Shayne Neumann (Blair, Australian Labor Party, Shadow Minister for Indigenous Affairs) Share this | Link to this | Hansard source

I rise to speak in support of the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. Labor is supporting this legislation. It is essentially the next logical step in the reforms of aged care. Labor has a strong record on aged care reform. In government, we introduced the 10-year Living Longer Living Better reform of the nation's aged care system. These reforms are rolling out as I speak and sit here in Parliament House.

Living Longer Living Better was a 10-year plan to build a better, fairer, sustainable and nationally consistent aged care system that would meet the challenges of our ageing population. Living Longer Living Better was developed and delivered with extensive consultation and bipartisan support. We deliberately chose to implement these reforms over 10 years to ensure the sector, consumers and government had time to make the necessary adjustments. Like those in the aged care sector, I am pleased to see the government continue to roll out Living Longer Living Better and a Shorten Labor government will build on our legacy and ensure the aged care system is sustainable, robust, fair and even better.

As we know our nation's profile is changing. Over the next 20 to 30 years, the population aged 65 years and over is projected to increase from over 14 per cent of the population to 25 per cent of Australia's population. Labor recognised these challenges and undertook the Living Longer Living Better reforms to ensure our aged care system kept up and will keep up with the ageing population.

The bill before us is making further changes to the way we allocate home care packages. This measure is in the spirit of Living Longer Living Better. I do note that it precedes the legislated review of Living Longer Living Better, which is required by mid-2017. I trust the minister will have an accountable, transparent and independent process. Certainly that is Labor's intention should the Australian population grant us the Treasury benches. That review is where we look at the impact of the reforms to date and then determine the way forward.

It was always envisioned that over the next five years we would see an increase in consumer choice, along with greater control for and by consumers. But I get it. I understand why the previous Assistant Minister for Social Services announced this measure as part of the 2015 budget. While there was extensive consultation with the sector and the community, while there was bipartisan support, these reforms are and will always be Labor's. These amendments allow the coalition to make their mark and say, 'I was here too.' I suppose that is true. But they are in the spirit of Labor's reforms.

What this measure will do is give the consumers of aged care services—our older Australians and their carers and families—greater choice and control of the services and support they need to remain as independent as possible within their own homes and communities and that is what they desire in increasing numbers. The Commonwealth allocates close to $7.5 billion for Commonwealth funded home care packages across the forward estimates. Given the government's inability to oversee the implementation of Labor's reforms efficiently or effectively, there is good reason for concern.

This bill is the first part of a two-stage plan to change the way home care services are delivered to and for older Australians. The first stage is addressed in this legislation before the House tonight, which would allocate packages directly to the consumers from 27 February 2017. Home care packages would 'follow the consumer', enabling the consumer to choose and change their provider. It would 'follow' them if they moved to another area. The second stage would integrate the Home Care Packages Program and the Commonwealth Home Support Program into a single home care program from July 2018. This will require additional legislation from whomever forms government after the next election.

The legislation before the chamber will make amendments to the Aged Care Act 1997 and Aged Care (Transitional Provisions) Act 1997 in three main areas. First, funding for home care packages would follow the consumer rather than the provider. Consumers would retain their funding arrangements even if they choose to relocate and live in a new area, or if they want to change providers. For example, if a woman is living with dementia in Ruthven Street in Toowoomba and is cared for by her husband and, sadly, her husband passes away, and her daughter living in Bridgeman Downs in Brisbane asks her to come and live with her, she would not have to abandon the package provided by, say, Blue Care in Toowoomba in the Darling Downs. She could take the package with her and move down to Bridgeman Downs to live with her daughter, who could be her carer. She could also choose to change providers and may choose to avail herself of the services of TriCare or Carinity in that particular location, or any other provider of her choice. That is how the reforms will operate.

This measure would remove the Aged Care Approvals Round—ACAR—process for home-care packages. The 2015 ACAR saw the final allocation of home-care packages to providers. Home-care providers currently compete for an allocation of packages through the ACAR, which they then offer to eligible consumers—so the providers have the control. In the 2014 ACAR, which was announced in January 2015, competition for new home care places was extremely high. The department received applications for 108,281 new home-care places with respect to the 6,653 places made available by the department. That means that approximately 17 new places were sought for every place available. That is intense competition and an enormous expense for the providers. This amendment would remove considerable red tape for aged-care providers, who would no longer be required to make these applications, and it would improve the profitability of the providers. Providers would be approved and would meet the accreditation and quality standards. That would not change.

Secondly, the amendments before the chamber tonight would create a nationally consistent approach to prioritising access to home-care packages through My Aged Care, the portal available to all Australians who are engaged with the aged-care sector. This measure would remove the regional ratios as well, with a prioritisation process to take into account an individual's needs, circumstances and waiting time, regardless of their location. Consumers would still be required to undertake a comprehensive assessment by an Aged Care Assessment Team, known in the sector as ACAT. Currently, a limited number of new packages are released within various aged-care planning regions according to the aged-care provision ratio. Approved aged-care providers compete for allocations of home-care packages through ACAR, at great cost to the sector and to them in particular. Much work is done by aged-care providers to ready themselves and make those applications. Those packages are currently then offered to eligible consumers. The number of packages with the changes before the chamber today would still be capped, but packages would be released progressively throughout the year, prioritising the needs of individuals. That would be determined through the My Aged Care portal. One of the benefits of the change will be more accurate data on the demand for home-care packages. Waiting lists are managed by individual providers. This measure would allow My Aged Care to capture just how many are waiting for a package, how long they have been waiting, what part of Australia they reside in and so much more. This has some real benefits for accurate collection of data, which will facilitate better government policy in terms of aged care.

The third change is the reduction of red tape for providers to become approved under the Aged Care Act 1997. The quality standards will remain, as I said before, but the criteria for assessing suitability will be streamlined. This is a very lengthy process that has been based on key personnel rather than capacity. Providers had to have an allocation of places in order to retain their status as approved providers. The legislation will allow providers to retain their status as long as they meet the quality processes and maintain accreditation.

The aged-care reforms are being progressively implemented, as I said before. I just thought that, for the benefit of those who might be listening to this debate, we need to look at just how they have changed. In 2012-13 and 2013-14, years 1 and 2, there were major amendments: new home-care packages and supplements in both home care and residential care; the establishment of My Aged Care and a national contact centre; the establishment of the Australian Aged Care Quality Agency; and the launching of the Aged Care Pricing Commissioner. Years 3 and 4 aim to significantly improve choice for consumers and strengthen system sustainability. In 2015, those things were built on. That included the government, with opposition support, improving consumer choice and flexibility. Now we have a situation where all home-care packages are delivered on a consumer directed basis.

There have been issues in relation to the functionality of the My Aged Care website and the contact centre hotline. There have been issues in relation to those. Changes have been made in relation to the implementation of national voluntary quality indicators for aged care. There has been growth in the sector with the creation of the Commonwealth Home Support Program. There are better regional assessment services. Public and private funding was introduced into the system. More residential aged-care providers are listed on the Stock Exchange. And there is greater productivity in the sector and greater profitability, if we can believe, as I do, the report done by the Aged Care Financing Authority recently and the report done on the Aged Care Act.

In 2016 through to 2022, there will be continuing changes in the sector. The legislation, as I said, mandates a five-year review. I am hoping that whoever gets into government will have—and we certainly will have—an independent, accountable and transparent process. The Abbott-Turnbull government removed Labor's Aged Care Reform Implementation Council and replaced it with the Aged Care Sector Committee. ACRIC was made up of a diverse range of specialist knowledge and expertise, including legal, union, gerontology and government, who were independent from the aged-care sector.

