Tony Pasin (Barker, Liberal Party, Shadow Assistant Minister for Infrastructure and Transport) Share this | Hansard source

It has been clear for a long time—indeed, perhaps since before the royal commission hearings but certainly since then and most certainly since the findings—that our nation has had to have a conversation with itself about reforming aged care. That conversation is one that will continue, but this bill, the Aged Care Bill 2024, represents a significant opportunity for those opposite to step into that conversation, and these reforms are very much about that.

From my assessment, the situation that we face in this country right now is devilishly difficult. We have aged-care providers in large capital cities, some of which are commercial operators and some of which are not-for-profit operators. We have aged-care providers in rural cities like the one I come from, Mount Gambier, South Australia's second-largest city—both commercial, for-profit operators and not-for-profit operators. We have aged care providers in the smallest of towns, some of which I represent. Some of these have as few as a handful of residents in them.

I can say none of those are commercial operators because, of course, those entities are barely viable in many cases. There is complexity in the nature of the provision of aged care—and that's before I even speak about the provision of in-home services, which are so important because at the heart of our national aged-care system is the desire to allow people to make dignified choices. There is a choice around aging at home or taking an alternative route—a choice about perhaps aging at home until a particular point in your journey and then a transitioning to an aged-care facility. In order to provide that dignity of choice, our nation has had to, over very many years, develop different systems that meet different needs, and a system, in a sense, that is as complex and diverse as our nation itself.

My view, for a long time, has been—particularly since some of the shocking revelations that came to light and gave rise to the royal commission—that the resources available en masse to the aged-care sector in our nation weren't sufficient to meet the standards that Australians expected for aged-care provision. Our nation had a choice. It was effectively no choice, but I'll set out what the choice was. We could either expect lower standards for those in aged care—this is why I say it's no choice, because of course that's completely unacceptable to every Australian, particularly given the revelations we heard in many of the places, and the stresses, financial or otherwise, on aged-care facilities—or we could find additional resources to ensure that the aged-care sector was sustainable and delivered the standard of care that Australians expect for their most vulnerable citizens.

That's the journey our nation has been on. It's not one that has necessarily been driven by one side or the other of this House. In fact, I think it's been a collective effort, and a collective understanding that we need to find those resources. When I say 'find those resources', that then leads to the challenge that presents itself here. Who pays? I've said that there needs to be additional resources, but what mix of resources? What contribution does the public make to aged care, generally, and what contribution does the individual receiving those services seek to make? Of course, that discussion is at the heart of these reforms.

I want to be clear. Whilst I'm saying that we as a nation we have had this conversation, this is not a bill that's been co-designed by those opposite with the coalition. In my view, it would have perhaps been preferable if there had been a genuine co-design exercise across the parliament. I think we'd be in a much better place. Instead, as a result of that failure to co-design, we remain critical, on our side of the House, of the failures to address workforce regulatory impacts and the timelines that are set out in the bill.

Last year alone, 49 aged-care homes closed, under the administration of those opposite. I don't have the number of aged-care places that amounts to, but you can imagine it would run to hundreds. That is a significant indictment on those opposite. Before I get to how the coalition has worked to improve this bill—not in a co-design phase but once it was presented to us—I think, in my time in this place, the greatest example of regulatory impacts that put pressure on particularly smaller aged-care facilities, the likes of which proliferate in my electorate, was the decision around 24/7 RNs. I don't have a difficulty with that decision at all; it was the timeline associated with it. One would think that, if that were your plan, if you wanted to ensure that that's where we were, you would say, 'We'll give aged-care facilities a number of years, perhaps four, to implement this,' and four years is important for a reason I'll talk about. And then we'll go to the university sector and say, 'Let's ramp up your capacity to educate young men and women—and middle-aged people or otherwise, who may want a change in career path—to attain their registration as a registered nurse,' so that, at a time when aged-care providers are seeking those registered nurses, to meet their regulatory obligations, there will be a pipeline ready to access.

Instead—I'll tell you what happens in my electorate, and, Deputy Speaker Archer, I'll hasten to suggest it's happening in yours too—an aged-care provider poaches registered nurses from the local hospital; the local hospital poaches registered nurses from aged care, and this cycle continues. Because, as I said earlier my contribution, for some time the sector hasn't been properly resourced in the way it should be, what ultimately happens in a fight between the aged-care facility and the local hospital is that the local hospital wins. And so the aged-care facilities in my electorate are reliant on temporary staff, who come at an incredible cost. That cost is forced upon them. Hence, we have this viability issue in the aged-care sector, and I suggest it is a significant reason why 49 facilities have closed in the last year alone—courtesy of those opposite.

