are seeing routine incidents that are not being properly reported and which people are not being held accountable for because of the failures of this parliament.

The bill does make some important changes—of course, changes that Labor greatly supports. The bill will require providers of aged-care facilities to manage incidents and to take reasonable steps to prevent them in the first place, and that's going to include requiring aged-care homes, for example, to put in place organisation-wide systems that will manage and report incidents of abuse and neglect.

The bill will require approved providers of residential care in residential aged care to report all serious incidents to the Aged Care Quality and Safety Commissioner. A wider range of incidents will now be reportable, including unreasonable use of force, unlawful or inappropriate sexual contact, psychological or emotional abuse, unexpected death, stealing or financial coercion by a staff member, neglect, inappropriate physical or chemical restraint and unexplained absence of care. The scheme is going to remove an exemption that exists at the moment for reporting assaults where the alleged perpetrator is another residential aged-care victim with a cognitive or mental impairment and the victim is another care recipient, obviously another important piece of reform. The bill will strengthen protections for people working in aged care who disclose incidents of abuse and neglect in the system. The bill will improve oversight of these new changes, expanding the powers of the Aged Care Quality and Safety Commission, and there are some other aspects that are more administrative that support the scheme.

You can hear from the things I'm describing here that these are important changes. I think the question that most Australians would have when hearing this list of things is: why in God's name aren't these things already law in this country? How can we have a system where people can be sexually assaulted in aged care where there's no real transparency and appropriate reporting of that to the people who run the aged-care system? How can we have a system where you can be the victim of a physical assault, for example, and where, because the perpetrator of the assault is another aged-care resident with a cognitive disability, that doesn't get reported?

The thing that enrages me about the changes that we're seeing—I'm happy that they're going through; I'm just frustrated that they weren't already part of our system—is the treatment of people in aged care. It is as though they have fewer rights and less dignity than every other Australian. Of course, that is completely contrary to Australian values. As I said, I'm pleased to see some of these changes, but why the hell are we having to have the debate now? Why wasn't this done urgently, when we knew all the way back in 2017 that this was the system that ought to have been in place?

I and Labor do have some critical concerns with some aspects of the bill. The main concern that we have about the bill is that it does not include serious incidents in home care. It's much more than an oversight because, as much of the parliament would know, the vast majority of the people who are consumers of aged care in Australia, who are citizens who are getting that support from services, are actually getting that support in their own homes. There are more than a million people in Australia today who are getting some type of home care through the aged-care system, and this bill offers them no additional protections and no additional transparency. Why would we make a big change like this to the aged-care reporting system for serious incidents and leave out the strong majority of people who are in the system?

It's not just Labor, of course, that has this concern. In the royal commission, the counsel assisting, in its final submission, asked that the government ensure that the new scheme that was going to be put in place include home care. That was a direct request from the royal commission. Yet here we are in this parliament passing a bill that will introduce a system that will protect fewer than a quarter of the people who are receiving aged-care services today. That we are failing to protect an additional million Australians in a way that we so easily could through this parliament just seems, again, like a negligent and silly mistake. So I want to call on the government today to look at this scheme and urgently assess how it could be applied properly in a home-care setting. Of course, there are serious incidents that are occurring in home-care settings. That's inevitable when you have a million people, and they're vulnerable people, who are receiving these services. As has been requested by the royal commission, we need to have a proper system in place to protect those critical Australians, and I'd like the government to put that in place.

I want to turn now to the second reading amendment which I'll move at the closure of my remarks. I just want to talk a little bit about the broader context for this debate. I know that the parliament and most people watching and listening will know that we have a royal commission on foot because the aged-care system in this country is in crisis. There are a quarter of a million vulnerable people in residential aged care who, we know, are living in a system that does not provide adequately for the needs of most of them. We, as a parliament, make choices about how we prioritise things and about how we prioritise funds. I just think it is absolutely bleeding obvious that we need to be doing more to ensure dignity in the later years of life of older Australians who have done so much for this country.

Reading this report is actually quite hard going. But I hope everyone in this parliament has read the report, because they would not be in any disagreement with me when I say that this system today is a national disgrace. Even reading the initial 12-page forward of this report is gut-wrenching. It is rage inducing that we have allowed a situation to transpire where people whom we say we care about are being treated so poorly by a system that is run entirely by the Morrison government.

The interim report describes horrific mistreatment of older people in aged care. Many of the people in this chamber will recall seeing images of maggots in open wounds. This royal commission report details older Australians who are lying for hours, sometimes days, in urine and faeces, because the aged-care provider has rationed continence pads. It details the fact that up to half of Australia's most frail people living in aged care are malnourished. They are malnourished in a system that the Australian taxpayer pays for. It describes how about 60 per cent of residents in aged care today are on psychotropic medication, but that medication is estimated to be justified in about 10 per cent of cases. For anyone who wants to read and better understand this system, it confirms that 4,000 notifications or allegations of suspected sexual abuse are reported each year, that 274,409 self-reported cases of substandard care were made, and that, indeed, in one year, 32,715 calls to the My Aged Care consumer hotline went unanswered. That's in one year. That is neglect. That's why this report is called Neglect.