There is the development of a road map, and I am asking the government to release that road map. It is outlining the next stage of aged-care reform, and I think the government should release that and should cooperate with the opposition in relation to that.

According to the vision of Living Longer Living Better, we need a more sustainable and affordable sector, more diversity, more rewarding career options, encouragement for aged-care businesses to grow and invest, and a higher and better skilled workforce. There needs to be greater choice, with control in the hands of consumers, and more support for people to stay at home as part of their communities as long as they wish.

We set a target, as I said, in relation to home care packages of 125 residential and home care places for every 1,000 persons aged 70 years and over by 2021-22. These 125 places comprise a ratio of 80 residential places and 45 home care packages. These changes aim to give consumers greater choice in selecting home care providers, but it relies very much, as I said before, on the My Aged Care website, portal and hotline as a single entry point to access these providers. This is where there have been big problems in the sector. The aged-care sector and consumers are very concerned, as are providers, about the My Aged Care system's capacity to expand even further, and the system currently is inadequate. In addition, it relies on an informed and competent consumer.

The government plans to make further changes, as I say, which will integrate the Commonwealth Home Support Program and the Home Care Packages Program on 1 July 2018. These changes have generally had support across the sector, but we in the opposition are very concerned. The No. 1 concern we have is in relation to My Aged Care. From 27 February 2017, consumers would apply directly through the My Aged Care gateway rather than directly to aged-care providers. The idea of a single gateway is desirable, and Labor supports it, but it has not functioned as it was first designed to. I have met residential aged-care providers who have never got referrals through the My Aged Care website and have had to rely on their own devices and, indeed, their backlog of people waiting to get into their facilities.

The implementation of the Commonwealth Home Support Program in July 2015 has made consumers and providers very, very wary of the functionality of the gateway. Certainly, whether I have been at the ACSA national conference in Perth or talking with providers in Brisbane at the Brisbane North PHN about all these issues, there have been issues raised again and again.

We saw the Commonwealth Home Support Program formed from four programs that were being done: the HACC Program, for home and community care services; the National Respite for Carers Program; the Day Therapy Centre Program; and the Assistance with Care and Housing for the Aged Program, which was for those people who cannot find any housing, are quite financially strapped and have found difficulty with issues of housing and homelessness. According to the government, this was meant to achieve similar outcomes to those proposed in the legislation before the chamber today, including streamlined access to entry-level support services through a regional assessment service, known as a RAS; a standardised national assessment process and entry point, as I say, through My Aged Care; and reducing red tape for service providers through more streamlined funding arrangements.

The subordinate legislation, principles and fee structure were not delivered until September 2015, some months after 1 July 2015. The fee guidelines—which the government completely and utterly botched—became principles while providers were functioning in a new system completely and utterly in the dark. This was the direct result of the delayed implementation, the last-minute consultation with the sector and a complete failure by the government to trial regional assessment services.

The government want to push legislation through the chamber today in order to give them enough time to ensure that the sector is better consulted and prepared for these changes. Having looked at the track record of the government, I say that is a good thing, because they have certainly not designed and implemented the reforms that they inherited from Labor very well at all. The sector, while supporting generally increased consumer choice, is rightly concerned about the government's capacity to implement this major change in the legislation before the chamber by 27 February 2017.

The Department of Human Services Medicare payments to providers and Centrelink means testing remain an issue. In late 2013, the Department of Human Services—Medicare—took over the payment of aged-care supplements and subsidies to aged-care providers. This resulted in a major breakdown of the system, and home care providers experienced major delays and errors in payments. Some providers were not paid from November 2013 through to March 2014 and were owed tens of thousands of dollars. The department had to conduct manual payments through 2014 and into 2015.

Leading Age Services Australia, LASA, has expressed concern about the readiness of the government and the department's systems in relation to the reforms before the chamber. Home care providers in particular have suffered over two years, so their confidence in the government's implementation of the reforms before the chamber is debatable. We need a workable payment system, and the problems have not been fully resolved.

In addition, there is significant delay in reconciling accounts, with Medicare taking up to three to four months to pay for services. This will make the portability of home care packages in the legislation before the chamber very fraught and very difficult. A consumer may want to change providers, but, unless there are changes to Medicare payment systems, providers may not be able to reconcile exactly how much funding actually remains in a package. The Department of Human Services has failed aged-care consumers as well.

Living Longer Living Better saw greater consumer contributions towards aged-care services, but, while older Australians are assured of access to equity in terms of quality aged care, those who can afford it are expected to contribute more. This has seen the introduction of means testing for residential aged-care and home care packages in greater numbers and with greater strengthening from 1 July 2014.

To date, older Australians are waiting a long time for assessments. Many have experienced errors, mistakes and delays in notification of assessments. The delays in receiving notification of their assessment have resulted in aged-care residents owing tens of thousands of dollars in means-tested care fees. Aged-care providers were not charging this, as they had received no notification from Medicare. This remains an ongoing issue in the sector.

The second major challenge is consumer readiness. The pre-baby boomer generation, which I have heard called the silent generation, are living through this period of rapid change in the aged-care system, and the baby boomers are next. According to electorate offices on our side of politics and the media, older Australians are struggling with the pace of these changes, the complexity of the system and the constant errors and misinformation. It could be argued that consumers have not been taken along this journey to greater consumer choice and control. As I said, the government has failed in terms of its implementation.

Not all consumers have the capacity to make informed choices, and safeguards are clearly essential for the most vulnerable and those with complex clinical care needs, especially those who will be required to pay more due to their means-testing arrangements. Elder abuse can occur when unscrupulous family members make decisions based on cost rather than care needs. Consumers will need significant education and information. I ask the government to make sure that the department handles this much better than the examples I gave earlier in this speech. Consumers need to be aware of their own needs, how much they will have to pay for the services on offer, what services are there and what is provided by the providers. They require greater levels of health and financial literacy and support to negotiate packages equitably and effectively.

This comes on top of the government cutting the aged-care workforce supplement in September 2013—$1.1 billion. This comes on top of the government cutting the dementia and severe behaviours supplement—$52 million. This comes on top of the government stupidly getting rid of the panel for positive ageing at the mere cost of $1 million. To the credit of Everald Compton, other organisations and Per Capita, through the Longevity Forum, they delivered their Blueprint for an ageing Australia. This comes on top of the aged-care payroll tax supplement being axed at a cost to the sector of $653 million. This comes on top of this government cutting $21 million when they rebadged ACSIHAG to DACS funding. This comes on top of the government cutting $40.2 million from the aged-care workforce development fund. It comes on top of the government cutting $595.1 million from the middle of this year, in MYEFO last year when streamlining health and aged-care workforce programs. It comes on top of the ACFI revision of $472.4 million they did in MYEFO from the middle of this year.

The government have cost the sector nearly $1.49 billion and they want the sector to be able to handle the changes they want to do. They have taken the sector for granted. They leave consumers in a position where they find it difficult to access the aged-care services that they need. They make the sector far less profitable. That is clear when you look at the reports I referred to earlier. Regional and rural communities are suffering and those residential aged-care providers are suffering.

This legislation comes on top of the government taking nearly 540-odd days to provide a report in relation to their own Commonwealth funded stocktake of Commonwealth funded programs in relation to the aged-care workforce. This was to be, as one of the ministers or assistant ministers for aged care said, the basis for the development of an aged-care workforce strategy. Instead, it was the precursor to nearly $1 billion in cuts in the aged-care sector and health sector combined in terms of workforce development and ACFI revision in MYEFO at the end of last year.

