Kate Chaney (Curtin, Independent) Share this | Hansard source

I welcome early implementation of some of the royal commission recommendations. It's a step in the right direction to protect our most vulnerable. However, I note that this bill, the Aged Care Amendment (Implementing Care Reform) Bill 2022, is introducing only a few of the 148 recommendations made by the royal commission. Even within the limited scope of this bill, there are many substantive issues that are likely to inspire differing views that are intended to be addressed in delegated legislation and so will not be subject to rigorous debate and scrutiny in this House.

This bill sets out some good changes. The government's commitment to 24/7 nursing is welcome. We need to ensure that the elderly in our community have access to immediate medical assistance if required. However, my electorate and I are concerned about how this commitment will be fulfilled. In this climate of severe skills shortages, where will all these nurses be found? How will the compliance of providers be enforced? How do we ensure that smaller providers can comply? What does it mean for the training levels of other staff? I understand that exemptions may need to be granted, given the current staffing challenges, especially in rural and regional areas, but there's no visibility of how exemptions will be given.

The amendments to the bill proposed today by the Deputy Leader of the Opposition and the member for Mayo require greater detail on these potential exemptions, which would allow appropriate scrutiny and discussion. I will be supporting these amendments. It is important that the implementation of these changes not be delayed, but proper scrutiny of the proposed exemptions is required to ensure a balance between access to better care and practical and geographical constraints.

The issues addressed in this bill are a good start, but just a start. I look forward to seeing the government respond to the rest of the recommendations as soon as possible. In my electorate, both experts and those with lived experience of aged care are looking forward to the broader review of the aged-care legislation. They've asked me to advocate for a better system. For example, I've had multiple aged-care advocates contact me expressing concern about related clauses in the recent Aged Care and Other Legislation Amendment (Royal Commission Response) Bill 2022. Constituents have told me they were particularly worried about schedule 9 of the royal commission bill, which legislates on restrictive practices in aged care.

The question of consent—for example, for chemical restraint—needs to be aligned nationally. In Western Australia, facilities can give consent for chemical restraint even if a family member has guardianship. A constituent told me of her mother, who was made to take tablets that caused nausea and a number of falls. The facility told the family the pills were required, as the woman was aggressive, but this seemed unlikely to the woman's daughter. They were concerned to arrive in the middle of the day to find their mother asleep.

In the lead-up to the drafting of the new Aged Care Act, my constituents want to know that there will be a robust and extensive consultation. They want to be informed as soon as possible of the community engagement process that will be undertaken to ensure that the new legislation is written with a human rights lens and consumer focus, to ensure the inclusion of a range of issues such as mandatory reporting of sexual assault.

Another area of reform needed is cultural safety. Recommendation 3 of the royal commission was that the act should incorporate this principle. Aboriginal and Torres Strait Islander people are entitled to receive support and care that is culturally safe and recognises the importance of their personal connection to community and country. Neither of the recent aged-care amendment bills address this principle.

Accepting this principle would require three things: firstly, the use of culturally appropriate assessment tools to understand needs; secondly, supporting Aboriginal and Torres Strait Islander people to use aged-care funding through home-care packages to maintain their connection to country; and, thirdly, supporting Aboriginal and Torres Strait Islander people to access aged-care support from Aboriginal and Torres Strait Islander aged-care providers. There are few of these and many providers are church based, with whom Aboriginal and Torres Strait Islander people may have difficult histories of forcible institutionalisation.

It's worth noting that the aged-care access rate for Aboriginal and Torres Strait Islander people in Perth is half the national average, for capital cities, at 8.5 per cent. This goes to a fundamental principle that needs to inform the broader review of the aged-care legislation of ensuring that service development is informed by the people affected by it.

There's also work to be done on the public reporting of complaints and incidents. One story brought to my attention was of an elderly lady assaulted by a staff member. The incident was reported to police, and the staff member consequently resigned. But as there's no public reporting or record, the family fears that the worker could go on to be employed by another aged-care facility.

While this bill is a start, I look forward to these recommendations and others from the royal commission being adopted in further legislation.

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