David Gillespie (Lyne, National Party) Share this | Hansard source

I rise to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Bill 2021. Aged care is a huge part of the annual budget of this nation, and there are many constituents in my electorate who are in residential aged-care facilities. The royal commission has uncovered gaps in the standard and some very distressing practices in some nursing homes. But, I must say, the quality of care in the Lyne electorate in the facilities that I've visited over the last 30 years has been second to none. These amendments amend the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018. It introduces three main measures.

The first regards the use of what are called restrictive practices. There were some egregious abuses of physical restraint and chemical restraint uncovered, as they should have been, documented by family members and friends who visited nursing homes. That's why the royal commission was there. There always has to be consent for these sorts of measures, either from family or guardians or the patients themselves. It is a fact of life that in aged-care facilities some aged-care residents get quite agitated and distressed and can be quite confused and violent, particularly around sundown—the so-called sundowning effect. While they need care, love and attention, that agitation and confusion may require physical restraint. But this bill now sets a much higher bar to establish consent and all other measures before the use of either physical restraint or chemical restraint. The other major change that this amending legislation makes is to the Aged Care Financing Authority, such that an advisory body will be created in its stead to advise the minister on aged-care funding matters.

The other big response in this bill is to set up a quality assurance program for the ever-expanding home-care system. As you know, there has been a huge backlog in constituents who have been approved for a home-care package but there hasn't been the workforce for it, but one thing that there has been no shortage of is the increased funding over the last three to four years. It's absolutely expanded exponentially. But a quality assurance review will monitor the delivery and administration to ensure that it is effective and efficient. It will support continuous improvement and policy development in relation to home care. It will inform further education of approved providers in relation to their responsibilities. It does empower the Department of Health to require approved providers and their employees to provide information about their quality assurance program. It also empowers the health department to name those providers who do not comply with notices to produce such information and publish reports on the assurance reviews. It is a very important issue, and these three things will be a significant improvement.

As you understand, we have committed $17.7 billion to improving aged care because Australia's senior citizens in some cases unfortunately weren't getting the quality of care that is demanded. Increased funding will definitely fix some of those problems. But there is a phenomenon happening in aged care in that it is very difficult to get aged-care staff. Not every person working in a nursing home or an aged-care facility needs to be a registered nurse. There can be assistants in nursing, enrolled nurses and personal-care workers. The main thing is it's an old person's home; it's not a hospital like an intensive care or a surgical ward. So you need registered nurses in some of the situations but not all. I think it would be a real tragedy if we tried to turn nursing homes into hospitals.

The other problem is that, with the NDIS funding expanding and the NDIS expanding, a lot of healthcare workers in aged care are moving over to NDIS work because the payment is far higher. A lot of staff are being cannibalised from the aged-care system and going into unskilled, higher-paid work.

(Quorum formed) I was just about to complete my speech. These three reforms are an important response to the aged-care royal commission, and I commend this bill to the House.

See this speech in context