The government said in Senate estimates that they are not intending to undertake an aged-care workforce development strategy. This is contrary to the request not just of the unions—that is, the AWU, the HSU, United Voice and the nurses—but all the other stakeholders, all of whom believe there needs to be an aged-care workforce strategy developed in this country. Every single aged-care provider I have met with—in boardrooms in Sydney, Melbourne, Brisbane or elsewhere—has said we need to work together to develop the workforce we need.

The Productivity Commission in 2011 said that we need to quadruple the aged-care workforce. The average age of a person working in aged care in this country is about 50. About 90 per cent of the workforce are women. About 34 per cent come from CALD backgrounds. They are paid low wages compared to those who work in other sectors. For example, a nurse working in residential aged care is paid hundreds of dollars less than a nurse working in a public hospital. We need an aged-care workforce strategy that brings the sector together to deliver the kind of reform we need.

We have about 350,000 people working in residential aged care, home care and Commonwealth home support programs in the country. We need, according to ACFA, about 900,000 by 2050. We are not going to get it if the government does not show leadership in the development of an aged-care workforce strategy in this country. This government has decided that the market will do the trick. It is wrong. It has failed. It gave back a lot of that money and more so, in terms of the aged-care workforce supplement, after it ripped it out of the hands of workers. It gave it back to the sector and we have seen in the sector no appreciable improvement in salary and wages, career pathways or professional development. There has been no appreciable difference, so the government has a lot to answer for.

The government have failed in this area. Like everything to do with aged care, they think it is just about aged care. It is not just about aged care; it is about ageing and longevity. It is about transitioning Australia to the future to an age-friendly country. Other countries have picked up those concepts, like the UK and Japan. The government's fixation is on aged care alone. They have had so many ministers and so many assistant ministers. One of their ministers, the member for Pearce, thought he was the minister for an hour or two. He had it ripped away and it was given to the current Minister for Health and Minister for Aged Care. Even the title 'aged care' shows that they are not even thinking about what we need to do in the future. We need to think about that and transition our aged-care sector workforce and the aged-care system. We need to think about ageing issues and dementia-friendly communities, which Alzheimer's Australia and so many advocates talk about. All of these things remain outside the understanding and the mindset of the government. They do not seem to understand anything about that, but we need to do it.

This legislation has merit. We support it. It is the next logical step on Labor's Living Longer, Living Better program. We support it and we will back this legislation in the chamber. But I urge the government to cooperate with the opposition and to think bigger than they are thinking. It is not just about aged care; it is about ageing and longevity, and that is what they need to do. They need an aged-care workforce strategy and they need to do far more than this legislation, and I urge them to adopt a bipartisan approach across this area of policy.

Karen McNamara (Dobell, Liberal Party) Share this | Link to this | Hansard source

I rise to support the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. The government's home care reforms have been designed with the intention to create an aged-care system that supports senior Australians with greater flexibility and choice. The New South Wales Central Coast is a popular sea change destination for retirees and, coupled with an existing ageing population, there is a recognised need to ensure appropriate infrastructure services and facilities are available and sufficient to meet the growing demand. According to the 2011 census, the Central Coast had over 78,000 residents over the age of 65, a full quarter of the total Central Coast population, with this projected to increase by a further 18.5 per cent, to around 93,000 by the year 2021.

Ageing in our population is something that we should be proud of, because it points to the successes of increasing life expectancy, greater access to quality health care and medical technology, and improved living standards, to name a few. Realistically, we are redefining what it means to be 'older' more than ever, and the senior residents in our communities are maintaining healthy and active lifestyles. They are vibrant and socially engaged and continue to enjoy a full life well into their later years. Of course, it means that there are opportunities and challenges to take into account to ensure that, as the number of ageing Australians increases, they are still continuing to enjoy the active and fulfilled life that they desire and deserve.

With their natural freedoms and desire to lead active social lives, older Australians are also seeking greater flexibility in terms of support services. The home care reforms are a key element to making this happen by supporting seniors' access to the services that they require. This government is ensuring that Australians are able to freely make informed choices about their care. These reforms will strengthen the aged-care system to ensure it remains competitive, of high quality and at the forefront of innovation through increased competition.

The reforms were announced through the government's 2015-16 budget as the Increasing Choice in Home Care measure. The Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016 gives effect to the first stage of the announced reforms and is an important step towards an aged-care system that is more consumer driven and market based and less regulated. These reforms will dramatically impact the way senior Australians have access to home care services which are based on the current consumer-driven care approach.

There are two stages to the delivery and implementation of reforms to the aged-care sector. This bill creates provision for funding for home care packages to follow the consumer. What this essentially means is that the consumer—that is, the senior Australian receiving home care—will have more choice and greater flexibility in deciding on their provider.

This bill amends the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 in three main areas. Firstly, the funding allocated to a consumer for a home package will follow them, instead of places being allocated to providers to service a particular area or location, as is the current system. Secondly, there will be a consistent national approach to prioritising access to home care packages through My Aged Care, which is the government entry point or gateway to the aged-care system. Thirdly, there will be a reduction in red tape associated with the approval process for providers under the Aged Care Act 1997, which will provide an incentive for new providers to enter the home care market, in turn facilitating greater choice for consumers. This does not, however, change the fact that providers still need to demonstrate their suitability to become an approved provider and meet quality standards.

The reality is that, while Australia has a world-class aged-care system that is well respected and provides high-quality services to a diverse population, the demands of our ageing population are changing. In the Productivity Commission's Caring for older Australians report in 2011, the commission noted:

Older Australians … did not want to be passive recipients of services, dependent on funded providers. Rather, they wanted to be independent and be able to choose where they live, which provider they would use, the way in which services are delivered … There is strong empirical evidence that consumer choice improves wellbeing, including higher life satisfaction, greater life expectancy, independence and better continuity of care.

We as a government are committed to ensuring that the system embraces and accommodates changes necessary to truly empower consumers to make decision about their own care.

The current home care system has a number of weaknesses, and one identified is that at present there is limited choice and flexibility for consumer in the home care system, including a lack of portability, since the funding is attached to the provider, not the consumer. In particular, it was recognised that the baby boomers are nearing older ages. For instance, in Dobell 11.8 per cent of the residents, or 16,280 people, are aged between 55 and 64 and many in the coming years will increasingly rely on aged-care services. The baby boomers are a different generation to the one preceding them, with different economic, social and cultural attitudes, expectations and lifestyles.

The government recognises the need to keep in step with these changing goalposts in delivering aged-care services, especially in the area of home care, as senior Australians increasingly want to stay in their own homes for as long as possible and prefer to engage services that assist them in doing so. The Productivity Commission's report in 2011 identified that a lack of timely access to care and limited choices available to senior Australians were an issue.

Under the current arrangements for home care, once a consumer has been assessed and approved as eligible for a home-care package, they have to source an approved provider with an available package that suitably meets their identified needs. Choices are limited because providers can only accept new consumers if they have not exceeded their allocation of places. In speaking with home-care providers in Dobell, I note this issue has been reiterated as an ongoing obstacle in the provision of services to consumers. There are four levels of home-care packages for consumers, ranging from basic at level 1 to high care at level 4. I am advised that there are little to no levels 3 and 4 available on the Central Coast at present. So, when a consumer is assessed and approved for home care, they need to find a provider that has a place available at the level of care that they have been approved for. If they happen to be assessed at a level 3 or level 4, it is an unfortunate reality at present that it is difficult for the consumer to get the care that they have been approved for, due to the lack of available places. More often than not, it requires them to be placed on a waiting list until such time as a place becomes available. Likewise, if an existing consumer has been receiving care at a level 1 or 2 but reaches the stage, particularly through illness or injury, where they are relocated to level 3 or 4, unfortunately, they likely have no option but to go on a waiting list until a place becomes available, either with their existing provider or, if transition is possible, with another provider.

