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

The Aged Care Bill 2024 is a very important bill. The aged-care industry is a huge part of Australian life and has been through huge changes over the last 10 to 15 years. We've been through the royal commission, and there's not much that's been said in the explanatory memorandum or in speeches in the second reading debate about all the things that we had already done. It's almost like this bill is meant to rewrite history.

I want to put on the record that most of the recommendations of the royal commission were enacted already by the last government. There was an extra $18 billion added to the aged-care budget by Senator Richard Colbeck and Minister Greg Hunt, who were the Minister for Senior Australians and Aged Care Services and the Minister for Health and Aged Care respectively. We already had an Aged Care Quality and Safety Commission and Commissioner, although, from reading the documents, one would think this is a new position. I just want to put that on the public record. Also, we created funding for thousands more home-care places, which are part of the aged-care spectrum of care. We have many more people who are cared for at home. The plans to merge simple assistance at home with aged-care packages and put them all in one homogeneous system were a policy development of the last government.

We're obviously supporting this bill because we support the aged-care industry, but I would like to make some other comments. It's all very well to say we have the new means-tested user-pays entry, but it appears that not everyone is paying more—just self-funded retirees, who again are cross-subsidising those who don't pay as much. Fortunately, due to the negotiations by our shadow minister for aged care and health, the terms and conditions are grandfathered for those who are already in or have signed up for an aged-care situation, so they won't be giving an extra amount of refundable accommodation deposit and they won't be charged more than what they signed up for, There is a lifetime cap of $130,000 on the contributions, but that only includes funding of their home-care package contributions and their non-clinical care. So if you get to the stage in aged care where you are the means tested funder, you may well go over that $130,000, because they define clinical care as different from independent support and everyday living. As I mentioned, they seem to be trying to rebrand the aged care commissioner, who has slightly more powers. But we had addressed a lot of the things when it is sort of implied that this is the legislation that is finally fixing up this whole tranche of problems. It's a new act, but a lot of the recommendations from the royal commission, the vast, vast majority, were already addressed in the last period of coalition governments.

I might add there are a few other comments I would like to make. Not only was there the development of a lifetime cap and a time-limited cap as well of four years, we also put in a $300 million capital funding round for rural, regional and remote aged-care facilities so that they could upgrade some of their facilities or expand their facilities, because in many of these rural and remote areas, there is no way in a month of Sundays that a lot of the people going in to rural nursing homes would have the capital to give a refundable accommodation deposit of, say, $1.5 million, which happens in Sydney. We have had aged-care providers come into our area during my time who have taken on aged-care facilities that they thought would have millions of millions in accumulated refundable accommodation deposits. When our current care provider came into Gloucester, they found it was $120,000, not $1.2 million, and they were shocked. But that is the way it is in country Australia.

We also got some more sensible policy evolved through these negotiations with the government to remove the criminal penalties from the act. There was no recommendation from the royal commission to have criminal penalties applied to board members or operators of nursing homes. In fact, you wouldn't have had any staff left. Those people are often unpaid directors of aged-care facilities in country Australia. It would have been hard to find any new directors, I can tell you. There are existing workplace health and safety laws, there are banning orders and there are Criminal Code provisions for the regulatory framework that applies, but telling people working in an aged-care facility that they could be put in jail is pretty scary.

The upgrade of nursing homes is an ongoing pattern, but I do note that during the time of this government, which is only a bit over 2½ years, 49 aged-care homes have closed around Australia. There was nothing like that happening when we were in government. We kept a few aged-care facilities open. In my electorate, we had one very prominent community built and operated aged-care facility that was taken on by a major provider, only to be shut down two years later. I'm so pleased that it has now been bought by another local not-for-profit community controlled organisation, which seems to have a much better business model that offers all the services, not just residential accommodation, which means people in the Bulahdelah district will be able to age in place when they do get to that stage of their life. They will be servicing the aged-care facility; upgrading the rooms at Cedar Wharf Lodge in downtown beautiful Bulahdelah, offering palliative and respite care services, as well as Meals on Wheels and other facilities in the aged-care home-care packages et cetera.

Many of the people in the aged-care industry are obviously happy for this legislation to occur, but what they are worried about is that a lot of the details of the bill will come later, in subsidiary legislation. A lot of them want to know the fine details. So there is a frustration with all the delegated legislation.

We also don't think that every nursing home needs to have an RN on duty around the clock. Most of the aged-care facilities in my electorate wouldn't be able to recruit that number of registered nurses. Even in metropolitan Australia, you would have trouble doing that, because the payment system for RNs in an aged-care facility is less than in a hospital system and in other areas like the NDIS.

This is an important bill. We will be supporting it. We think the contribution caps need much more detail, but it appears that self-funded retirees will be bankrolling a lot of the extra income, rather than facilities getting more from the federal government. We don't want aged-care facilities to be turned into a purely medical model, because they aren't meant to be hospitals. That's the thing. In aged care, the use of the phrase 'nursing home' gives some people the impression that it should be like a hospital. It's not meant to be a hospital. It's meant to be a home for senior Australians so that they are in a comfortable, well-managed, well-cared-for environment. By all means, don't try to turn it into a hospital.

But, apart from those concerns, I commend the bill to the House. We should look at getting a reduction in the costs of running aged-care facilities, and one way of doing that is removing the mandate to have totally fixed numbers of hours per person. It sounds good in theory, but in reality it means there's not much care happening but there's lots of filling out of forms and you have a lot of overqualified people that are mandated, which puts huge costs on low-margin businesses. There are many aged-care facilities whose costs are going up but whose incomes are not going up to match them. It would be better to reduce their cost burden with cheaper electricity, cheaper food and less rigid application of that nursing model rather than a care model.

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