Ann Sudmalis (Gilmore, Liberal Party) Share this | Link to this | Hansard source

The inevitability of growing older means that as we see our friends and parents ageing we wonder if the system is up to the demands that will be part of our collective future. In 2011 the Productivity Commission report on caring for older Australians identified some key weaknesses of the system. These were that the system is a little difficult to navigate, that choices are limited for consumer services and that there are inconsistencies or inequities in pricing, subsidies and user co-contributions. We have a great record for caring for the aged, and the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016 is an extension of that ethic.

The policy changes that are introduced with the legislation are to address the reported weaknesses. Some were initiatives of the previous government, but we have developed those concepts in line with consultation processes, creating a system that is more in line with the Productivity Commission's recommendations. In January this year the government created a more independent and robust approach to complaints by transferring responsibility for the Aged Care Complaints Scheme from the Department of Health to the Aged Care Complaints Commissioner. The My Aged Care gateway has been established to be the one identifiable place to go for information and support in order to access aged care. This is now assisting people to find their way through the aged-care system and, despite some initial difficulties, is now undertaking assessments for those people who need low-level care at home.

The government has worked hard to address inconsistencies and apparent cost inequalities in the system in terms of the prices to be paid and the consumer contribution. One of the main considerations is that competition rather than regulation will be a catalyst for increasing innovation as well as better-quality services that are both sustainable and efficient. Naturally the government will maintain a central role in setting policy and in ensuring safety and compliance in aged-care services. Our aged-care system is the envy of many other nations. We must retain that quality, service, affordability and accountability. We are a diverse population and living much longer, mostly because we have a healthier lifestyle but certainly because we have a great healthcare system. However, as an ageing population in which there is to be a shift in the demographic prevalence of our older Australians, we really must make sure that our aged-care services work well into the future. Older Australians want more choice and control over the care they receive. That demand will only increase.

The government's home-care reforms, announced in last year's budget, place a priority on ensuring choice and flexibility for older people. In addition, the reforms will strengthen the aged-care system to provide high-quality and more innovative services through increased competition. There is a staged reform process; all good things take time. After February 2017, someone qualifying for a home-care package after being assessed will be able to direct government funding to the provider of their choice. A very important change that will be available is that the consumer will have the flexibility to change their provider if they need or want to, and if they move to another area or state they can take their package with them. Importantly, once the changes are introduced, the aged-care provider will not have to apply for care packages from the government. In addition, there will be a consistent national approach to prioritising access to care. This major policy change has received widespread support, and the implementation arrangements for these changes have been developed in close consultation with stakeholders, including the National Aged Care Alliance and groups representing consumers, carers and providers.

The second stage of home-care reform will further simplify the way services are delivered and funded and will commence from July 2018. After establishing the first stage, the government will, as has been clearly signalled, move to a single, integrated care-at-home package. Once again, the main theme is to enable greater choice for the consumer, exploring different funding and service delivery models, including activities that promote restorative care.

The integration of the Home Care Packages program and the Commonwealth Home Support program in the second stage will be informed by extensive consultations with stakeholders. This is an absolutely essential step. This was loudly demonstrated by many groups in Gilmore when the concept was first floated. There will be many individuals and groups, such as Meals on Wheels volunteers, who will need to be part of the build for stage 2. This bill implements stage 1 of the reforms and will amend the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 in three main areas. The first allows consumers to choose where to use the package with their provider of choice. Such a choice may also include the need for a provider to be culturally suitable. The package will be portable, including the utilisation of unspent funds, and approved providers will no longer have to apply through the Aged Care Approvals Round to receive home-care places. This reduction in red tape will also increase competition in the sector, allowing more consumer focused and innovative providers to expand their businesses to meet local demand and consumer expectations, including the needs of consumers with dementia and other special needs.

There will be a consistent national system for prioritising access to subsidised home care. Currently, waiting lists for packages are managed by individual providers. There can be significant variations in the waiting periods for such packages across Australia, with no systematic way of measuring or addressing that variation. Just recently a family came to me after four years of waiting for a package to be allocated to their older mum. They had a package before they moved to the local area. It took four years to get a new one. At the moment these packages are actually applied for and distributed by the providers. This change will make a difference to so many people.