But enough of that. What are the improvements that the coalition have made to this bill—but not during the co-design phase, because we were excluded from that phase, as was, by the way, the sector, who are frustrated and have expressed their frustration to me and others about having not been appropriately consulted in that phase, despite now being asked to make contributions to the Senate inquiry, the one, of course, that we referred this bill to. What are the improvements that we've been able to achieve? The member for Curtin just mentioned one at the conclusion of her contribution—the grandfathering provisions. It is only fair and proper that someone, having made a decision based on the laws of the day, entering into an aged-care journey, should be governed by those rules and not other rules or rules that have changed during the course of that journey. That grandfathering provision wasn't included in the original iteration of the bill, and I'm pleased to say that it is a measure which will give a significant deal of comfort to the older and ageing Australians who have already entered into their aged-care journey. And it will include anyone who's on a home-care waiting list and others.

We fought for a much lower taper rate because we wanted to ensure equitable contributions for Australians who have worked hard all their lives and saved for their retirement. We wanted an assurance that the Federal government will remain the majority funder of aged care, not the consumer. It is a challenge in public policy circles. We ask people to work hard and save for their retirement and, then, seemingly—and many constituents have made this point to me—we punish Australians for having done exactly what we asked them to do. Fighting for the lower taper rate is about saying to Australians who worked hard and saved for their retirement, 'We've heard you and we understand it's important that you're not treated in a way that is so inequitable as to be unfair.'

On a similar line of betting, if I can say that, we fought hard to ensure that there are caps around the total sum a consumer can pay over the lifetime of their aged-care journey. Those caps are important because, again, they give some certainty to Australians who've worked hard and saved for their retirement.

We 've removed criminal penalties, which, of course, is important. A member of my own staff volunteers her time for an organisation in the aged-care sector. She's on the board of a local aged-care facility. When she came to me and asked whether that was a course she could adopt, given her employment with me, of course I was open to that. I did point out to her, on a personal level, that I'd be concerned about the criminal penalties that hang in and around this sector. So I'm pleased to say they are a thing of the past. We don't want to dissuade, in particular, volunteer directors from doing the good work in their community that they can do for fear that perhaps something untoward might happen at their facility and that they'd face an immediate term of imprisonment.

We ruled out the workers' voice, which was really just those opposite having a lend, quite frankly. The idea was outrageous. It was an attempt to force unionism into every aged-care home. Labor wanted a workers' representative to be able to come into every single aged-care home and demand an explanation on any aspect of its operations. Now, we support aged-care providers working consultatively with their staff, but we're not going to let unions bash down the door and march into aged-care homes and tell them how to do their jobs. This is why we've successfully fought to remove this provision.

But the most important change from the proposed bill to the one that's currently being debated, from my perspective, is funding for rural and regional Australia. Having said that, I still think it's insufficient, and I expect most people who've thought deeply about this will agree with me. It's important for those listening to the contribution to understand that these things are always negotiations. It would be fantastic if we were in a position to be able to mandate particular provisions, but we can't; we have to do this by way of consultation, and the coalition has secured $300 million in additional capital funding, through the Aged Care Capital Assistance Program, for rural, regional and remote aged-care facilities. The truth is: because of the approach taken by those opposite—particularly around regulatory changes and other things, making aged-care facilities marginal, if not unsustainable, across the country—there has been an investment strike. That is, no aged-care facility is building any additional capacity anywhere in the country. That's got to change. The situation is at its worst in regional, rural and remote Australia, and that's why this $300 million is important.

I say, though, that even this provision is modest and that, in a perfect world—one perhaps governed by a coalition government—I'd hope to see additional capex in this space, because, just in relation to the last Modified Monash Model 5 to 7 grant funding round, we saw an oversubscription rate of 10 to one. Literally billions of dollars of capex are required in this sector right now. So I'm hopeful that the reforms will give the aged-care sector the ability to invest that capital, to grow and meet the demands of a baby-boomer population that will need to access aged care, but I remain a little sceptical that the $300 million—whilst I support it, and obviously it's an achievement to go from zero dollars to $300 million in this space, courtesy of our negotiations—is sufficient. I hope it is. But, in any event, I'm grateful to have made the contribution. I am pleased that, despite being excluded from the co-design phase, the coalition's interest in this matter has improved the outcome for older Australians.

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