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

When the Royal Commission into Aged Care Quality and Safety was released in 2021, it was a moment of reckoning for this country. It was the culmination of what I have described as a slow collapse, one that occurred over decades of the aged-care system in Australia. It was a collapse overseen by Commonwealth governments of all political stripes. The royal commission found the aged-care system was in such dire need of renewal that an entirely new aged care act was required. The current system simply could not be salvaged. It's the policymaking equivalent of knocking down the house and starting all over again. At the time the royal commission was released, I supported all 148 recommendations and called on the government to respond with action and funding not just words. The Aged Care Bill 2024 is an important step forward in responding to these recommendations.

In assessing the bill before us, I'm guided by the same values and principles that will always guide my work as the independent member for Indi: Will this bill improve the lives of people in the north-east of Victoria that I represent? Will this bill improve the lives of people all over Australia? Will it help older Australians age with dignity and empower them to enjoy all the richness of their later years? I know for the people of Indi, where we have a much higher proportion of older people compared to the national average and where, in our beautiful towns, many people move to retire, this crucial reform is absolutely essential to their quality of life. I also ask whether this bill will assist aged-care providers and aged-care workers.

This bill is about putting older people at the centre of our aged-care system; it's not about putting the providers at the centre of our aged-care system. But it's important to remember that aged-care workers—the nurses, the carers, the cooks, the cleaners and the admin staff—are essential. For many of these people, working in aged-care isn't just a job. It's a vocation worthy of dedication. If I turn my mind back a long way, I remember being a young matron of the Chiltern Bush Nursing Hospital, pulling my clothes on over my pyjamas at two in the morning to make sure one of my older residents received the care that they needed. I cared deeply about the residents under my watch, and I know that people working in aged care do too. They want to see a system that delivers the best care possible for their residents. I thank those who provide these services in Indi. I thank those places like Kellock Lodge in Alexandra, the rural city of Wangaratta, Westmont in Wodonga and St Cath's in Wangaratta. I thank all those who spoke to me about what the bill means to them, and I thank aged-care workers right across Australia.

It's important our aged-care system is sustainable now and well into the future. Australia is ageing. By 2026 more than 22 per cent of Australians will be aged over 65—almost triple the eight per cent of the 1970s. As our country ages, more people will enter the aged-care system and we need to set it up for long-term success—and that's a task that cannot wait for future years and parliaments; it's a challenge we must tackle right now.

In analysing this bill, with more than 1,000 pages of legislation and explanatory material, I'm guided by three key questions: Will it put the sector on a sustainable footing as our population continues to age? Will it provide regional Australians with equitable access to quality aged care? And will it enable more Australians to access home care without harmful delays?

The Aged Care Bill 2024 implements the first recommendation of the royal commission to create a new aged-care act built upon a rights centred approach to aged-care services. This bill impacts almost all aspects of the aged-care system. This includes changes to how at-home care and residential care are funded and establishes a new single assessment pathway for all aged-care services. It creates new powers of oversight and enforcement for the aged-care regulator and a new statement of rights for older persons, and they will underpin the sector. I will address each of these.

One of the biggest challenges introduced in the bill is to change the way people contribute to the cost of aged care, both residential and at home. While the government will continue to fully fund clinical services like nursing care, allied health and other therapeutic services, a revamped means testing process will ensure those who are able to will contribute more to nonclinical costs like personal care such as showering and everyday living like food or gardening costs. The government has made it clear lifetime contributions will be capped at $130,000, and how much you will contribute will also be means tested.

For those currently in the aged-care system, whether at home or in residential care, the government's no-worse-off principle is one we must hold on to and hold them to. This means that no-one currently in the aged-care system will see their contributions change; the new system will only apply to new entrants. When an older person currently receiving at-home support moves into residential care, they will keep their existing contribution arrangements or opt to move to the new arrangements. However, for new entrants, I hear concerns about this difference in contributions for clinical and personal care. I query whether a person should have to contribute for showering services when, as they age, they absolutely need this basic help. For people who are frail or have chronic disease, it is not an optional extra and can in fact be important clinical care.

One of the ways to ensure a sustainable residential aged-care system is to ensure it is financially sustainable. The bill seeks to address this by putting more money into the system. To be clear, the government will remain the major funder of aged care. But new provisions in this bill will enable aged-care providers to retain up to two per cent of the refundable accommodation deposit, the RAD, in residential aged-care facilities each year for up to five years. I cautiously welcome this change because I know how hard it is for providers in my electorate to balance their books. We know that in the past year almost half of residential aged-care facilities were making a loss from accommodation. This included facilities in my electorate. By making changes to the RAD and to room prices, we can help ensure providers stay open in our regional centres and tiny rural hamlets. Capital improvements are incredibly difficult to achieve, and I hope this changes that. However, I will be following the implementation of these changes very closely because we must ensure any increased revenue resulting from these changes will be reinvested into infrastructure and amenities that residents need, not corporate profits.