The government's aged-care and home-care reforms address this situation. Providers in Dobell have expressed great optimism for the changes, citing a number of benefits, particularly in increasing the number of clients that they can take on and the fact that they will no longer be limited by the number of packages that they have been allocated to deliver. By attaching the funding to the consumer, providers are now able to service the actual number of clients they have the capacity to manage. They will be able to offer the delivery of home-care packages at any level to consumers without the need for places to become available. They are also enthusiastic that the changes will drive the quality of service delivery because consumers will have the freedom to vote with their feet. If they are unsatisfied with services offered by a provider or if the chosen provider does not adequately suit their needs, the consumer will now have the flexibility to move to a more suitable provider.

These reforms represent real and positive change for senior residents as well as service providers in Dobell. They present an opportunity for growth in the aged-care services sector. In turn, this will provide more jobs and better services across the board, driving forward the quality of delivery to meet the needs of senior Australians and facilitating their increased quality of life and greater freedom and independence. The aged-care services sector will, as a result of these reforms, transition into a more competitive, market-driven environment and will be consumer focused, which not only benefits the consumer in terms of the quality of service delivery but also opens up a world of opportunity for providers to expand their business to meet the demand without being constricted by the number of places that they are allocated. It will provide more surety for consumers in having the freedom to relocate, knowing that they will have continuity of care and access to a range of quality service providers who are able to meet their needs.

The government recognises that, in order to provide the best options and flexibility in home care, it is necessary for the funds allocated to the consumer to move with the consumer, enforcing the concept that the home-care package belongs to the consumer. Adssi is a not-for-profit organisation on the Central Coast that provides outstanding aged-care services to the community from low care to care for the frail aged, the disabled or those living with dementia. They offer a holistic approach to care, and, like many existing service providers, are excited about the opportunity these reforms represent and are embracing the opportunity to grow. Adssi have over 8,000 clients between the Hunter, Central Coast and northern Sydney regions. They are currently allocated 75 home-care packages. Adssi pride themselves on concentrating on the goals and needs of each individual client, believing that having a person centred approach is key to quality service delivery. They believe cultural change is empowering for the local community, and, even though the competitive market will open up in terms of service delivery, it has given them an opportunity to look at their whole business model and identify possibilities in terms of growth and change in the way things are done.

Just as Adssi provide quality services in the aged-care sector, the government is ensuring that any newly approved private provider will be required to demonstrate they are capable and suitable to provide home-care services and meet quality service delivery standards. The current process and criteria for becoming an approved provider are considered outdated and inefficient. There have been no substantial changes to the suitability criteria since 1997—almost 20 years ago. Feedback submitted by various stakeholders expressed the concern that there is too much focus on personnel, who may change over time, rather than the capability of the organisation as a whole to provide care services. Potential providers are also required to go through separate processes to gain approval as a provider for home care and residential care, despite significant overlap in the types of details required under both applications. This has created an onerous red-tape process in becoming an approved provider and a disincentive for entering the aged-care service provision market in the first instance. Providers will still need to be approved by the department under the act in order to provide subsidised home care, but the process for becoming an approved provider will be simplified. All approved providers will be required to meet the home-care standards and will be subject to independent quality reviews.

These reforms provide senior Australians greater choice in who provides their care and establish a consistent national approach to prioritise access to care through My Aged Care. The prioritisation process takes into account the relative needs and circumstances of individual consumers, which are determined through the comprehensive assessment undertaken by an aged-care assessment team at the time a person was waiting for care. But, overall, these changes demonstrate the government's commitment to reducing regulatory burdens and increasing choices for Australians. The government is strongly committed to working closely with the aged-care sector in preparing these reforms, and the changes are widely supported.

I am looking forward to Dobell's senior residents having the opportunity to choose their care providers and service delivery after February 2017. I commend the Minister for Aged Care and all the government agencies and departments, organisations, groups, committees, businesses and individuals who have contributed to the formulation of these outstanding reforms. These consumer-driven home care reforms are a momentous achievement for our senior Australian and the organisations that provide their home care services. I commend this bill to the House.

Tony Zappia (Makin, Australian Labor Party, Shadow Parliamentary Secretary for Manufacturing) Share this | Link to this | Hansard source

As the member for Blair stated earlier on in his remarks, Labor supports this legislation, the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. We do so because it effectively follows on with reforms that Labor began when we were last in office and, indeed, reforms that arose from the Productivity Commission's 2011 report titled Caring for older Australians. When that report was released, I can well recall hosting some forums in my electorate of Makin with the then minister, the member for Port Adelaide, to hear firsthand from older Australians about the aspects of the Productivity Commission's report that they would like to see implemented and how important some of those recommendations were to them. There was no doubt in my mind, from the feedback from those forums, that the aged-care services provided in this country needed to be reformed—and, in fact, needed to have been reformed years ago. The reforms are well overdue. Labor began the process of implementing those reforms when we were in office, and this legislation, as I said a moment ago, in my view, continues that process.

The notion of enabling people to live in their home for as long as possible has considerable merit. In my view, it is something that most older people would prefer to do if they were given the choice. Indeed, I have never heard anyone say to me that they would willingly like to go into a nursing home. Some may move on to a retirement village, depending on the nature of it—that is perhaps an easier transition—but most people prefer to stay in their home. That is because it enables them to remain in their local community, where they are in the company of the people they have grown up with, they are in surroundings that they are familiar with and they will still have access to their friends.

Often it is the case that a person wants to stay in their own home because, even though they might be at an age where they need considerable care, they might still be with their husband or wife, who might be able to provide some of that care for them. It also means that, in essence, they are surrounded by the comforts that they have become accustomed to living with and the freedoms that they would otherwise not enjoy once they are transferred to another place. Staying in a person's own home has considerable advantages to all concerned. There is no doubt in mind that it ultimately means that it is a less expensive way of continuing a person's life than moving into a retirement village or a nursing home. There are cost savings to government and, as I said a moment ago, it also meets the needs of most older people.

One of the important matters relating to people being able to stay in their own home is the ability for them to continue the lifestyle that they have had, particularly if that lifestyle is tied to a cultural difference that they might find if they are placed in a nursing home or even a retirement village. When I have spoken to older people, I have particularly noted that cultural differences are one reason that they want to stay in their home for as long as they possibly can. There are of course other matters relating to financial differences that sometimes arise and also the fact that, for some people, moving out of their home also means that they have to move away from the local area in which they were raised, particularly given that not all areas have all of the facilities that an older person requires. This is particularly so if we are talking about regional and country areas, where sometimes there might be some facilities but not all of the facilities that are required by a person who reaches a point in their life when they require a range of services. For them, moving out of their own home becomes very, very traumatic.

Another issue that I have noticed in recent times—and I speak with experience about this, because I have dealt with some families who have faced this very issue—is that, in today's lifestyle, the work commitments of children often take them away from their local area and sometimes interstate or perhaps even overseas. So, whereas in the past older people might have had children who would pop in and care for them from time to time, that is sometimes becoming less the case because their children have had to move interstate or overseas in order to secure work. So there is a whole range of issues that need to be taken into account.

