Daniel Mulino (Fraser, Australian Labor Party) Share this | Hansard source

The Aged Care Bill 2024 is an extremely important bill in relation to a key plank of Australia's safety net. This is a once-in-a-generation reform of an element of our social service supports for some of the most vulnerable people in our society, which has long been in need of reform. This bill is designed—

A division having been called in the House of Representatives—

Sitting suspended from 15:56 to 16:31

I was just in the middle of saying that this bill relates to one of the core elements of our safety net. If one thinks about our safety net, one of the first elements of the safety net, going way back to the years just after Federation, was the age pension. Indeed, this was one of the first elements of safety nets around the world, including in Bismarck's Germany in the 1880s and in other countries. When one thinks about the healthcare system, much of that is directed towards providing assistance to the elderly in our society. Indeed, just yesterday the Member for Hughes and I were at the launch of a paper on preventive health measures for older Australians. So there are many parts of our safety net that are directed—and rightly so—at older Australians, but our aged-care system is an absolutely critical part of that. It's the part of the system which provides so many of our older people with their accommodation, and it's also the place in which they receive services.

This bill is a significant, once-in-a-generation strengthening of the way in which those services are funded, regulated and provided to older Australians. What lies at the heart of this is to provide additional choice and agency and also guarantees in relation to quality of care. I won't step through absolutely every element of the bill, because it contains many, many elements. It responds to many recommendations coming out of the inquiry by the royal commission. But I will look at a couple of areas that are worth focusing on.

One is the rights of older people being put front and centre. A statement of rights is provided for in this legislation, and that will outline what Australians can expect from aged care. In addition, the greater clarity and protection of rights will provide for more culturally sensitive, appropriate and trauma-aware services being provided to older Australians. As a member representing a very multicultural part of Melbourne, I am certainly very aware of how particularly important it is that culturally sensitive services are provided to our older Australians, given that that's an age at which they often particularly rely on those kinds of services.

There's a considerable amount in this bill which provides for greater empowerment of people relying on aged care. For example, there's a minimum age requirement of 65 for aged care, and there is a different age requirement for First Nations and homeless people. Those minimum age requirements will ensure that spots are not being taken from those who most need them.

There's significant additional funding—$4.3 billion in additional investment—for support services for those at home, and there is also better tailored support for those at home. That support will now be tailored with eight levels of support rather than the existing four, so there's additional funding and better targeted funding. There's also going to be the 'no worse off' principle, which will provide greater certainty to people already in or assessed as needing home care. And then there are key protections and guarantees in relation to quality of care. There's a duty of care both for employees and for clients, which is critically important. Of course, clients need to have that duty of care applied to them, but we have also become increasingly aware, over recent years, of the need to protect the workforce, to train the workforce and to provide the supports that the workforce needs. There are going to be greater powers for the regulator and the independent complaints commissioner. The royal commission was critical of current weak and ineffective regulatory arrangements that often merely paid lip service to delivering high-quality regulatory care, so new regulatory powers are essential and will provide significant benefits.

Then there are a range of measures in relation to workforce. The royal commission uncovered that aged-care workers are systematically underpaid and undervalued. Low wages and poor employment conditions are obviously a bad outcome for employees, but they're also bad for the sector. They lead to greater rates of turnover. They lead to lower rates of people applying for positions. They lead to lower investment in skills that are specific to the sector while people are there. For a whole raft of reasons, it's absolutely critical that we pay people appropriately and that we train people better. That will lead to better outcomes for people working in the sector, and it will lead to significantly better outcomes for clients as well. So there's going to be much greater prioritisation of the training of well-skilled and empowered workers, who will then be in a position to deliver higher quality care, and the bill will also introduce new worker-screening measures, which are absolutely critical. In addition, there will be strength and quality standards which will require providers to engage with workers at a service level on workforce planning.