The report confirms, too, that we have an aged-care workforce that has been profoundly let down by the Morrison government—an aged-care workforce which is undervalued, underpaid and not properly resourced to do some of the most important work in the community. I want to ask why you think it is that today you can earn more doing a shift in a supermarket than you can in caring for one of the most vulnerable people who live in our country. How can that be the case? Yet it is the case because for almost eight years the Morrison government have known about these problems and have commissioned report after report after report and have done nothing to fix the problems. Instead, they have made the situation profoundly worse by taking funding out of this incredibly stretched system.

Hearing these stories and digesting what has happened on the watch of the Morrison government is very difficult. It's really difficult to confront some of these issues. In the report the royal commissioners speak about the fact that a lot of people don't want to think about their own ageing, so it's hard to really engage with some of the difficulties that are talked about, but we have to because we cannot stand back when good people are being treated this way. Overwhelmingly, the victims of this horrible system are some of the most elderly and frail people in our whole country. Not just that; they are people who contributed to this system their whole lives by paying taxes. I think that, as Australians, they have a reasonable expectation of getting a dignified life and a good quality of life in their retirement, but not in Scott Morrison's aged-care system.

I want people to really take notice of this. We will have the royal commission final report released in about three weeks. This is a report that doesn't affect just the quarter of a million Australians in residential aged care and their families; it is a report that is going to affect all of us. It affects all of us because we have many millions of people who are using the system or are families of people using the system. We have a very large generation of Australians, the baby boomers, who are starting to make decisions and have discussions about how they are going to age. I don't think that that generation of Australians should feel fear about what might happen to them as they age. It's important for people of my age, as most people of my age have ageing parents and we're also having to think about how we are going to help them as they age, and about the issues that happen as one ages. But it's also very important because many, many millions of Australians are going to access this system themselves. The royal commission report talks about the fact that, if demographic trends remain as they are today, more than half of all Australian women are going to spend time in residential aged care. So, if you are a 20-year-old out there on the street and thinking that aged care isn't important for you, that's not right. This is a system that we need to invest in and that we need to fix, because no Australian could read this report and think, 'That's the system I want to end up in.'

It's absolutely the case that there are providers of aged care in Australia—and, most importantly, the amazing staff who work in this sector—who are doing extraordinary things. I want to include in that my amazing mother-in-law, who's one of my heroes and who's an aged-care nurse in regional Victoria. I could not respect the work that she does more. She looks after people who are at the most vulnerable and difficult phase of their entire lives, and she does it with more love and more commitment and more community spirit than you could ever imagine. But what the royal commission report points out is that the providers that are doing a beautiful job of looking after elderly people, and the amazing staff who are so undervalued and so unsupported by this government, are doing that not because of this system but in spite of this system. There is nothing in the system today that actually promotes great quality of care and great quality of life for Australians.

One of the things I want Australians to be outraged about is the cost of this system to the taxpayer and the outcomes that we're getting. As I've said, this is a system that is in abject crisis. There is no room for debate about that question. Today we are paying literally billions and billions of dollars—$22.6 billion—to an aged-care industry. While this has happened, while we have had maggots in wounds and vulnerable people sitting in urine and faeces for days, we have also had operators of aged-care facilities that have essentially behaved like profiteers, who have accumulated vast fortunes on the back of, really, the poor treatment of older Australians. Whatever we do, coming out the other side, to fix this system—a conversation that Labor are more than keen to have—we need to address that problem. It is despicable that we have had people getting rich off the mistreatment of older Australians. With every power that we have to control what lies ahead, Labor will not allow that to continue.

I've talked a little bit about Labor's commitment to this; I actually don't think that the Australian public are going to have much trouble believing in our absolute and genuine desire to see this problem resolved once and for all. We have, over long periods of Labor government, invested in this system. We have reformed this system, and we have done everything we can to look after older Australians. In the last eight years, we've had eight years of despicable neglect. There has been neglect from the point of view of funding, but also—and more importantly, perhaps, for this parliament—a neglect in prioritisation. I want to come back to the bill before us. We make choices in this chamber and, in particular, the government makes choices about what it will legislate and how it will prioritise the different issues that face the country. Whenever it has had the chance, the government has put aged care and vulnerable older Australians at the back of the queue. That is what has to change, and I am looking forward to Labor holding the government to account for that over the coming months.

I move the second reading amendment circulated in my name:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House:

(1) notes the systemic, ongoing failures in Australia's aged care system as evidenced by the Royal Commission into Aged Care Quality and Safety, including, but not restricted to, serious incidents in residential aged care;

(2) further notes the bill as drafted only deals with incidents in residential aged care facilities and not incidents that occur in home care; and

(3) calls on the Government to explain their plan to deal with serious incidents that occur in home care."

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