If we are going to enable people to remain in their own home, services like the Home and Community Care service, the National Respite for Carers Program, the day therapies centres and the assistance with care and housing for the aged that has been made available all need to be accessible to those people who are staying in their own home. I note that there have been some significant changes to the Home and Community Care services that are provided. I also note that, as a result, many of the people I represent have had some difficulties in accessing those services. Either they have become ineligible or there are only a limited number of services available and therefore they miss out. For them, staying in their own home becomes difficult. We are talking about people who are getting on in life, older people, and sometimes single older people who do not have any support, who might have to do basic home care and maintenance which they are simply no longer up to and for which they need a little bit of support.

Aged care issues are, in fact, frequently raised with me and, certainly, access to services that are available for the aged is one of the main issues raised. The difficulty is that, for many older people, getting through to government departments has become increasingly difficult. Many of them are not familiar with the use of computers and IT systems, and so navigating the bureaucratic system and trying to access services online can be not only difficult but impossible for them to navigate. When they hit a barrier they inevitably contact my office, and then we intervene and try to assist.

The other area where there seems to be a problem is the aged care assessment process. My office has been able to assist people on several occasions with respect to getting the assessments carried out in a timely manner. Without the assessments, they can get no services. In fact, they will not be admitted to a nursing home unless they have gone through the assessment process. Again, it seems that if we are going to provide a system where people can have services, we need to ensure that the process by which they access those services is easy for them to get through. One of the issues the member for Blair touched on is that dealing with government departments has proven to be problematic in the past, with both service providers not being paid and people having to wait unreasonable lengths of time to get the answers they require in order to access the services they need.

I just want to briefly touch on some additional issues with respect to keeping people in their own home. For some people, it is not even a matter of choice any more. It is a case where they have no choice but to remain in their own home. They have no choice because the cost of entry into nursing home facilities, or even retirement villages for that matter, is prohibitive. They might have some assets but not sufficient assets to give them access into those other facilities, and so they have no choice but to remain at home. That being the case, we, as a society, should be doing everything we can to assist them with the in-home services they require to continue on with their lives. I know that many people who stay in their own home and require those services struggle. They struggle in a way that none of us would like to see our own family members or parents struggling. Indeed, when you go to services like Meals on Wheels you get a terrific understanding of that because, quite often, it is services like Meals on Wheels that enable these people to remain in their own homes and at least have someone call in on them every so often to ensure that they are still okay. Whilst I am on that topic, can I just take this opportunity to acknowledge the terrific work that Meals on Wheels does for communities right around the country and the tireless work of the volunteers I see in my own community; and I hear from other members in this place that that is the case right across the country.

The same applies with retirement villages. I know of many older people who would dearly have loved to downsize their homes. They might live in a home that has three or four bedrooms and a reasonable backyard of some kind, but they are no longer capable of doing the maintenance, and nor do they require that property. But, firstly, if they want to relocate into a smaller home that is more modern and does not require maintenance, they may not be able to afford the transfer costs. Secondly, they might also be concerned that, when they exit that retirement village, they lose too much of their money because of the financial structures that many of them operate under. These are issues that we also need to address. Whilst I accept that aged care has always been and continues to be a matter of responsibility between the federal and state governments, it is high time that all of us in government work together, because we all have a common objective here to try to assist the older people as much as we can and resolve some of these issues that are not helpful to older people or governments.

My understanding of this legislation is that from 27 February 2017, roughly a year away, the home care packages will be allocated directly to the consumer and not to the service providers as they have been in the past. That is a good thing, because that gives the consumer much more choice. It also allows the consumer to move from one place to another without the loss of those services that are required. It is something that, I believe, will benefit the consumer immensely. The critical concern, though, as outlined by the member for Blair, is the number of hurdles people have to jump over to access those services, and there is also the issue of having appropriately qualified personnel to deliver the services. Since being elected to this place, I have regularly gone into nursing facilities and spoken with aged people. One of the things I have noted is that many of the staff who work in this industry sector are people who have come from overseas, which highlights to me the shortage of the number of qualified people within Australia who are willing to work in the aged care sector broadly. We currently have, from my estimations, about 3½ million Australians who are aged over 65. By 2050, the figures are probably likely to rise to about 10 million. That is, the population of Australia is projected to be about 40 million and, if you look at the stats which suggest that 25 per cent of Australians will be 65 and over, that means we will have about 10 million older Australians who might require some form of care. If we cannot manage the provision of services to them now, with numbers being at about a third of that, then what is going to happen in years to come, unless we start to plan the workforce that is required to provide those services. We are simply not doing that well enough. As recently as a couple of weeks ago, when I sat down and spoke with some people from the aged care sector, it was clear to me that the shortage of appropriately qualified staff working in the aged care sector is becoming a problem. It will be a greater problem in years to come so, hand in hand, we are trying to assist people to stay in their own homes. We also need to ensure that we have a workforce that can provide the range of services they require, so it will be a multipurpose workforce.

As the member for Blair has made clear, we support this legislation but want to ensure that the aged people of this country not only have a legal right to the services but also can access them in a timely way.

Bob Baldwin (Paterson, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. This bill provides the necessary legislation for a more flexible aged care system that will support what the whole of our community wants and, in particular, affected seniors want—that is, to remain in their homes for as long as possible. Home is where they are familiar, comfortable and engaged with their families, neighbours and friends.

One of the roles of government is to care for its people. To this end, the government subsidises aged care packages for those who are no longer able to live, independently, in their own homes. The Paterson electorate, before the redistribution of boundaries by the Australian Electoral Commission, was ranked the fourth highest electorate in Australia where residents were aged over 70. My electorate had 18,642 people over the age of 70, which is 15.6 per cent of its population.

Unfortunately, this redistribution has meant that many wonderful organisations I have had the pleasure of visiting and, more importantly, working with for a number of years will no longer be in the electorate of Paterson. These include the Lara Aged Care facility at Dungog, Stroud Community Lodge, Glaica House and Beaumont Terrace at Tuncurry, Baptist Care at Kularoo Centre and Barclay Gardens at Forster, the Great Lakes Nursing Home at Bulandelah, the Peter Sinclair Gardens at Hawks Nest, and The Frank Whiddon Home at Largs. I have shared their battles. I have been involved in the development, establishment and refurbishment of many of these fine facilities over the years.

However, the boundary changes mean that other aged care facilities will now come under the federal electorate of Paterson. These include Green Hills Nursing Home, Mount Carmel Village and Benhome at Maitland, Kurri Kurri Masonic Village and Maitland Opal at Rutherford. They will join the Opal at Raymond Terrace Tanilba Shores, Salamander Bay United Aged Care facility, the Regis The Gardens at Salamander, the Bill King Aged care facility at Fingal and Harbourside Haven at Shoal Bay plus the many assisted living facilities and service provider organisations, throughout my electorate, servicing the growing needs of my community.

This bill gives effect to the first stage of the home-care reforms announced by this government in the 2015-16 budget. Consumers are right to demand more choice and control over their aged care service provider, as is the industry right to demand reduced red tape and regulation for aged care providers. This bill will provide for this outcome—and it is all about the outcome. The changes also lay the platform for future aged care reforms, which will be guided by the Aged Care Sector Committee Roadmap for Reform and will be jointly developed with the sector. These reforms will improve the way home-care services are delivered to older Australians.