Once these changes take effect, there will be a national system to manage eligible consumers' access to packages within My Aged Care. An effective national system is important to ensure that there is equitable access to care, as the total number of home care packages will continue to be capped in line with the aged-care planning ratio. A prioritisation process will take into account the relative needs and circumstances of consumers, determined by the comprehensive assessment undertaken by an aged care assessment team and the time that a person has been waiting for care. A consumer who has been assigned a package will be supported by the My Aged Care gateway with referrals to approved providers, but the consumer will be able to choose which provider delivers their care. There will be close monitoring of these new arrangements to ensure that all consumers, including people with special needs and those living in rural and regional areas, are able to access care in an equitable manner.

The final part of the proposed changes will mean that the red tape associated with providers being approved under the Aged Care Act 1997 will enable more providers to exist, giving a whole lot more choice. But they will still be required to show their suitability to become an approved provider. All approved providers will need to meet the home care standards and will be subject to independent quality reviews. The legislative criteria for assessing the suitability of a person to become an approved provider will be streamlined and made more contemporary.

Most of us would prefer to live our wise years in our own home—a location that is familiar and special. As I began my support for this bill, I also mentioned the aspect of caring for the aged that is so important to this government. Our older citizens need to be respected holistically. Getting great provider services is most definitely part of the responsibility we have, as is monitoring of the other aspects of being an older person.

Following the establishment of the Aged Care Complaints Commissioner, just this week Senator Brandis has released a report by the Australian Institute of Family Studies, which was commissioned by this government to conduct a scoping study of elder abuse in Australia. As a consequence of that report, the Attorney-General has now tasked the Australian Law Reform Commission to conduct an inquiry into laws and frameworks to safeguard older Australians from abuse. The government is, by such action, putting the respect and recognition of the human rights of the elderly fairly and squarely on the agenda for government attention.

Consumer choice is absolutely significant and essential as we go forward, but consumer protection is important, both socially and legally. There have been instances of potential elder abuse brought to my notice, and now we have the correct pathways to investigate how to improve the system and protect our elderly. Those abuses can range from physical abuse to legal abuse, where the power of attorney can be manipulated and older people, who are not aware of what is happening, can change their will. Different family members can change that. We need to have an avenue and a process where the rights of our older people, who may not be aware of those changes going on around them, are protected. Some of the cases that have been brought to my attention have already resulted in families becoming financially bereft and an older person not being in a position to go into care.

My government is taking the best, most appropriate and most relevant steps forward in these most important aspects of safeguarding and caring for older Australians. I am both proud and grateful to see these changes, for, after all, each of us is moving to that very same place, in our wise and mature years, as our senior friends and family. We all need to be respected and safe.

Dennis Jensen (Tangney, Liberal Party) Share this | Link to this | Hansard source

Growing older is a certainty. It is a part of the natural course of life. However, it does not mean that we have to lose sight of who we are. Rather, as we mature, we truly begin to understand and recognise who we are. The definition of wisdom is the quality of having experience, knowledge, and good judgement; the quality of being wise. Wisdom comes from experience, and experience comes with age. Older Australians have a wealth of experiences and skills. They have lived through experiences and situations that many of us cannot even imagine. This wisdom, this knowledge and this life experience should be both acknowledged and respected.

Over one million older Australians receive aged care services every year. By 2050, over 3.5 million Australians are expected to use aged-care services.

The 2015 Intergenerational report shows that the number of people aged 65 and over is projected to more than double from 3.6 million people in 2014-15 to 8.9 million people by 2055. Furthermore, in my own electorate of Tangney more than nine per cent of the population is over 65 years old. This is a significant number of people within my electorate who would benefit from changes to the current aged-care health system.

It is obvious to see that there will be a huge increase in the number of older Australians in the coming years, with the passage of the baby boomers into the older ages. And thanks to better health and better health care they are keeping active, staying at home and living longer lives. They also differ significantly economically, socially and culturally from the previous generation. Expectations will increase, as older Australians want more choice and more flexibility in what services are available to them and also how they are delivered. They have a strong preference for continuing to live in their homes and communities for as long as possible. Older Australians also want to have a much greater role in decisions about their care, including what services are provided and by whom and when.

It also means that the demands on Australia's aged-care system are changing. As such it is important that the government recognises these changes, and shifts and does something about them. This bill actively allows us to do just that. We talk a lot about being innovative, agile and flexible. We talk a lot about giving Australians a fair go. Older Australians should and must be treated no differently. These are our true Aussie battlers. They have battled; they are the ones we look up to. They have been through the highs and the lows of life and come out the other side.

We recognise that older Australians are important, and now the coalition government recognises that we need an aged-care system that reflects this sentiment. Presently, most older Australians are limited for choice and flexibility when it comes to who delivers their care and services. The 2011 Productivity Commission Caring for older Australians report identified a number of key weaknesses of the system, including that it is difficult to navigate, services and consumer choice are limited and coverage of needs, pricing, subsidies and user co-contributions are inconsistent or inequitable.

