Helen Haines (Indi, Independent) Share this | Hansard source

I rise to speak in support of the Inspector-General of Aged Care Bill 2023. Today I'm thinking about Edie Dryden. Edie is the north-east's leading centenarian. In fact, she's one of the oldest people in Australia. She celebrated her 107th birthday last year. She has six children, 19 grandchildren, 29 great-grandchildren and 47 great-great-grandchildren. Edie lives in residential aged care in Yackandandah. She lived independently until she was 101, and then she moved into a facility in the same town that she had first come to in December 1960. She has now lived there for over 60 years. We owe it to people like Edie not just to talk about fixing the system but to actually make it happen.

As the royal commission reported, our aged-care system is broken. As a result, too many older Australians are denied high-quality and safe care. Countless reports have told us so. Successive governments saw these problems and papered over the cracks. The system is opaque. We need to do better, and this bill is a step there. This bill establishes the long-awaited Inspector-General of Aged Care, implementing recommendation 12 of the royal commission report. The commission recommended an inspector-general to provide strong oversight to a system that for some time has fallen short of providing care and support to allow people to age with dignity. The inspector-general will have powers to identify, monitor, investigate and report on systemic issues in our aged-care system—the common, deeply rooted, complex issues. The inspector-general can also investigate the complaints system, which is a big concern for many of my constituents who have experienced distressing and unsatisfactory frustrating processes. Importantly, this bill brings a new level of transparency and accountability to the aged-care system. It will report to the parliament and the government on these issues, and recommend solutions to bring about real systemic change.

Ensuring our aged-care system is transparent and accountable is one step towards instilling the trust of families, older people and workers back in a system that has failed them for so long. Critically, the inspector-general must report on the implementation of the royal commission recommendations. I cannot say strongly enough how important this is. For so long, Australians have listened to royal commissions and not seen action. The royal commission into aged care was so powerful, so compelling and so distressing to Australians that it is incumbent upon every one of us in this place to stand tall and strong, and to insist that those recommendations are implemented.

When the royal commission handed down its report two years ago, I called, right then, for the implementation of all recommendations. Like other members, I stood up again and again in this place and called on the previous government to act urgently. I was frustrated by the pace of reform. I hope that now, under the watchful eye of the inspector-general, we will realise the ambition to implement all recommendations.

As the minister said in her second reading speech, we are at the precipice of the great next test of our aged-care system: the baby-boomer generation. Our population is ageing, and we need to ensure that our aged-care system places people at the centre of all aspects of that system. This bill is important to me because my constituents are older and more likely to rely on aged-care services, and this reform aims to improve their quality of life. Twenty-four per cent of my constituents are aged over 65 years—compared to a national average of 17 per cent. In my electorate, 2,687 people are in residential aged care and 2,129 people receive home-based aged care. The Hume region, in my electorate of Indi, has a higher rate of use of at-home supports—under both the Commonwealth Home Support Program and Home Care Packages—to help us age in place.

Before I came to this place I had the privilege of working in aged care. At the beginning of my career I was a director of nursing at a bush nursing hospital and aged-care centre. More recently, I was a volunteer director at a larger aged-care facility. I saw firsthand the challenges of becoming older in a small rural area, the challenges of finding workforce to care for those people and the challenges of being an administrator and a clinician. Now, as the member for Indi, I receive daily emails from constituents about their experience of aged care. I meet aged-care providers who are trying their hardest in the most difficult of circumstances, and I sit down with health and aged-care staff and talk about the burnout they're facing.

We have no shortage of suggestions of where the inspector-general could start on this important work of investigating and reporting on systemic issues in our aged-care system. Let's go to the first. The first is the aged-care workforce crisis. Staffing levels are at the centre of aged-care system failures. Aged-care workers in my electorate are hardworking, committed, professional and compassionate. But the workforce has been decimated from years of policy failure, the pressures of COVID and the lack of skilled migration. It's a battle to recruit and retain staff. One provider told me, 'As with most facilities, we are struggling for staff. Registered and personal-care staff applicants are almost non-existent.' Another told me, 'Our future depends on our ability to attract a workforce, which is a major issue in rural Victoria.' In the small town of Alexandra, I met a nurse in her 70s who'd come out of retirement to head up the nursing team because they could recruit no-one else. Alpine Health, which has aged-care facilities in Bright, Myrtleford and Mount Beauty, is offering $5,000 incentives and short-term accommodation for workers who take up a permanent full-time role. As CEO Nick Shaw said, 'The cost of employment is great for any small rural health service, but the cost of not having a competent and skilled workforce is even greater.'

We simply don't have enough clinically trained aged-care workers. Providing quality clinical care in aged-care facilities prevents unnecessary emergency department admissions, unnecessary transfers of elderly frail people to other locations, unnecessary distress to their family and friends and unnecessary pain and distress to those people in the last years of their lives.