They will be implemented in two stages. In the first stage, commencing February 2017, importantly, funding for a home-care package will follow the consumer, and I welcome that. This will enable the consumer to choose a provider that is suited to their needs and allow them to direct their funding to their provider of choice. The consumer will be able to change their provider, if they wish, including if they move to another area to live. The second stage of reforms will build on these changes by integrating the Home Care Packages Program and the Commonwealth Home Support Program into a single care-at-home program. This will further simplify the way services are delivered and, in particular, funded.

These changes are an important step in moving towards an aged system that is more consumer friendly, market based and less regulated. It is all about the consumer—their rights; their needs—first and foremost. Thankfully, Australians are living longer and healthier lives and it is important that as people age they have choice about their care. The home-care reforms will strengthen the aged care system to provide high quality and more innovative services through increased competition. Our elderly Australians deserve nothing less.

Home-care packages are available at four levels, with the majority of packages funded at levels 2 and 4. There are around 73,000 operational home-care packages across Australia. At present, home-care places are allocated to providers through the Aged Care Approvals Round, ACAR, and around 6,000 new packages will be allocated to providers through the 2015 ACAR. We expect the results to be announced shortly. It is important to note that this will be the last ACAR, in which home-care packages are allocated directly to providers, before the proposed February 2017 changes commence. In addition to having an allocated place, to receive a home-care subsidy, a provider must also be approved by the Department of Health, under the Aged Care Act 1997—that is, be an 'approved provider'. The subsidy is paid to the approved provider for a home-care place occupied by the care recipient, the consumer.

It is critical to understand that providers are required to comply with a range of responsibilities, under the act, relating to factors such as quality of care, user rights and accountability requirements. Currently, to access a home-care package, a consumer has to be assessed and approved as eligible for home care by an ACAT and offered a package by an approved provider. The new Consumer Directed Care, CDC, system gives consumers greater flexibility in determining what level of involvement they—I repeat, they—would like to have in managing their own home-care package. Consumers and providers work in partnership to identify the consumer's goals and needs, which form the basis of their care plan. The CDC also provides consumers with clear information about what funding is available for their care and services and how those funds are spent through an individualised budget and monthly income and expenditure statements. These tools ensure that providers and consumers have a shared understanding of available resources and how those resources are being expended to meet the consumer's needs.

The expansion of the CDC across all home care packages in July 2015 was an important step in moving to a consumer-driven system, but further reform is required to fully empower consumers to be in control of their care. Through the introduction of the CDC, many consumers now have more choice as to how their care is delivered, with increased transparency over what budget is available and how funds are spent. However, under current arrangements, it is difficult for consumers to change to another provider or move to another location.

Once the changes take effect, all consumers, both new and existing, will benefit from these changes. We all want and expect choice. These changes will provide greater choices for consumers when selecting a provider. The new arrangements will be closely monitored to ensure that all consumers, including people with special needs and those living in rural and regional areas such as Paterson, are able to access care in an equitable manner. Service providers that do not currently have an allocation of home care packages, and in some cases may be providing subcontracted services to an approved provider, will be able to provide services directly to consumers, should they become an approved provider.

As I outlined earlier, under these proposed changes providers will no longer need to apply for new home care places through the ACAR. While welcoming the reduction in red tape, some existing providers in my electorate of Paterson have expressed concerns about the impact of increased competition and the loss of certainty of business income once home care places are no longer allocated to providers. The financial impact of the changes on providers will be closely monitored by the Aged Care Financing Authority. The monitoring will particularly examine the impact on service delivery in regional and rural areas. I welcome that.

This is not a piece of legislation designed to reduce funding or care places. In fact, the total number of home care packages is continuing to increase each year, so there is an opportunity for all providers to continue to operate in the market. The challenge for all providers is to understand their consumers' needs and to deliver services which meet the needs of the consumers. It is all about the consumer and the outcome. That is what this bill is about.

Changes are also proposed to streamline and simplify the process for becoming an approved provider of subsidised home care. Providers will still need to be approved by the Department of Health under the Aged Care Act 1997 in order to provide subsidised home care, but the process for becoming an approved provider will be much simplified. This will include updating the suitability criteria for approved providers, streamlining the processes for becoming an approved provider and providing a simpler model for existing residential and flexible care providers to also provide home care. Simplifying the process for residential and flexible care providers to become home care providers recognises that these providers have already been tested against the standards required to become an approved provider of aged care.

Once an organisation has been approved as a provider under the act, approved provider status will no longer lapse after two years if the provider does not hold an allocation of places. That is critically important. This change will apply across all care types, including home care, residential care and flexible care.

Making these changes will remove some of the barriers to entry for new providers whilst still ensuring that standards of care remain high. Increasing the number of approved providers able to provide home care will support greater choice for consumers. Importantly, new providers will still be required to demonstrate their suitability to become an approved provider. All approved providers of home care will need to meet the Home Care Standards and will be subjected to independent quality reviews.

ACATs undertake comprehensive, holistic, multidisciplinary assessments to determine a person's eligibility to access Commonwealth-subsidised aged care. In Stage 1 of the reforms the role of assessing eligibility for home care will continue to be undertaken by the Aged Care Assessment Teams. Once home care places are no longer allocated to providers, the assessment approval will indicate a specific package level—level 1, 2, 3 or 4. A guidance framework is being developed to inform and assist ACATs in determining a specific home care package level for each consumer. All consumers who have been assessed by an ACAT and approved as eligible for a package will be prioritised in order to access subsidised home care. From February to mid-March 2016 all ACATs will commence using the full functionality of the My Aged Care assessor portal to conduct comprehensive assessments, create support plans, make delegate decisions, transmit approvals to the Department of Human Services and make referrals to services or waitlists. The changes in Stage 1 will build on this platform.

At present, new home care places are allocated to providers at a regional level through the Aged Care Approvals Round. While this system aims to achieve an equitable distribution of the total number of packages, there are significant variations in the distribution of packages between states, regions and local areas. Currently waiting lists for packages are managed by individual providers. There can be significant variation in the waiting periods for packages across Australia, with no systematic way of measuring or addressing the variation. The move to a consistent national system for prioritising access to subsidised home care will allow a more equitable and flexible distribution of packages to consumers based on individual needs and circumstances, regardless of where they live. There was general support from stakeholders for a national approach in the consultations.

Once these changes take effect, there will be a national system to manage eligible consumers' access to packages within My Aged Care. This is important to ensure there is equitable access to care. The national prioritisation process will take into account the relative needs and circumstances of consumers, determined through the comprehensive assessment undertaken by an ACAT, and the time that a person has been waiting for care. A consumer who has been prioritised for a package will be supported by My Age Care with referrals to approved providers. But the consumer will be able to choose which provider delivers their care. The department will closely monitor the new arrangements to ensure that all consumers, including people with special needs and those living in regional and rural areas, are able to access care in an equitable manner.

We are a government that cares for our ageing. We face an issue with an ageing population. The challenge is upon us to make sure we have the best possible systems in place to care for our elderly with dignity. Therefore, I commend this bill to the House.

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

I am glad to see this bill come forward so we can try to work through some of the issues that many are facing in the aged-care space, whether they be families of older Australians, whether they be older Australians themselves, whether they be any of our not-for-profits providing aged-care services. There have been issues with the implementation of the Living Longer Living Better package since it was first introduced. Reform in this space needs to be continuous and ongoing to ensure that we do get the best possible model for our older Australians.