We have already implemented a range of measures to address these weaknesses. Some were started by the previous government, but this government is going further. We always go further, moving the aged-care system more in line with the Productivity Commission's recommendation. In January we transferred responsibility for the Aged Care Complaints scheme from the Department of Health to the Aged Care Complaints Commissioner, creating a more independent and robust approach to complaints.

The My Aged Care gateway is now supporting people to find their way through the aged-care system, and increasing its role as the one identifiable place to go for information and support to access aged care. This user-friendly site is giving older Australians all the information they require in one easy-to-navigate place, along with access and support to aged-care programs and services.

The Productivity Commission's report also stated that competition rather than extensive regulation is the key to delivering innovative, quality services and an efficient and sustainable system. Creating a competitive home care market will ensure that consumers have the ability to pick and choose their providers. It also means that older Australians will be able to choose providers based on their own specific and unique health requirements, as well as cultural or other personal factors.

The government already plays a crucial role in setting policy and ensuring safety and compliance in aged-care services. It will continue to be there to promote equity of access, support vulnerable consumers and a sustainable system. However, it must be acknowledged that market based solutions and consumer choice will increasingly be the driving force for quality, value and performance of services. As such, moving to a market based system, giving consumers choice and allowing providers to run their own services, is central to the government's plan for at home aged care now and in the future.

We live in a world where everything is at our fingertips. We are constantly bombarded with a plethora of options and choices for everything and anything. Everybody should be able to make choices. Everybody should be given the opportunity and have the ability to compare options and make informed decisions based on needs and requirements. We have all grown accustomed to this luxury and expect to have this ability wherever we go. Why should older Australians be treated any different?

In 2011 the Productivity Commission noted that:

Older Australians did not want to be passive recipients of services, dependent on funded providers.

Rather, they wanted to be independent and able to choose where they live, which provider they would use, the way in which services are delivered, and whether to purchase additional services and/or a higher standard of accommodation. There is strong empirical evidence that consumer choice improves wellbeing, including higher life satisfaction, greater life expectancy, independence and better continuity of care. Additionally, competition amongst providers in a system where consumers can exercise choice leads to a more dynamic system with enhanced incentives for greater efficiency, innovation and quality. A more flexible system would also enable providers to increase the range and scope of their services, freeing them from the current highly regulated, risk-averse regime.

In order to support and deliver more choice to older Australians, the government announced significant reforms to home care in the 2015-16 budget. The reforms support consumers to ensure they receive the services and support they need, while at the same time strengthening the aged care system, providing higher quality and more innovative services through increased competition. Changes build on the current consumer directed care approach in home care and will be introduced in two stages.

From February 2017 home care packages will follow the consumer, making it easier for consumers choose a home care provider, change providers, and also remove red tape for home care providers. This will give older Australians greater choice in deciding who provides their home care, all the while establishing a consistent national approach to prioritising access to care. The second stage will integrate the Home Care Packages Program and the Commonwealth Home Support Program into a single care at home program to further simplify the way that services are delivered and funded. This bill allows us to implement stage 1 of these reforms as well as amend the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 in three main areas.

Firstly, funding for a home care package will now follow the consumer. This replaces the current system where home care packages are allocated to individual approved providers in respect of a particular location or region. It offers far more choice for the consumer in selecting their provider, as well as more flexibility to change their provider if they wish to do so. A consumer will be able to choose a provider that is suited to them. They will be able to find providers that tailor to their specific health needs, as well as other cultural or personal factors.

Home care packages will also be portable for older Australians. If they wish to move to a new location or change to another provider, the package as well as any unspent funds will move with the consumer to their new provider. This will give older Australians a new-found freedom. It will give them the ability to change providers as their health needs change and as their living arrangements change. Providers will also no longer have to apply for new home care places through the Aged Care Approvals Round, significantly reducing red tape for businesses. This will increase competition in the sector by allowing more consumer focused and innovative providers to expand their businesses to meet local demand and consumer expectations. This will include the needs of consumers with dementia and other special needs, making finding a home care provider for unique and special needs easier and simpler.

Secondly, there will be a consistent national approach to prioritising access to home care packages through My Aged Care—the government entry point/gateway to the aged care system. Currently waiting lists for packages are managed by the individual providers. This means that there can be significant variations in the waiting lists for packages across Australia. We want to create an aged care system which prioritises the needs and circumstances of consumers based on the importance and nature of their situation. Once this legislation goes through, the prioritisation process will take into account the relative needs and circumstances of consumers. It will be determined through their comprehensive assessment undertaken by an aged care assessment team, and the time that a person has been waiting for care.

