Ged Kearney (Cooper, Australian Labor Party, Assistant Minister for Health and Aged Care) Share this | Hansard source

I rise to address the House on the Aged Care Amendment (Implementing Care Reform) Bill 2022. This bill implements a number of our government's important election commitments that will improve integrity and accountability for aged-care facilities. The bill puts nurses back into nursing homes and caps home-care administration and management charges. This will ensure that older Australians receive the aged care they deserve, and that security, dignity and humanity are put back in the system.

These reforms must be done urgently. This is because hundreds of thousands of families have seen the aged-care system in crisis and they need to know that the system is changing for the better—that it will be fixed. It is reforms like these that only happen under Labor governments, and it is reforms like these that are precisely why I am standing here where I am. I am so honoured, as a registered nurse who's worked in aged care, to be here today, speaking in the chamber about the importance of these reforms. These are reforms that I have worked on with my colleagues and have played a role in nurturing, from the idea stage through to legislation, and that those in the mighty union movement—in the ANMF, the UWU and the HSU, with other unions—have worked on collectively, along with their members, the hard-workers in aged care, and with providers and consumer advocacy groups, because when we do things together we get things done.

This bill also responds to recommendations of the Royal Commission into Aged Care Quality and Safety and demonstrates another step this government is taking to address these shortcomings in the care provided to older Australians. In the history of aged-care facilities in Australia, there will be a 'before this legislation' and an 'after this legislation'. The 'before' is a terrible national tale of neglect, where older Australians—mums and dads, grandmothers, grandfathers, neighbours, friends and community members—were left to languish in a system that was not geared to protect them. Under the previous government, we saw COVID rip through these facilities. Under the previous government, aged-care facilities didn't have an adequate supply of personal protective equipment or enough RATs. There was a failed delivery of booster shots. There was a cynical cash bonus incentive for poorly-paid workers. But they would not commit to any real wage increases. We saw facilities struggling to fill shifts, with a stampede of workers leaving the sector for less stressful and better-paid work elsewhere. There was a failure to act decisively on the royal commission's recommendations, including in making sure that workers had enough time and resources to care for residents appropriately.

I want to paint this 'before' picture, which is a bleak portrait of the sector that was almost on its knees. While there are many great examples within the sector, by and large, it was one that had been failed by the government and was failing Australians. The picture we are working to paint, with these reforms as a significant part of that, will be very different. These reforms will shift the way aged-care facilities fundamentally run and operate and the way people are supported to age in the community and residential care settings.

Schedule 1 of this bill will introduce a new responsibility for approved providers of residential care. From 1 July 2023, aged-care providers will need to have a registered nurse on site and on duty at each residential facility, 24 hours a day, seven days a week. Put differently, we are putting nurses back into nursing homes. Nurses offer so much. They're a highly skilled set of hands. They offer expertise. They're a steady and measured presence that many other staff often look to for guidance and support.

The royal commission found unacceptable staffing levels in over half of all nursing homes. For too long staff have been stretched too thin, and the consequence of this has been that our older Australians are not guaranteed the care they deserve. By putting nurses back into nursing homes, we are implementing a crucial election commitment. This will save thousands of unnecessary trips to hospital emergency departments and will ensure that older Australians living in residential aged care have access to the nursing care they deserve. It will lift care and quality standards and improve health outcomes. Crucially, this will put expertise in house.

The dedicated women and men who work in aged care are so critical to getting the settings right for this sector. These workers, the personal care workers, cleaners, cooks, nurses and administrators, are such exceptional people who've had to work in incredibly difficult circumstances. After enduring the pandemic and its massive implications for the sector, they are bone tired. They've worked around the clock to care for their elderly residents. They've often taken on additional responsibilities to keep residents cared for and safe. They've been spread so thin, looking after way too many residents, and these workers have had to make extremely difficult decisions about how to prioritise care. They've worked double shifts covering colleagues out sick with COVID. They've taken yet more shifts as colleagues have left the sector for less stressful and better paid work.

The ANMF released a survey of nearly 1,000 aged-care workers in March this year. Thirty-seven per cent of these workers said they planned to quit the sector within the next one to five years, with another 21 per cent planning to leave within the next 12 months. These workers said they were feeling hopeless and abandoned, exhausted, demoralised and resigned. Being both overworked and underpaid is not only a terrible position to put workers in but it's potentially dangerous for the residents, as it leads to a rapid exodus of workers.