Close to $7.5 billion is allocated to the Commonwealth-funded Home Care Packages across the forward estimates. Home Care Packages allow our older Australians to receive aged-care services in their own home and community. It was a significant part of Labor's Living Longer Living Better package of reforms. In the legislation that we have before us, the first and the second stages are about ensuring that the Home Care Packages would follow the consumer and enable the consumer, or the person with the package, to choose and to change their provider. It is one of the critical things that is needed. I always feel a bit uncomfortable to refer to people seeking these packages as 'consumers'. Yes, technically, there is that element to it, but there is a level of care and support that goes into what a lot of this work is.

I thought it would be important to highlight some of the challenges that we have had in Central Victoria and the intersection of this new reform before us—the package about Commonwealth-funded Home Care Packages—with some of our local government areas in regional Victoria. In my own area, our councils still deliver their own HACC services, as they are called in Victoria. They receive block grants from our state government. There was some confusion among families when these packages first rolled out over whether they would be better to stay with the council service, which they could qualify for if they reached a certain criteria, or whether they should switch into the Commonwealth-funded service. A lot of families spoke about how confusing it was between which option they should take. That, I guess, is one of the great challenges when you roll out such a bold new reform and try to transition. I hope that some of the lessons we are learning through this process can be applied to the NDIS as it rolls out in our area. I am sure that some of those challenges will come up in that space, as well.

Some of our providers, like our councils, are quite nervous about the impact these reforms would have on their own client base. At one stage, it looked like they were going to outsource—contract out—their HACC services because they believed they would not be able to attract enough clients to keep the service viable. And they are not the only council area in Victoria that have gone through that challenge. I have two other Victorian council areas in my electorate, and they, as well, are having this debate as we speak. At this stage, they are keeping them in house and rolling them over.

It is incredibly nerve-racking and stressful for the clients—the people that are seeking these services. They want to know the person coming in their door every day. Whether it be for low-level support, such as helping with the cleaning, doing the gardening or providing their meals, or whether it be for more high-level support, such as assistance with showering and support in some of the most personal ways, the person seeking the care wants to know the person coming in. It is a very intimate and close relationship that they have. They want to know that the person, the aged-care worker who is coming in, is someone that they trust. They are opening up their home to this person. A lot of concern that came through the HACC debate in the City of Greater Bendigo was on: who will be my carer? Who will be my aged-care worker if this work is outsourced? I will touch on that a bit later—that is, with any system, we need to make sure that we have an element of funding and support for workforce development to ensure that we get the very best working in this sector so that our older Australians and their families do have that peace of mind and security.

The other issue with the HACC services was about the level of service. Once you apply a cost price to something, that worker is then under stress. They only have 15 minutes or 20 minutes. They do not have the time to sit down and have a cup of tea or share a story. We need to ensure that within this system and this package that we are funding that opportunity for the person to genuinely engage. The language we have about 'consumer' is just so transactionary. We have to remember that these are people and that people are social creatures. It is important that we do allow time for the very basics—not just, 'Hello. Good morning. I'll see you tomorrow,' but a chance to really engage and understand and support one another.

Some of the other issues that came up in the very early stages of the rollout of the package were complaints from BDAC, Bendigo & District Aboriginal Co-operative. They said that a number of their clients, the people that they know who had been signed up to these packages, had actually lost 60 per cent of their package in administration fees. There was not proper education; there was not proper engagement. So they went through the process of renegotiating a fairer package on behalf of a number of their clients. I believe that the reforms before us today will help clean that up, streamline it and make it easier for people to, if they do believe that the package they are getting is not delivering the quality of care, move to a new provider.

To lose 60 per cent of your package in administration fees just demonstrates how it is not always a fair market and you do not always have good providers in this space. You do have some providers out there who will look to make money, and we need to make sure there is integrity in the system so somebody can move to a new service if they do not believe that they are getting the quality that they deserve.

Advocate Ruth Hosking has met with me several times to talk about the delays in getting these packages processed. Those waiting for residential care packages, she mentioned, need to provide Centrelink with an asset and income statement every six months. However, it is often longer than six months to wait for a residential aged-care bed, so this is another challenge that we have within the aged-care space. Ruth is incredibly passionate about ensuring that these documents are easy for people to fill in and that, if you fill one in and it is valid for six months, you can have some surety that your claim will be processed within six months. You do not have to complete a new form as you are required to do every six months. This means that families think they have done all the paperwork with regard to their application only to be told once they get a place that their asset and income assessment is out of date.

Aged-care advocate Ruth Hosking has regularly told my office that this paperwork is overly complex, confusing and stressful for older people, and I do believe that that is one of the reasons why we need to continue to look at, reform and make this space as practical and easy as possible, ensuring those integrities are in place so that people do not get, as I mentioned earlier, tricked like BDAC and lose 60 per cent of their package in administration fees.

Some of the other issues that have been raised with me include the greater demand for home-care packages. There has been some great demand for them, and people have been told that there are none available in their area, particularly for people who live in regional areas where there are smaller towns and they may not have a provider or only have one provider in that space. Denise has been waiting for a package since 2014 and her situation has been made worse because she lives in Woodend, where there is only one provider. This bill will help change that. Another example is in Heathcote and, while Heathcote Health has not been allocated any packages, they have been subcontracted by Bendigo Health to deliver these packages in Heathcote. So there is that tussle that has occurred between Bendigo and Heathcote Health about how many packages they can have in Heathcote. These changes, again, will help relieve some of that tension and help address that situation.

People who have signed up for home-care packages are not always aware of how much it would cost. I have mentioned the example of BDAC. Another example is someone who signed up to a home-care package at level 1 and received five visits for cleaning for 1.5 hours per visit and two hours for gardening maintenance. Despite the minimal service, the customer was charged $29 per day for the 63 days they were on the package, totalling $1,700. Their complaint was that they were not aware that they would still have to pay $29 every day even though they did not get support every day. Again, education and understanding for older Australians and their families helps them know exactly what they are signing up for. It is always tricky when you introduce a market into a space which is about quality and care, and it is important that people have the information and know who to go to if they do not believe that they are being treated appropriately.

The final things I wish to touch on are workforce and workforce issues. Aged are is one of the lowest paid sectors in Australia and has a very high turnover. People who stay in the industry a lot time tend to work for the employers, businesses, not-for-profit organisations or councils that have been around and involved in a service for a while. They tend to have the higher pay and conditions. My fear is that we need to do everything we can to ensure that those providers stay in the system. My fear with any kind of market driven, consumer driven care system is that it could be a race to the bottom and we would see good-quality providers undercut by those who do not offer the same quality of care and support for our older Australians.

The wages are too low. This is a sector where they rely heavily on penalty rates, yet some of the providers have said to me that they are not compensated for those Sunday penalty rates. I have had some people raise with me that they cannot get someone to come out on a public holiday for their father or their mother, because the providers are not willing to pay the penalty rates. It is really sad that it is because of people's rates of pay that this service is denied. So we need to make sure there is enough money in the package to pay people's minimum entitlements.

These are not workers who are earning a million dollars. They are not even earning anywhere close to decent wages. They are people earning the basics, the minimum income in this country. They are on very low wages. They love their work. They will tell you when you meet with them that they do not do it for the money; they do it for the work, for the people, that there is a love and a care that they have. But they still should be properly rewarded for the work that they do. That is why it is so disappointing that this government when it was first elected cut $1.8 billion from the aged-care sector. That had largely been towards the development of the workforce, whether it be through professional development, extra funding for training to continue to skill up the workforce or workforce pay supplements.

