Libby Coker (Corangamite, Australian Labor Party) Share this | Hansard source

Our fathers, our mothers, our grandparents and our loved ones all deserve the best care in their old age. They have worked hard their entire lives, paid their taxes, volunteered in our communities and raised families. They deserve to live out their twilight years with dignity and respect. But, instead, the final report of the Royal Commission into Aged Care Quality and Safety provided a damning assessment of how many older Australians have been treated in aged care, an assessment summed up in one word: neglect. The report exposed a failing system where treating older people without dignity was normalised. Since the final report was tabled, 136 recommendations of the royal commission have been addressed under this Labor government, 58 of which are directly addressed in this bill that I stand to support today.

This bill, the Aged Care Bill 2024, addresses recommendation 1 of the royal commission. This new act will put older Australians, not providers, at the centre of aged care. It promotes positive attitudes towards ageing and empowers people with choice and control in the planning and delivery of their care. It builds trust and confidence, with strong complaints mechanisms that prevent mistreatment, neglect and harm from poor quality and unsafe care. Importantly, it addresses the pain and suffering that so many older Australians, their families and workers have experienced in aged care.

Under the former government, so many families in my electorate contacted me to raise their serious concerns about these challenges. Donna, a personal-care attendant in a local aged-care facility, came and spoke passionately at a forum I held in Armstrong Creek. Donna spoke about low wages, insecure work and the frustration of being unable to properly care for frail and elderly residents. These are her words—and I think she was such a brave person at the time to speak so boldly:

I love my job. I wanted to make lives better, but … we're facing a roadblock. We've got six minutes to put each resident to bed each night.

That's why I'm so proud to stand and support this bill. This bill and the many reforms we've rolled out under this government are for people like Donna. Thank you, Donna. As a direct result of stories like yours, aged care is changing for the better under a Labor government. It's stories like yours that have shaped this bill—a bill that, for the first time, includes a statement of the rights for aged care.

The statement of rights outlines what all Australians can and should expect from aged care—person centred care that is culturally safe and trauma aware with dignity and respect, individuality and diversity, independence, choice and control, dignity of risk and privacy. As a result, the rights of older people will be embedded in care delivery in the way workers are trained and in the way people talk about the care they receive. Including a statement of rights in this bill is about empowering older people to have conversations about the dignified care they deserve. If a provider breaches the rights in this bill, the Aged Care Quality and Safety Commission will have tough enforcement actions at its disposal.

On top of this, the bill brings together the complex multiple-entry pathways criticised by the royal commission with a single, culturally safe entry and assessment pathway. Assessment will actively involve older people in discussions about the services they need.

The bill continues our mission to take younger people out of aged care and into accommodation that meets their needs, because right now there is no statutory age minimum for aged care. The result is that aged care has become a system of last resort. We've seen younger people who aren't able to get the care they need relying on residential aged care as a safety net. This bill seeks to legislate for the first time a requirement that makes it clear that aged care is for people aged 65 years and older. It isn't just older people receiving aged-care services or aged-care providers that will be affected by this bill; it will also affect the aged-care workforce. Among the many dark themes that emerged from the royal commission was that workers are systematically underpaid and undervalued. Low wages and poor employment conditions meant that the sector struggled to attract and retain well-skilled people. One of the hallmarks of the Albanese government's approach to aged care has been to recognise the value of all aged-care workers.

First, the bill prioritises the training of well-skilled and empowered workers to deliver quality care, including specialised dementia care. Second, the bill introduces new worker-screening measures, an important step towards professionalising the workforce through positive registration. Third, the strengthened quality standards require providers to engage with workers at a service level on workforce planning and delivery of care. Fourth, the bill is mindful to ensure that the statement of rights is balanced with the rights of aged-care workers to have a safe and respectful workplace.

We know older Australians want the freedom, support and choice to remain in home and with the community that they love. Our $4.3 billion investment in Support at Home will deliver better and more tailored support to more people. Support at Home will cut wait times to receive in-home aged-care services. It will deliver more tailored support, with eight levels of ongoing care instead of four. It will ensure faster access to assisted technology like walkers and wheelchairs, and it will increase the maximum level of support available from $61,000 to $78,000.

Support at Home will offer a temporary boost in funding, available to those who need restorative and allied health support to help them stay at home after an incident. It will provide palliative care support to ensure older people can spend their final days at home, surrounded by their community and loved ones. It's not an overstatement to say that this bill, if passed, will change lives.

So these reforms are important, and to deliver them we need a sustainable funding system. These reforms, based on the recommendations of the Aged Care Taskforce, deliver a fairer aged-care system and foster quality and innovation. Some things won't change. The government will remain the major funder of aged care; there will be no new taxes or levies; there'll be no changes to the means testing of the family home; and older people with low means will still be supported to access the care they need. But some things will change. The government will now fully fund all clinical care, while older people will make contributions towards services that they have been paying for or have been responsible for their entire lives, such as gardening, cleaning and personal care.

In Support at Home, you will no longer have to pay a flat weekly fee. You will make a contribution towards services categorised as everyday living or independence. The amount you contribute will be based on the pension status and the means test, and you'll only contribute to what you use. In residential care, the residents who can afford it will now make contributions towards the hotelling supplement and non-clinical care based on a means test. Accommodation pricing will also change. This will ensure residential aged-care providers can attract the investment they need to keep current facilities open, improve quality and build new homes. The 'no worse off' principle will provide certainty to people already in or assessed as needing home care, or already in residential care, that they won't make a greater contribution to their care than they have already planned for.

In closing, this bill has the potential to provide an enduring foundation for the Australian aged-care system for years to come. Of course, it builds on the many reforms the Albanese government has rolled out since coming to office. The very first act of the 47th Parliament was passing aged-care legislation, responding to the royal commission. Its passage delivered a new funding mechanism for residential aged care, a sector-wide code of conduct, an expanded Serious Incident Response Scheme and stronger provider governance. The Aged Care Amendment (Implementing Care Reform) Act came shortly after, delivering greater transparency, capping home care fees and, most importantly, putting nurses back into nursing homes 24/7.

The creation of an Inspector-General of Aged Care reinforces the Albanese government's commitment to being open with the Australian public about how aged care is administered and how it is being reformed. It demonstrates that we are holding ourselves to the high standard that we expect of the sector. We made aged care more transparent with star ratings for residential care, empowering older people and their families to make informed decisions. We're delivering an $11.3 billion investment in an historic pay rise for aged-care workers. A registered nurse is now on site in aged care 99 per cent of the time, across Australia. Older Australians are receiving an additional 3.9 million minutes of care every single day, 1.7 million of which are delivered by a qualified registered nurse.

This is incredible progress, but we know that there's more to do, and that's what this bill is all about. This reform will put the rights of older people first. Thank you to all the older Australians; to carers, including Donna, who I met all those years ago; to union providers; to advocates; and to other experts who helped us get this incredibly important milestone to this point. I hope that it will now be passed and that it will become a reality. Thank you.

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