I also wanted to touch on some of the measures which lead to greater sustainability in the financing. Before touching on those, I thought I would just make some observations about the longer term, macro, systemic challenges that we, like all societies, are facing. We're aging, and I want to start by saying that's a wonderful thing, because it reflects the fact that we're living longer. It reflects the fact that we are having longer and healthier lives on average. This is a great gift that is provided to us by better health care, healthier lifestyles and a whole range of things, but, at a macro level, our rising average life expectancy and our rising median age create challenges for our society in the sense that we are trying to fund and finance services from a relatively shrinking taxpayer base. If we look at some of the statistics that came out of the Intergenerational report 2023, six per cent of GDP was constituted by the care economy in 2002. That will rise, based on median projections, to 17 per cent by 2062, which is not all that far away. In effect, in less than 40 years, there will be a tripling of the care economy as a share of GDP, compared to where it was just 20 years ago. If you look at the workforce requirements, that will rise from one million to well over four million—around 4½ million—in that same period. These are drastic changes in an economic sense.

If we think about it in terms of a commonly used metric, which is the dependency ratio, the old age dependency ratio is the ratio of people aged 65 and above to those of working age, generally measured as 20 to 65. That ratio was 15 in 2002, and it's projected to rise to 38.2 by 2062. Again, that's a wonderful thing. It means that there will be more of us living longer lives. It means there will be more grandparents around to take care of grandkids. Certainly, well before 2062—I'm certainly going to be older, but I'll definitely be old by that time. I'm looking forward to being part of that 38.2. That's a good thing, but that 38.2 is a ratio that, when it more than doubles in that period, raises questions about how a society is going to provide sustainable services. If one looks at the total dependency ratio, that is also projected to rise, when one includes young and old members of society who aren't of working age. That's projected to rise from 25 to 45. These are challenges, and if one goes back to the nineties, superannuation was, in part, a response to these broader macro trends. But some of the measures included in this bill, which are very balanced and sensible measures, are also necessary long-term horizon reforms that are a response to these changes that we know are coming in the decades to come.

What this bill provides for is sustainable funding for an ageing population where the number of older Australians is expected to double, and also where they are expected to significantly increase as a share of the economy relative to working-age Australians. Just to stress from the outset that this government, even after the measures contained in this bill are put into place, will continue to be the major funder of aged care. There are no new taxes or levies contained in this set of provisions and there will be no changes to the means testing of the family home. What we are bringing in is a range of measures that will provide that some people, based on means testing, will provide a well-calibrated contribution, and I'll set out some of the specifics over the coming part of my contribution. This is a very sensible and balanced and necessary set of measures that are important if we are to maintain the stability and sustainability of our system.

The measures that we are bringing in include the full funding for all clinical care while older people make contributions towards services that they have paid for or been responsible for their entire lives such as gardening, cleaning and personal care. Support at Home means you will no longer have to pay a flat weekly fee and the contribution that you make will be means tested. Residential care, where residents can afford it, will now involve some residents making a contribution towards the hotelling supplement and non-clinical care; but, as I said before, this will be based on a means test. And there will be a change to accommodation pricing, to indexing daily accommodation payments so that their true value doesn't diminish. And people who pay with refundable accommodation deposits will pay a two per cent retention from the principal deposit for a maximum of five years. There will be a lifetime contribution cap for care costs and that will apply across the aged-care system. No-one will contribute more than $130,000 to their care costs whatever their means or duration of care.

As I said, these are really important measures. They form part of a package of measures that include more rights for people who are living in aged care, that include more protections, more agency and more choice. Also, as I spelt out in the last set of changes, they provide for greater systemwide sustainability. And that is absolutely critical, because our older Australians and those of us going to be older Australians soon enough deserve to know that the system is sustainable. They deserve to be confident that the expectations they have are realistic and that the government and our society will see them through and fulfil those expectations.

I'm very pleased to speak to this bill. It's a really important bill. It's a once-in-a-generation change in response to a whole series of recommendations made by the royal commission to what I believe is one of the key planks of our safety net. Australia has one of the great safety nets in the world, and those aspects of our safety net which protect the interests of our older people are, for me, some of the most important parts of that safety net. I commend this bill to the House.

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