And thirdly, there will be reduced red tape associated with providers who become approved under the Aged Care Act 1997. This will help encourage new providers to enter the home care market, supporting greater choice for consumers. All providers will still need to demonstrate their satiability to become an approved provider and meet quality standards but this process will become much more streamlined.

The coalition's plan to implement these measures clearly shows that the government understands and recognises the importance of older Australians. Considering the integral role that is played by older Australians in our society, I am reminded of the painter Rembrandt. Unlike other artists who treated and painted old age with curiosity or cruelty, Rembrandt always celebrated the effects of time. He painted old age with a certain dignity and nobility, approaching his subjects with kindness and compassion. Instead of making a mockery of age, Rembrandt recognised the character of elderly faces, embracing the marks of time as beautiful. What Rembrandt did with paint, so we are doing with this legislation. We are celebrating the achievements that come with age. We are honouring the years of work and dedication to this nation. We are approaching changes to aged care with kindness and compassion. Ronald Reagan once said:

Our country is great because it is built on principles of self-reliance … innovation and compassion for others.

This is the country that we, the coalition government, continue to build. Legislation such as this allows us to extend compassion where compassion is due, to bring innovation into areas where innovation is required, and to give choices and options to those who—well and truly—have earned it. We aim to create an aged-care system which respects older Australians, a system which gives them exactly what they want—self-reliance, independence and the ability to choose how they want their healthcare delivered, by whom and when. This bill ensures that the aged-care system improves the wellbeing of older Australians through targeted support, access to quality and information services.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

Labor has a very strong record when it comes to aged care. The legislation we are debating today is building on Labor's Living Longer Living Better reforms that were introduced in the last parliament—reforms that really transform the way aged care works in Australia. This bill, the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2015 is something that we on this side of the House will not be opposing, but it is really important to make a few points along the way.

The legislation we are debating comes from the 2015 budget, and it is the first part of a two-part process. This will change the way home care packages are allocated. Instead of being allocated to a provider, home care packages will actually be allocated to a person—a person who needs an aged-care package. It gives that person choice. The whole premise of the Living Longer Living Better package was that it was person-centred; it was about the person. By allowing the dollars for the package to go to the person, it gives them greater control over how that package is delivered. My only worries are that there probably has not been enough consultation around the change. I get a little bit concerned about the My Aged Care website and about it being the central entry point. There have been a few problems with that, and I think that the government needs to work a lot harder on fixing those problems.

The first stage of the change is addressed in this legislation we have before us. It will make sure that, no matter what happens, that home care package will follow the person—so that person, no matter where they are, no matter what they are doing, will be able to link into their package and purchase services where they are living. If a person moves from the Hunter to the Central Coast they will be able to purchase a package. There will be providers in areas, but that will not necessarily guarantee that a person who needs a package will be able to obtain one immediately, because those providers will have waiting lists of their own. And one of the big problems over the years, particularly in recent times, has been the waiting list and the waiting time—the time people are forced to wait before they can pick up a package.

Generally speaking, when a person needs an aged-care package, they need an aged-care package. There is great work that is done in both the Hunter and Central Coast. One of the most innovative programs that I have been associated with operates through the Hunter area health service: if an older person over the age of 70 presents at an accident and emergency department, there is a team there that assesses that person to determine whether or not they will need extra services, and whether they can go home and live independently and can care for themselves. If it is determined that a person needs extra services, then the nurse who is responsible for coordinating the package in that accident and emergency department will contact the relevant organisations, and the person will be linked in—from the hospital, not from the community. And they organise the ACAT assessment—and I think it is really important that I put on the record that part of the requirement for a package is that a person undergoes an ACAT assessment, where it is determined whether or not they need assistance, and what type of assistance they need, and then the package is built around them—and that is the person-centred part of the package. But now it is also ensuring that the person has choice.

There have been a few glitches with the changes that have taken place through the Living Longer Living Better reforms. A lot of those glitches relate to the fact that this government does not believe in talking to people. It is very focused on the, 'what I do, what I say,' approach to implementing any policy, and it has a pretty poor record in the area of caring for and providing services for older Australians. Look at its attack on the healthcare system. Look at the fact that it has put in place structures that will lead to a reduction in bulk billing. The removal of bulk-billing incentives from pathology and radiology services is something that will impact on older Australians.