We need to do more if we are going to have quality aged-are providers that have quality, well-paid staff. We do not want to see a race to the bottom in this sector. We want to make sure people working in this industry have good, secure jobs so that we can ensure that any of those providers who do want to cut corners are cut out of the industry.

Luke Howarth (Petrie, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. To begin, I would like to use this opportunity to thank and acknowledge the seniors in my electorate of Petrie for their contribution to Australian society and the great country that they have left people like me and my kids and their kids and grandkids. They really have great stories to tell. I want to acknowledge them and thank them. As Australian seniors, they have contributed so much. Thanks to all of them for their contribution and for sharing their experiences and knowledge with me as I travel around the electorate to retirement villages and aged-care homes.

It is important to talk about aged care. This is quite a complex portfolio, and I do congratulate the Minister for Health and Aged Care, the Hon Sussan Ley, for the work she has already done in making sure the system is easier to navigate. The thing is that Australians are living longer and healthier lives. And that is great. But it is important that, as people age, they have choice about their care. For far too long, people in the aged-care system have been looked upon as one homogeneous group, instead of as individuals.

The Australian government understands that people are individuals and everyone has different needs and wants. The worst thing for someone entering the aged-care system would be to have all their choices taken away from them. This is not what any Australian would want from our aged-care system, and it is why we announced significant reforms to home care in the 2015-16 budget.

From February 2017, funding for a home care package will follow the consumer. This will make it easier for consumers to select a home care provider and to change their provider, should they wish to do so. The current requirement for providers to apply for home care places will be removed, significantly reducing red tape. The changes will give older Australians greater choice in deciding who provides their care and establish a consistent national approach to prioritising access to care.

From July 2018, the government intends to integrate the Home Care Packages Program and the Commonwealth Home Support Program into a single care-at-home program to simplify the way services are delivered and funded.

The Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016 expands on the reform we announced in last year's budget. It makes amendments to the act and the transitional provisions act to enable funding for a home care package to follow the care recipient. This means the care recipient will be able to direct the home care funding to a provider of their choice. Home care places will no longer be allocated to an approved provider in respect of a particular location or region. The amendments will create a consistent national process for prioritising access to subsidised home care.

The amendments will also simplify the approval process for approved providers. The legislative criteria used to assess the suitability of a person to become an approved provider will be streamlined. This will also provide for a simplified process for residential care and flexible care providers to become approved providers of home care. An organisation's approval to provide home care will commence as soon as the approval is granted and will not lapse. Currently, approved provider status lapses after two years if the provider does not hold an allocation of places. The lapsing provision will be removed across all care types—home care, residential care and flexible care.

For the first time, there will also be a consistent national approach to prioritising access to home care through the My Aged Care gateway, the entry point to the aged-care system. This option will increase choice, flexibility and portability for the consumer. It will reduce the regulatory burden for providers and provide a nationally consistent approach. Removing the concept of allocated home care places will enable the sector to transition to a more competitive, market-driven environment and allow consumer focused and innovative providers to expand their businesses to meet local demand and consumer expectations.

Too often I have been approached by families in my electorate whose relatives—parents or grandparents—have been waiting many months for an aged-care place. Some had been waiting years. And this places a lot of stress on the family—particularly if their loved one, their mother or father or even grandparents have an illness. How does it affect those people if they are working full time and raising children of their own? It does place a lot of stress on them. This bill will help alleviate that.

The last years of your life, when you looking to go into aged care, are not years that anyone would want to spend in limbo. This is not the time to put pressure or stress on people—especially if they are suffering from a chronic illness like arthritis or dementia. I am glad that seniors in my electorate will have more choice and will be able to access aged care more efficiently.

I also want to thank the workers in the aged-care industry. As I have moved around my electorate of Petrie, visiting different aged-care facilities, I have got to meet some of the workers. They do a wonderful job for seniors. They care for them in ways that I could not, and they do so with love and interest. My father actually works in aged care. He works as a handyman at a local aged-care facility just outside my electorate, fixing up trolleys and wheelchairs. He does not do it for the money; he does it because he enjoys doing it—using his hands. But he tells me that he often spends quite a bit of time just talking to the residents in the aged-care facility and that they really appreciate that, because not everybody is blessed to have family that can visit them and so forth, and people are often looking for a good chat. I am sure members on both sides of the House who have been into aged-care facilities would say the same thing when they visit senior Australians.

I want to say to people in my electorate too that if they are looking to find a place for their parents or their grandparents then they can visit the website, www.myagedcare.gov.au, which provides all the information on all the services that they would need—where to find those services and other relevant information for their families and for elderly Australians. Again, I congratulate the minister, and I commend this bill to the House.

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak tonight on the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. Over the next three decades in Australia our population of people who are over 65 years old is projected to increase from just 14 per cent of the population, as it is currently, to 25 per cent of the population. With this increase comes really significant challenges to a number of programs and support services, including the aged-care sector.

Labor accepts and recognises these challenges and undertook the aged-care reforms when in government to ensure that our aged-care system can keep up with that ageing population. A significant part of Labor's Living Longer Living Better package of reforms was the home-care packages that allowed older Australians to receive the care they require in their own homes while remaining in the community where they live, where their networks and families are. The federal government has allocated close to $7.4 billion for Commonwealth funded home-care packages across the forward estimates.

The first component of the amendments that are before the House really takes aged-care reform in a direction that has been consistent with Labor's Living Longer Living Better program. Although there is a risk of some of those elements being rushed, I think that the generally bipartisan support that has been committed for much of the reforms in the aged-care sector is a good thing. It enables this parliament to have reasonable discussions so that providers and families can have some confidence in the direction of aged care and the sorts of services that all of us in this House believe should be provided.

The amendments before us tonight are going to change the way those home-care packages are being allocated. This bill is the first part of a two-stage plan to change the way the home-care services are being delivered to older Australians. And there is always room for improvement. I know that two approaches are going on in this particular package tonight. The first stage, addressed by this legislation, is really making sure that those home-care packages follow the consumer, as we have heard in this debate tonight—enabling people to choose their own providers, to make that choice and, likewise, be able to change that provider at any time that they see fit, and in making those changes and decisions that package would indeed follow them.

The second component of these amendments would be to create a nationally consistent approach to prioritising access to home-care packages through the My Aged Care gateway. It is actually this second component that I think would have helped address a situation that a family brought to my attention—a case where their mother had had a very unexpected stroke. She was assessed as requiring a level 4 home-care package when she was to be released from hospital, but, unfortunately, at that time there was no level 4 packages available for that family whatsoever. The family was left with no option but to accept a level 3 package. That was a package that failed to meet all of the care needs of their mother. Then the family was advised that the only way a level 4 package would become available was upon the death of another person in a level 4 arrangement. After some time, and through the tragic circumstances for that other family, the level 4 package did become available, but that is clearly a most unsatisfactory situation for anybody's family to be in.

If the amendments that we are looking out tonight go at least some way towards assisting the availability of home-care packages that meet the actual needs of people in our community, then that is a good thing. As I mentioned earlier, we have lent out support and, indeed, we believe that many of the reforms that began through Labor's Living Longer Living Better reforms are continuing to progress in this bipartisan manner now. That is a great thing for all concerned.

There is no greater challenge, perhaps, than ensuring that older Australians get to live productive, fulfilling, healthy, active lives for as long as possible, and then, when they need those support structures in their home and in their community, that those structures are available for families to access. So it is with great pleasure that I get to lend our support to the bill before us tonight.

Debate interrupted.