Susan Templeman (Macquarie, Australian Labor Party) Share this | Hansard source

In my early years as the member for Macquarie in opposition, I witnessed our aged-care system descend into a crisis of neglect. We saw it happen. Since Labor came to government, we've made it a priority to reform the sector so ageing Australians receive the dignity and the quality of care they deserve. We've done this by lifting wages in the sector, putting nurses back into nursing homes, giving carers more time to spend with residents and offering fee-free TAFE so we can encourage more people to take up qualifications in aged care—and we've also improved transparency and accountability. These changes in two years have pulled the aged-care system out of crisis and brought back dignity, respect and quality. But there is so much more to do. We need to secure a long-term and sustainable future for the whole aged-care system, or, quite frankly, there will not be enough support to care for our ever-ageing population.

There are two major challenges we face. In the next 40 years the number of Australians aged over 65 is expected to more than double, and the number of those aged over 85 to triple. The current residential aged-care system just doesn't have enough beds to accommodate the ageing population, and at the same time—I know from speaking to older people, some of whom are simply my friends; we're all getting older—no-one, if they can help it, wants to leave their own home. People want to stay in their own home—and that includes my 84-year-old mum. But most people recognise at some point that they can't do it on their own. They simply can't do it alone. The Albanese government has listened to that message. We've heard what people are saying, and, along with improving the funding and viability of residential aged care so that providers will invest in building more rooms, we're investing $4.3 billion in a new system of home care that will help Australians remain independent in their homes and their community for much longer. We've worked really hard to achieve bipartisan support on these changes so that we have long-term certainty for older people, for aged-care providers and for aged-care workers.

The first thing I want to talk about is supporting people to be in their homes. That's what's going to be called Support at Home, starting from 1 July 2025. It will allow quicker access to support from the time you're assessed and provide more tailored support with eight levels of care. The top level will provide around $78,000 a year in support. There'll also be support for home modifications, with up to $15,000 to make homes safer, plus faster access to assistive technology like walkers and wheelchairs, and there'll be a new equipment loan scheme. These are all really practical things. If I think about the time it takes to get into the system right now, it isn't the assessment that takes time; it's being able to access a package. Faster access to a package, whatever level it is, will make a difference to people. I have heard people's frustration. It is the same reason we're training up workers so that that's not the area where the delay happens. It's making those packages available.

There's a new category. Support at Home participants will also have access to an expanded support program to get back on their feet after an illness or an injury, with a 12-week program that works with a team of allied health and other care professionals. That is often what people need—short-term support rather than ongoing support. So I'm really pleased to see that, and I know that's because the minister has listened to what I've been feeding through about what the needs are.

There's one other new support that is so crucial, and this is around palliative care. According to the Productivity Commission, up to 70 per cent of Australians would prefer to die in the comfort and privacy of their own home, but fewer than 10 per cent actually do. Support at Home participants will be eligible for up to around $25,000 in additional support to spend their final months at home so they can be surrounded by loved ones in a familiar and cherished environment instead of spending those precious last months in hospital and having family trying to see them within those constraints. This is another really significant part of the reforms that this bill brings in.

I think that at this point it's really important to make clear that, for people who are already on a My Aged Care package, there won't be any additional costs, and, for new entrants, the government is going to pay 100 per cent of clinical care services, with individuals making some contributions to the help they receive around independence—which might be help with showering, getting dressed or taking medications—and everyday living—the things that we do all our lives, such as shopping, cleaning, gardening or meal preparation. How much someone contributes will be based on the age pension means test and will be highly dependent on their personal circumstances. It is not going to be one size fits all. It will also be dependent on the level of support they are assessed to need and their combination of income and assets.

If you are eligible for contributions once you begin to access aged-care support, whether it's in your own home or in a residential setting, there will be a lifetime cap on what you pay, at $130,000. I think that really deserves a little bit more explanation. One of the things I want to absolutely clarify and make sure there's no confusion about is that there will be no changes to the means testing of the family home. Older people with low means will still be supported to access the care that they need. They're the things that just will not change. The government will also remain the major funder of aged care.