In just three months, on 1 July, the 24/7 nurse requirement will start. This is a crucial part of raising the standard of care across the system. Our local providers support it, yet there are serious concerns that rural and regional providers simply can't find the staff to meet this deadline. We currently have 245 registered nurses in my electorate working in aged-care residential services—this isn't enough right now, and we're going to need a whole lot more. Frankly, I don't know where we're going to find them. I'm glad to see that the government will grant providers in rural and remote areas an additional 12 months to meet this requirement, but I'm concerned. I'm very concerned that even in 12 months we simply won't find them. I'm relieved that areas of my electorate where the staffing shortages are most acute are eligible for this extension of time, and I'll be keeping a very close eye on how our providers will be assisted to meet this requirement because, gee, they need assistance. They're desperate for it. If you don't fix the staffing crisis, you don't fix aged care. That's where the powers of the inspector-general are so important. So we need to monitor how the 24/7 mandate will be resourced and its impact on the system. The government says there are changes in the pipeline that will alleviate the growing aged-care skill shortage, and this includes a 15 per cent pay rise in minimum wages for aged-care workers and the return to normality of the skilled migration program. We need to monitor these changes to make sure that they have the intended effect, or if more is needed. We absolutely need to monitor and observe the impact in rural and regional Australia and tailor support, because there's isn't one-size-fits-all for any of this.

The second systemic issue really is the financial viability of aged-care facilities, especially those in rural, remote, and regional Australia, where there are so many facilities struggling to make ends meet. In fact, in the 2021-22 financial year, 74 per cent of aged-care homes in regional Australia were operating at a loss. We feel this, close to home. In the last two months, two aged-care providers in my electorate have sounded the alarm on the extent of their financial losses. One is experiencing losses of $100,000 per month. It's a fantastic facility, and we can't afford to let it fail, but the struggle is real. In rural and regional Australia, when providers go under, the consequences are felt everywhere. It's losing a major employer. It's losing a skilled workforce that has been painstakingly built. It's a blow, a serious blow, to the morale of a regional community. And it is devastating for the residents and their families who are forced to move away from a place in which they've chosen to age. Stories of husbands and wives having to travel hours or more to visit in places where previously they had been able to pop down the road are simply heartbreaking.

When there are not enough aged-care beds it affects the whole health system. In public hospitals across my electorate we have older patients medically cleared for discharge, but they're stuck because there's nowhere for them to go. This means fewer beds for inpatient services, and these beds are desperately needed for clinical care, treating chronic conditions, emergency procedures and important surgery. The federal government steps in to help providers who are going under, but this is at a cost to taxpayers. The Structural Adjustment Fund, which supports providers who are in financial trouble to exit the market or wind down operations, has paid out $51 million to 62 providers since December 2022, according to research from the Parliamentary Library. We should investigate what is causing these providers to end up in this position.

Finally, we should investigate the disgraceful state of residential aged-care buildings. Too many facilities, especially those in our small regional towns, are outdated and not fit for purpose. This is because successive governments have failed to properly invest in aged care. The royal commission called for a $1 billion investment into building and upgrading residential aged-care facilities every year from 2023. With proper funding, we would have the opportunity to upgrade our rundown facilities in regional Australia and give older Australians the quality of care they deserve. The Bright Hospital redevelopment precinct in the Alpine Shire in my electorate is one upgrade so worthy of the government's attention.

In conclusion, this bill is a good start, but I want to see the remaining recommendations of the royal commission implemented and I want to see that done urgently. One major recommendation was a whole new aged-care act, which, I understand, the government is drafting. And any new legislation must focus on the safety, health and wellbeing of older people and put their needs and preferences absolutely at the centre, absolutely first. Aged care is not just about supporting a person's basic daily living needs; it's about ensuring older people can contribute to socialising, be empowered to make decisions about their own care, and supporting people to achieve their goals for a meaningful, happy life.

In drafting legislation, the government must listen to any recommendation of the Council of the Elders, the Aged Care Advisory Council and all stakeholders to ensure that legislation is best practice. I recently met with Allied Health Professionals Australia, the national peak for allied health. The royal commission found that, although allied health services are fundamental is to aged care and particularly critical to maintaining a resident's wellbeing, they're underused and undervalued. In my experience in aged care, the impact of having a speech pathologist to assist with swallowing in someone who has had a stroke, physiotherapists to assist with continence management and to avoid falls, nurse practitioners are crucial to high quality aged care.

The royal commission called for allied health services to be viewed as a valuable service rather than a burden and should be intrinsic in residential aged care. Further, it called on this bill to be strengthened to ensure that the inspector-general is adequately resourced to fulfil their functions and recommended measures to ensure that the government meaningfully responds to the inspector-general's recommendations by setting out what measures they have taken in response and how effective they've been. I urge the government to consider these recommendations.

We need to make sure the work of the inspector is not left on a shelf gathering dust. We need to make sure that the older people in our society all across Australia, irrespective of who they are and where they live, have what they need for a meaningful, dignified final years of life, that their loved ones feel confident in that care and, importantly, that the workers who provide for them have a meaningful job as well, that they come home at night feeling like they've done all in their power to provide good, high-quality clinical compassionate care.

I thank the government for this bill and I'll be watching to make sure it's acted upon.

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