It is sad that this government is also looking towards attacking people's pensions. It has introduced changes that have dramatically decreased the amount of money that old Australians are receiving, and that is really not good enough. I strongly support greater choice and putting that choice in the hands of the consumer. In saying that I emphasise that I have been visited by many of my constituents and their families who have wished to change providers and, due to the rigidity of the rules of the moment, have had difficulty with that. Improved choice is a very good part of this bill, and that has been strongly supported by COTA, the Council on the Ageing, an organisation that has advocated for older Australians for a very long time. COTA says this will lead to older Australians receiving better services, allowing them to remain in their homes longer.

Aged and Community Services Australia are a little more cautious. They believe that 'strong supports and safety nets' need to be maintained for disadvantaged older Australians. Unfortunately, that is something this government has not embraced. It does not understand that some people work very hard all their lives, contribute through taxes but at the end of the day do not have the same level of advantage that other Australians have. It is really important that the government does not forget those people—so a word of caution there.

This legislation also replaces regional ratios with a prioritisation process to take into account an individual's needs, circumstances and waiting time regardless of location. That worries me a little. I do not want to see fewer home care packages being made available in the area I represent, the Hunter. In the Shortland electorate 19.8 per cent of the population are 65 and older. I would hope that, because there is a greater proportion of older people in Shortland, more packages will be made available in our area. I would not like to see more packages being made available in the heart of Sydney because it is easier to deliver services there. Even in my local area I would not like to see packages being made available only in the population centres. The outlying areas in the Shortland electorate, such as Catherine Hill Bay and Nords Wharf, have traditionally had to fight harder for packages because care workers have to travel further. I know that some rural electorates require even greater travel than Shortland does, and I would hope that members of the Nationals in particular are arguing to make sure their constituents are properly taken care of.

The other aspect of the bill that I am concerned about is the length of time that people have to wait for assessments. We are constantly trying to speed up that process. A person who presents at an accident and emergency department and is taken into that stream is in an advantageous position because they can bypass some of the waiting time. On one occasion the family of a constituent contacted me because their mother needed to move to a higher level aged care package. By the time the assessment took place she was dead. So waiting times are something we need to be very concerned about.

I also need to put on record problems with Human Services. Since Human Services has been involved in the system there have been significant delays in reconciling accounts, with Medicare taking up to three months or more to pay for services. This is not a direct criticism of the Department of Human Services. I understand how short-staffed they are because their staff has been significantly cut. But I also understand the implication of this delay in reconciling accounts.

This has been told to me by aged-care providers who operate aged-care facilities. The delay and the communication with human services have been less than optimal. There are problems in that area. There are problems with the long waiting times. There are also problems with the fact that this system was supposed to make it simpler for older Australians but in some ways has actually been more complex. With constant errors and misinformation given to older Australians, it is really not good enough.

This government needs to step up to the mark and remember that services are services. They are services to vulnerable older Australians. They are services that they look to the government to deliver to them. This is not about the government; this is about people, and the people that use those packages rely on them being delivered. Those people that deliver the packages rely on receiving payment for delivery. The change to give more control to older people is good, but there are a few things this government needs to work on.

Andrew Hastie (Canning, Liberal Party) Share this | Link to this | Hansard source

I agree with the member who just spoke that the role of government is to care for the elderly and for those who are vulnerable, so I speak today to support the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. I commend it because I believe it does just that.

According to the 2015 intergenerational report, Australia's older generation is on track for unprecedented growth, with the number of people aged 65 and over predicted to reach 8.9 million, more than double the current population, by 2025. This is particularly pertinent in my electorate of Canning. To give you a sense of some of the demographics: as of September last year, 16.6 per cent of Canning residents were aged between 60 and 69, 15.2 per cent of Canning residents were aged 70 or above and 49.1 per cent of the Canning population was aged 50 or above. As you can see, the question of aged care into the future is a big one, and Canning will get a lot of benefit from this bill.

Understandably, this increase will put pressure on our aged-care system, so, in order to meet the demands of such significant growth, we need to start the reform process now. That is exactly what this bill seeks to do. These reforms will be delivered in two stages that will see the focus of home care shift from the provider to the consumer in order to create a more competitive, affordable and user-friendly aged-care system.

Australians place great value on their independence, so it is no surprise that many of us wish to maintain this as we grow older. While in some instances it is not always possible for older Australians to live fully independently, the government believes that individual freedoms should not be forfeited when you reach a certain age. I know a lot of elderly Australians have spent a lot of time throughout their lives making shrewd investments, saving money and preparing for their retirement. I think the family home represents this, so I understand that a lot of elderly Australians want to remain in their family home. I speak from personal experience; both grandparents on both sides of my family remained in their family homes almost to their final years, before they moved into aged care. They enjoyed the benefits of home care. I think they would have benefited from a more flexible approach to home care. If they were alive today, this bill would certainly resonate with them.