There are a whole lot of technical differences that will come through. In Support at Home, for instance, you will no longer have to pay a flat weekly fee. You will make a contribution towards services categorised as everyday living or independence, as I've said, and that amount will be assessed. In residential care, those residents who can afford it will make contributions towards the hotelling supplement and the non-clinical care, based on a means test. Accommodation pricing will also change. There will be an increase to the maximum room price and to daily accommodation payments, which will be indexed so 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.

These are some of the modest things that we're doing to ensure that there is sustainability for the aged-care providers. What we've seen in the last decade is no significant new residential accommodation built. There has not been enough viability and certainty for that sector. Quite frankly, I look around this chamber, and not all of us will need it as early as others—I think I'm probably the oldest one here, so I'll probably need it first! But I know our families will want to know that in the long term, into the future, this system is strong.

I'd like to talk a little bit about the approach to this bill. It is really about putting older people at the centre of their care and making sure the system works for them rather than anything being configured around the system. It is all centred on older people, and it's about high-quality, safe and compassionate care and services for older people.

It's also worth saying at this point that the people who work in aged care now are absolute heroes for the work they do, and I've witnessed this in recent years. My father spent two years in aged care. It was mainly during COVID, from 2020 to 2022. He died in 2022. During those two years I witnessed wonderful care being provided to him. People would have a joke with him in even the most dire circumstances. That's why those workers are so important. It's why one of the very first things we did in government was ensure there was a significant pay rise for workers in aged care. We've delivered more than $15 billion in funding for pay rises to workers. This has seen registered nurses earning up to $10,000 a year more and personal care workers earning up to $7,000 a year more. We want those care workers to also be treated with respect and dignity. We've made sure that across Australia there are registered nurses on site in aged care homes 99 per cent of the time so that our residents get the care they deserve.

Older Australians are now receiving an additional 3.9 million minutes of care every day thanks to our changes, and that has resulted in changes to the wellbeing of residents. There has been a statistically significant decrease in the proportion of residents experiencing polypharmacy antipsychotic medication use, falls that result in major injury, use of physical restraints, significant unplanned weight loss and consecutive unplanned weight loss. We're also seeing improvements in the star-ratings data, with fewer one- and two-star rated homes and more four- and five-star rated homes. That's about making sure the quality of care meets what we would all expect our older family members or neighbours to receive, and for us to receive one day in the future.

Along with this legislation around the financial reforms and changes and the new Support at Home program are things like a statement of rights for older people and a positive duty for providers to uphold those rights. There are also statutory duties for registered providers of aged care and there are civil penalties and a compensation pathway attached to those. There's a new approach to regulating aged care which really balances the incentives for continuous improvement and high-quality care and the stronger regulatory powers and civil penalties to protect people from harm.

Significantly, there is a new ministerially appointed complaints commissioner and whistleblower protections to make sure that older people, workers and other people have clear pathways to raise concerns about the quality of aged-care services. I think for older people and their family members, for carers, for advocates and for workers—and I really want to stress that—that a new complaints commissioner with powers and responsibilities independent of the regulatory commissioner means there is a voice to raise issues, to have them heard and to have them taken seriously, with an expectation that providers will work to address them or face really serious consequences.

This is a package of work that I'm really pleased to be supporting. These reforms are really significant because they are the next step in implementing the recommendations of the royal commission into aged care. The interim report of that royal commission was called Neglect, but many of us could see that neglect happening long before it was the title of a royal commission report. It's what drove us to want that investigation to look into the practices, the systems and the flaws, and to try and identify where it was working and how we could replicate that across the board.

I'm very confident that the changes that we're bringing in will lead to a different way of thinking about aged care and about being supported at home. The changes will mean Australians have respect and dignity as they age. They get to stay in their home for longer—as long as they can be supported there, and we hope that that will be longer. I hope it also means that families will feel less of a challenge in supporting their older relatives, and I really commend this bill to the House.

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