The previous government must be held accountable. The sector has been haemorrhaging staff and we need to stem the flow. We need to get these people back and encourage a pipeline of the next generation of aged-care workers. One of the ways we plan to do that is also a part of these reforms. We need to give aged-care workers the time and resources to provide appropriate care for residents. This is why we will be mandating care minutes for aged-care residents.

Everyone who works in aged care is there because they want to be there, they want to provide care to our older Australians, and they must be given the time to do that. That is why the government will mandate that everyone living in residential aged-care facilities will receive an average of 200 minutes of care per day by October 2023, and this will increase to an average of 215 minutes of care per day by October 2024. This, crucially, includes 40 minutes with a registered nurse. This will fulfil our election commitment and is in line with recommendation 86 from the Royal Commission into Aged Care Quality and Safety.

By mandating these care minutes, workers will be able to dedicate an appropriate amount of time to look after each person in their care. It will make sure that residents get an average of 35 additional minutes of care above current levels. It will mean that workers don't need to make a difficult decision about whether to feed someone or follow a resident who is wandering and keep them safe, because they will be able to look after everyone in their care. It will mean residents aren't put to bed at 4.30 in the afternoon because there are not enough staff on an evening shift. It will mean they can spend the time talking to the residents and assessing their mental health, their cognitive awareness and their wellbeing and give them some much-craved company. It will mean more care for every resident every day and not just for essential medical treatment. It will mean they can help a resident have a shower, get dressed or even phone a loved one. We know this will improve the lives and wellbeing of residents immeasurably. It will improve not only their health but also their mental health.

Another part of this suite of reforms is capping administration and management charges for people receiving home care. When charges are capped it means that more of the funding will go directly to care. Too many older Australians who are living in their homes have crippling high management and admin charges. Currently approaches to charging vary significantly across providers. While they are required to publish prices for care and package management, there is little transparency about how these prices are set and there is no cap on the amount that may be charged. Our government is reducing the high levels of administration and management charges and will remove the ability of providers to charge care recipients for ceasing care.

Evidence to the aged care royal commission demonstrated some organisations gouge as much as 50 per cent from people's packages. These historically high charges have had a significant impact on the amount of funding that can actually be spent on care while people are living at home. This has meant older Australians are missing out on care. Ultimately we want to be keeping people in their homes as they age as long as it's safe and they are comfortable. We've listened to older Australians and we will keep listening to them and their families. So many older people want to stay at home as long as they can. They want to stay in their communities, stay where their family and friends can drop in, stay where they can make tea and coffee in their own kitchen and sleep in their own bed, and live on a familiar street with neighbours who know and love them. When someone is well enough to stay at home it encourages their independence. Light physical activity is important and it supports general wellbeing and connectedness. It's so important to have the support systems and services in place so that people can stay in their homes.

A Labor government is not afraid to put the quality and safety of home care first by reining in unscrupulous providers who are charging exorbitant management and admin fees. These reforms put transparency, integrity and accountability into aged care. For too long under the previous government the aged-care sector was encouraged and rewarded for opaque, greedy and even deceptive fees. This has to change. We were very clear that a Labor government will stop this. We'll ensure that older Australians and their families have access to more comprehensive information about aged-care services and providers, including how money is spent on care. The Labor government have long said that we will improve transparency, integrity and accountability in this sector. We'll shine a light in the dark corners in areas where poor behaviours and practices have flourished.

The amendments in schedule 3 of the bill will ensure that older Australians have access to more and better information. These amendments will ensure information is published in a format that is clear and able to be understood. This will empower older Australians and their families to make better decisions about their care and will strengthen the integrity and accountability of providers and incentivise best practice. This will deliver improved nursing care and provide for improved pricing and transparency. It demonstrates this government's commitment to putting security, dignity, quality and humanity back into our aged-care system.

This bill takes several important steps towards fixing the aged-care crisis. Change takes time, and we don't believe things will be fixed immediately, but change means fixing many things, monitoring them and continuing to talk to workers, residents and other people in this sector to understand how the reforms are progressing. However, at its heart it is all about dignity; it's about restoring humanity and respect to the sector; it's about standing up for workers and their conditions; it's about enshrining integrity and transparency; it's about improving people's lives as they age, both in their homes and in aged-care facilities; and it's about reforming the aged-care sector to do what it is meant to do—care for people.

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