We also recognise that conversations about aged care can be difficult to have with loved ones, which is why we are taking the initiative to simplify the process for consumers, their families and providers. Stage 1 of the reforms contained in this bill is set to commence in February 2017 and will allow funding for a home-care package to follow the consumer rather than be allocated to the provider. This builds upon the change introduced in July last year that saw all home-care packages delivered on a consumer directed care basis, allowing consumers and providers to work together to determine the most appropriate type and level of home care.

Consumer directed care also ensures greater transparency of the aged-care process by introducing individualised budgets and regular income and expenditure statements so that consumers are kept aware of how resources are being used. But, while consumer directed care is a progressive step in the right direction, further reform is necessary to bolster the aged-care system. By allocating the funding to the consumer rather than the provider, consumers will have the ability to choose the provider best suited to their needs. A central tenet of coalition philosophy is the choice of the individual to make their own decisions, whether it be through freedom of association or how they spend their money, which is what we are talking about here with particular reference to aged care.

Importantly, a redirection of funding in this manner will also enable consumers to change their provider if they are reallocating or if they feel their needs would be best met elsewhere. In the past, anyone wishing to change their home-care provider might have experienced disruption in their care either through a lengthy transition process or through lower level interim services. They also might have been discouraged from moving to another provider by the fact that unspent funds allocated to the approved provider for a particular consumer's care can be retained by that provider when the consumer no longer receives home care from them. This is not good enough. We understand that circumstances change and care should not be compromised because of this. People, particularly at a fragile time in their lives, should still be afforded choice without punitive financial consequences.

It is important to note that the changes proposed in this legislation are not driven by a government agenda. I note that the opposition broadly supports the passage of this bill. In fact, in its 2011 report the Productivity Commission found that government involvement in aged care is justifiable because of the inequitable access to services for vulnerable consumers and the provision of information.

The coalition government is committed to reforming the aged-care sector in so much as facilitating its transition to consumer driven, market based care models that are vital to the industry's sustainability. In facilitating this transition, the government is employing a bottom-up approach by consulting key industry stakeholders such as providers, consumers and department officials. The key belief underpinning this reform—that competition is essential to consumer driven care—is a sentiment thus echoed by key industry bodies:

The National Aged Care Alliance lamented the lack of consumer choice in both its 2012 and 2015 blueprints for aged care reform; and the Aged Care Sector Committee, established to guide the government with ongoing reform, notes choice, support, innovation, affordability and sustainability as its guiding principles.

While the government is focused on streamlining the aged-care process for consumers, we are also focusing on reducing the regulatory burden on providers already operating within the industry as well as those looking to enter. The first step in this direction is to abolish the aged care approvals round or ACAR. ACAR is a competitive process through which prospective and current providers are required to submit detailed proposals of their care models and capabilities in order to be allocated federally funded home-care places or capital grants. This process places an extremely high and unnecessary administrative burden on providers, who are required to submit applications focused in part on key personnel and individual performance indicators rather than the organisation's overall capacity to deliver quality consumer outcomes in aged care in line with the legislation.

If I may digress, I know that the ACAR has proved to be a significant hurdle for Canning residential aged-care providers in the past due to the regional nature by which places are allocated. For example, residential care providers in Pinjarra, located approximately an hour and 10 minutes south of the Perth CBD, have been grouped together with larger metropolitan providers to compete for places under the ACAR process. When we consider the fact that last year only 6,045 home care places were available for allocation in the 2015 ACAR, despite the 126,826 applications received by the department, it is little wonder that providers who find themselves at a disadvantage by distance are struggling to compete.

As such, I am glad to see that the government is moving on from this antiquated system. We are the government that removes red tape, not enhances it. That is not to say that providers, particularly smaller providers in rural and remote areas, have not expressed concern about the challenges associated with transitioning to market driven care—such as comparatively less marketing capability and increased costs of service provision.

There are providers within my electorate that would likely fall within this category, and so I am pleased that the government engaged stakeholders on this very issue, some of whom have noted that smaller providers should be able to better position themselves as providers of choice in their local communities by drawing upon existing local knowledge and relationships. It is perhaps also worth noting here that not-for-profits currently control much of the home-care market, overseeing 82 per cent of allocated places.

