Matt Keogh (Burt, Australian Labor Party, Shadow Minister for Defence Industry) Share this | Hansard source

[by video link] There have been 21 expert reports that said our aged-care system simply isn't good enough. There have been 21 reports that said that older people were suffering in aged care, but the problems haven't been fixed. There have been 21 reports, yet the Prime Minister, when he was Treasurer, actually cut funding. Labor supports action to fix the aged-care system but is concerned that the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021, like much of the government's response to the aged-care crisis, falls short.

I don't want my parents to experience the horror stories we've heard through the royal commission, should they have to go into aged care one day. I fear for my parents and for anyone in my community that they may be subjected to some of the substandard aged-care system as it is. After eight years of this government decimating aged care, older people in my community cannot afford another three years. There is literally no time to waste. The government has fobbed off, delayed or outright rejected key recommendations from the aged-care royal commission. Of the 148 recommendations, more than half aren't being implemented or are being implemented only half-heartedly. This bill is no different, with alterations and a number of items missing from the original royal commission recommendations that it is claimed the bill would be addressing.

It's also concerning that older Australians, aged-care peak bodies, providers, workers and unions were not consulted in the drafting of this bill, despite the impact that this bill would have on all of them and across the sector. Residential aged-care funding, workforce screening, provider governance, banning orders and a code of conduct: no-one knows these issues better than those who have been working on the front line, who will not only be subject to these changes themselves but will be enforcing and implementing them. They are the experts. These are not small changes and they need proper consultation. The Morrison government's response to the royal commission into aged care falls well short of resolving this crisis. But, ultimately, workers tell me that they didn't need a royal commission to know that aged care in Australia is in crisis. You just have to ask them.

Ultimately, nothing will change without serious reform for the workforce, but the aged care royal commission recommended nothing to improve wages for overstretched, undervalued aged-care workers. Our aged-care workers are some of the most generous, kind-hearted and overworked individuals, and my community is home to many. It is vital, in the very first instance, that we improve wages for these overstretched and supremely undervalued aged-care workers. Many of these workers are earning less than $23 an hour. To put that in context, the typical Coles casual team member gets a salary of $24 an hour. What a complete slap in the face it is to those who look after some of our most vulnerable. These are workers who go above and beyond for their residents, who work extra hours and put in extra time because they know that, often, they are all their residents have. These are workers who become like family to their residents. These are humans that are affected by the loss of patients as if they were friends and family. Yet before they've had a chance to process those losses, there's a new resident in that bed, and workers are expected to just push on, with no opportunity for counselling and no time to debrief the loss.

A recent survey from the United Workers Union revealed that 37 per cent of aged-care workers are looking to leave the sector now. In regional areas, 45 per cent are looking to get out. Many organisations spend a great deal of time and money training new staff, but, when they get started, they get out as quickly as they can, appalled by what the industry is really like. How on earth are we going to encourage people to move into this industry out of school? In Western Australia alone, there will soon be more than 15,000 people aged over 60 years working in aged care. There is no-one to replace them when they retire. Remember: this often involves difficult physical work. You need a particular level of fitness to do this work. At this point, with workers treated the way they are, why on earth would you want to get into an aged-care career?

My community is also home to a number of great aged-care facilities. They are doing a lot with what they've got, which is sometimes very little. They rely heavily on the saints that are our large local aged-care workforce to keep things ticking over. All the independent assessors have said that there needs to be a minimum of a $10 billion investment into aged-care workers, and that's just the starting line, not the royal commission's recommendations. The Morrison government has decided to gift $3.2 billion to aged-care providers via the basic daily fee increase, but with no strings attached to ensure this actually goes to better care or better food for the residents. As it stands, it could easily end up as management bonuses or a new office fit-out.

The government has failed to clear the home-care package waiting list of 100,000 people. Only 80,000 packages were included in the budget over the next two years, and thousands will join the waiting list every year. Indeed, every year hundreds die while on the waiting list. The maths doesn't add up. It is inhumane. The Morrison government has also ignored the recommendation to require a nurse to be on duty—24 hours a day, seven days a week—in residential care. This is core to improving clinical care for frail Australians. After all, it is a medical facility that is home to many likely unwell residents. The fact that there isn't a nurse in aged-care facilities—24 hours a day, seven days a week—is appalling and is resulting in poor standards of clinical care, through no fault of the aged-care workers. Indeed, it leaves many waiting for hours, and it leaves families stressed, having to make sure that their relatives get the care they need. Some of the aged-care providers in my community tell me that they're constantly fighting just to stay afloat. They would love to employ more staff—indeed, a nurse. They'd love to pay them better and ensure there's a nurse available at all times, but there's simply not enough in the budget to make it happen under the current funding arrangements.

The Morrison government's promise of mandatory care minutes for each resident is also full of holes. It doesn't meet the royal commission recommendation, and we now know that cleaning and some administrative tasks will be included in these care minutes. These vital workers in aged-care facilities are equally as important as the hands-on staff in ensuring that there is a safe and clean environment for residents. But these are two very different types of work, and they should not all be lumped in together as care minutes.

There are a number of potential concerns with the bill as it stands, and we believe they must be examined further. Primarily, the consultation with stakeholders was absolutely appalling, with most telling us there was little to no consultation during the drafting of the bill. There are concerns with the idea of implementing worker screening rather than following the royal commission's actual recommendation of a national registration scheme. They are indeed not the same thing. The Morrison government's proposed nationally consistent pre-employment screening process will be introduced for aged-care workers and governing persons, which includes individuals responsible for executive decision-making, with authority or influence over planning, directing or controlling the activities of the provider. On the other hand, a registration scheme was proposed by the aged-care royal commission whereby the Australian government would establish a standard for the personal care workforce with the following features: mandatory qualifications, ongoing training requirements, minimum levels of English proficiency, criminal-history screening and a code of conduct through which necessary disciplinary action can be taken. That is very different to what this bill will do. Once again, this is not doing what is required to improve standards of care or to support the workforce at all.

The new governance standards put forward in this bill are also less prescriptive than those in the royal commission's recommendation, and the sector is concerned that regional providers may struggle to meet the standards as they are set out in the bill.

Currently providers are exempt from certain freedom of information requests. The royal commission recommended that this exemption be removed. Instead, this has been completely left out of this legislation. Workers have been included in a code of conduct and are subject to banning orders, which were originally recommended for the provider leadership. It is unclear why this has been directed to the workers. There are also concerns that the review process for challenging a banning order might be quite long and slow.

The bill will also change the funding and finance landscape for aged care in three important areas: the introduction of a new residential aged-care funding model, known as the Australian National Aged Care Classification; the introduction of new powers for the Department of Health and the Aged Care Quality and Safety Commission to request information about loans made using refundable deposits; and the establishment of the Independent Hospital and Aged Care Pricing Authority, which replaces the existing Independent Hospital Pricing Authority.

Providers say that they are concerned about transition funding, but, frankly, they haven't been consulted to an appropriate extent to know if they should be concerned or not. There are simply too many questions being left unanswered by this bill. There must be greater consultation. A Senate inquiry would at least be a good start to getting to the bottom of how this legislation will actually affect the sector. The Morrison government must do more to fix the aged-care crisis under their watch and must do more than this bill will actually achieve.

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