This bill also makes changes to the home-care system for older people so that more people can stay at home in their communities for longer. We know Australians want this. I welcome the government's investment of $4.3 billion into home care, and I'll be pushing the government to ensure people in regional Australia have equitable access to home care. There are a few major themes for people in my electorate of Indi when it comes to the home-care system as it currently exists. These themes include the waiting times for assessments, the long distances that must be travelled for care and the workforce shortages to deliver this care. Across my electorate, whether it be in the upper reaches of the Murray at Mitta Mitta or in the far south part of my electorate in the Murrindindi Shire, I hear from older people who do not receive the full benefit from their existing home-care packages because of the costs of travel for providers and taxis, and other travel costs for the participant, and this means their budgets are chewed up way too quickly.

I'm also concerned, as are the people I represent in Indi, that the new Support at Home packages will not be large enough for regional participants and these issues will be repeated all over again. This concern was echoed by Dr John Davis, a member of the government's Aged Care Council of Elders, who lives in Wangaratta in my electorate. He's concerned that there will not be enough funding in packages to cover the reality of the costs of gardening, cooking and cleaning. We must ensure new Support at Home participants are going to receive all the care they need and I'm hopeful the government's plans to expand the tiers of home-care packages from four to eight will address these specifically regional concerns. These tiers must be carefully considered to cover travel costs, in particular, and they must truly reflect the time it takes to keep a home clean and the garden under control.

Support at Home will be underpinned by a single assessment pathway, and under this new single assessment model, non-government providers can play a role in assessing new claims for support, not just government assessors. Providers in my electorate tell me that this new system is showing real signs of promise and hope that wait times for assessments will, in fact, meaningfully reduce. Because it's critical here. The implementation of these changes is the bit where the rubber hits the road. For too many people in Indi, long waitlists are stopping them from getting the support they need. Even for people who do not receive a funded package, workforce shortages and a lack of suitable providers in regional towns means it can be hard to actually get any care.

The bill will also establish a new, independent statutory complaints commissioner and expanded powers for the Aged Care Quality and Safety Commission. These were key recommendations of the Royal Commission into Aged Care Quality and Safety. I support these expanded regulatory powers because unscrupulous providers and workers must be held accountable. We heard shocking stories of abuse, neglect and violence during the royal commission and in the years since. The government must do more to protect vulnerable older people. A new complaints commissioner and expanded quality and safety commission, underpinned by a new statement of rights and principles that focus on the safety, health and wellbeing of older people and puts them first is indeed a good start.

When I spoke to Jim Blundell, a resident of Mansfield in my electorate, he said that he wants to be listened to and to be heard by the new aged-care system. He wants genuine consultation with older persons to be at the heart of the new system, and he wants to feel safe to make a complaint when one is warranted. However, I share concerns of some older persons advocacy groups that not all rights under the act will be enforceable by the quality and safety commission and the complaints commissioner. I am also concerned about limited pathways for reviewing any decisions of the complaints commissioner, because if an older person does not feel that the response to their complaint is sufficient, they should have fulsome review rights. I urge the minister to consider any amendments to address this particular concern.

There are further improvements that the government should make to this bill. I support calls for amendments such as strengthening whistleblower protections, which the Human Rights Law Centre and Transparency International have said are not up to scratch and provide a worse level of protection than employees in the corporate or public sectors. I support their calls for an end to the fragmented, overlapping and inconsistent whistleblowing regime and the creation of a whistleblower protection authority. I also very strongly support calls for triennial reviews of the act. It's currently set at five years, but, as we know, that's a long time in aged care. Any unintended consequences should be looked at much sooner. I will pay close attention to recommendations from the Older Persons Advocacy Network and COTA Australia, and I thank them for meeting with me to discuss this bill and for their substantial and long-standing work in this area.

I acknowledge that this bill is part of a broader package of reforms, many of which I hope will benefit communities in north-east Victoria. While I welcome many aspects of this bill, I hear from older people and providers alike that it will do little if we cannot address workforce shortages. Regional communities in my electorate know all too well that this is often a significant contributor to the delays our older people experience in accessing the quality, reliable, affordable aged care that they deserve. The government must do much more to address these workforce shortages.

In conclusion, while this bill isn't perfect, it's a significant step towards fixing our aged-care system and a significant step towards learning the lessons of the royal commission and doing better by our mothers, our fathers, our aunts and uncles, our brothers and sisters and our friends and neighbours. I look forward to working with the government more to improve aged-care services, especially in regional Australia. I want to thank the minister for the exceptional hard work that it has taken to get us to this point. I thank her staff, the department and the many, many people who have contributed collaboratively to this bill.

I commend this bill to the House.

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