The second stage of the reforms contained in this bill is the integration of the home care packages program and the Commonwealth home support program into a single, streamlined home-care program as of July 2018. These two initiatives are already simplified versions of a range of home-care options, and thus this phase is a continuation of broader industry reform.

The government understands that these changes may overwhelm consumers who are not entirely confident in their own ability and knowledge to access the best information on aged or home care. The My Aged Care portal, a one-stop-shop that facilitates access to the most up-to-date information and services, will thus create this opportunity for consumers to better understand the process.

We also recognise that providers, such as those who have provided their feedback on these changes through Aged Care Services Australia, will also have some reservations about transitioning to a market driven aged-care sector. That is why the government has established a new Home Care Reforms Advisory Group, which will continue to provide advice to the Minister for Aged Care and the department about implementation, communication and monitoring issues for stage 1 as well as areas of stage 2.

I note the department has also been engaging with stakeholders since these changes were announced in the 2015 budget, and I am pleased hear that this active engagement will continue in 2016 and beyond. This legislation is good coalition government policy: it is consumer focused, market driven and represents innovative reform with a look to sustainability and affordability. At the height of it is the recognition of the dignity of the individual, particularly for those in their elderly years. It respects freedom of choice. It respects the fact that people have invested in their retirement, particularly in the family home, and would thus like to age accordingly in their home without disruption to their daily patterns of life.

Backed by a range of stakeholders, the legislative changes included in this bill lay down a clear path of reform that will provide far-reaching benefits for consumers and providers across Australia, including those in Canning. With this in mind, I commend this bill to the House.

Warren Entsch (Leichhardt, Liberal Party) Share this | Link to this | Hansard source

It gives me a great deal of pleasure to speak on the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. There is no doubt that Australia has an ageing population and, with advances in medical technologies, together with education about disease prevention and control, it is leading to us living longer lives.

I find in my own electorate that I am sending out more and more 90th and 100th birthday certificates—and even older—to my constituents. However, an ageing population creates challenges in how we best cater for the needs of our elderly community members—there is no-one-size-fits-all solution. We need a modern, adaptable and sustainable aged-care system so we can best help older people maximise their participation in society for longer.

This bill creates the framework for a more flexible, consumer driven aged-care system that will support older people to stay living at home much longer. It puts in place the first stage of the home care reforms that were announced by the government in the 2015-16 budget. These changes are about cutting red tape and giving consumers more choice and control over their aged care.

There are a number of areas where this funding is going to work. I refer to four of those areas. Firstly, funding for home care packages will actually follow the consumer, replacing the current system where home care places are allocated to individual approved providers to deliver service in particular locations or regions. This will give people more choice in selecting their provider and the flexibility to change their provider if they are not happy with the service or if they want to move house, for example. It also gives them the opportunity, should family members offer to support them, to relocate somewhere else. It allows them to be able to have the flexibility of being able to find another closer facility to meet their needs and to be able to maintain that connection with their family.

Secondly, the providers will no longer have to apply for new home care places through the aged care approvals round, significantly reducing red tape and regulations for businesses. Having worked with the Mossman District Nursing Home committee as they completed several ACAR applications, I know how much of a burden it is for any small community organisation in following these guidelines.

Thirdly, there will be a streamlined process for organisations seeking to become approved providers, encouraging new providers to enter the home care market while ensuring the same high standards are met.

Lastly,    there will be a consistent national approach to prioritising access to home care packages through My Aged Care, the government entry point or gateway to the new aged-care system.

In its 2011 inquiry, the Productivity Commission found that the aged-care system was prone to high levels of regulation, lack of timely access to care and very limited consumer choice. The changes being put forward through this bill will address this, with the Productivity Commission making the following points:

… consumer choice improves wellbeing, including higher life satisfaction, greater life expectancy, independence and better continuity of care. In addition, competition amongst providers in a system where consumers can exercise choice leads to a more dynamic system, with enhanced incentives for greater efficiency, innovation and quality. A more flexible system would also enable providers to increase the range and scope of their services, freeing them from the current highly regulated, risk-averse regime.

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 is for them to understand their clients' needs and deliver services that tick those boxes.

There was an earlier bill that went through the House and was passed recently which I want to touch on now as it has specific relevance for my electorate. The Aged Care Amendment (Red Tape Reduction in Places Management) Bill 2015 came as a result of a 2013 election commitment to review the administration of aged-care places in a bid to slash red tape in the sector. It makes the business of delivering aged care easier for service providers, and gets rid of unnecessary administrative processes so that service providers can get on with doing what they do best—focusing on delivering high quality care services.

Firstly, approved providers will find it much easier to transfer their places to another approved provider without having to seek approval from the department. The current process will be replaced with a simple notice of transfer.

Secondly, the bill reduces red tape by reducing the number of times that approved providers must apply to extend the period of provisional allocation. This was a major problem in my area. The department accepts that it takes providers, on average, four years to get a bed in place and operational and that 80 per cent are operational within six years. Under the changes, approved providers are now automatically given four years with the possibility of two 12-month extensions. Further extensions can be provided under exceptional circumstances. But, importantly, it means that providers have to explain to the department what the hold-ups are. These places are not just sitting in limbo.

As we see these changes continue to progress through this place, they are very much to the benefit of our community and, of course, to the client, which is very important. We had a situation in Far North Queensland over the past couple of years with aged-care places management being an ongoing and complex issue. There were numerous local media stories blaming hospitals for ambulance ramping and a claim that aged-care patients were taking up too many much-needed beds at Cairns Base Hospital because of a shortage of residential and home care places.

It was very, very difficult to get an accurate state of play as to how many beds and packages we actually were short. As a result, I asked then Minister Fifield for an audit of aged-care places in Far North Queensland that had been previously allocated but had not yet become available. As at 30 June last year, there were 386 provisionally allocated residential care places, of which over 80 were six years old or older. It concerned me that those places had been allowed to stagnate, given the demand in our region.

I recall one very sad case where a husband and wife had been separated because there were not beds available. The wife was living in residential care in Cairns, and her husband was placed in residential care in Herberton, on the Atherton Tableland, because they were not able to be placed together. In a regional area with no public transport and at that age, when they were requiring high care, it was impossible for one partner to travel the 1½ hours necessary to see the other. Sadly, by the time we managed to get it resolved, the husband had passed away. Actually we had got him a place in Cairns, and in the process of the transfer he passed away. Fortunately, with this new legislation, there will be greater accountability as to why beds have not come online. If an approved provider after four, five or six years decides not to proceed with these beds, they can be easily transferred to another operator who may be in a better position to act swiftly.

With a meaningful focus on aged care, we are now starting to see some remarkable developments in Far North Queensland. In the 2015 Aged Care Approvals Round, we will benefit from around 416 new residential aged-care places and around 109 new home care packages. In the second half of 2015, two facilities, with 338 additional places, became available, and a further 30 beds are due online in the first part of 2016.

There was a great community atmosphere at the opening of the Bupa Cairns aged-care facility in September, which brought 144 beds online, including 36 that are dedicated for dementia patients. Already, the facility has 102 residents, and it is a beautiful set-up. Anybody interested in finding out about a place there should get in touch with Bupa in Cairns, because there is still potential there for them to be able to take additional people.

One that has been very close to my heart is in Mossman. The Mossman and Port Douglas nursing care committee have been working for many years. The Douglas Shire Council have been working closely with them. They have paved the way for construction of stage 1 of the Mossman and District Aged Care precinct in Johnston Road. This is an incredible outcome, a result of over 20 years of advocacy by the Mossman District Nursing Home Committee, the council and, recently, The Salvation Army Aged Care Plus, who have come on board and will build and operate this facility. My congratulations to the founding and executive members, Marj Norris, Shirley Vico and Joan Gray. The trio were recognised as Douglas Shire Council's 2016 Citizens of the Year, and rightfully so. They have done an absolutely fantastic job over the last 20 years. We have gone from this being just a dream to something that will be a reality in the very near future. The preliminary approvals, which have just been given, include a development permit for the 42-bed aged-care facility and a preliminary approval for the balance portion of the land and reconfiguration of one lot into two lots to facilitate stage 1 of the precinct. Stage 2 is earmarked for a retirement facility that features an activities building, a community wellness centre, approximately 60 private suites and a low-care and independent living precinct over the balance of that land. It is certainly an exciting time. The Salvation Army Aged Care Plus is now free to start building this vital community asset.

Up in the Torres Strait, the Star of the Sea Elders Village is another example where flexibility is really going to make a huge difference. This is a facility that over the years had deteriorated to a point where it was in appalling condition a couple of years ago. I had been very strongly advocating to have it refurbished. It is the only facility of its kind in the world, focusing on Torres Strait people and their needs. As a result of that advocacy, I managed to get the Torres Strait and Northern Peninsula Aged Care Master Plan developed. Through that, it was fantastic to get a $19 million injection into a long-overdue refurbishment plan and redesign and a further $5.8 million for construction of new staff facilities. It has worked out very well. Sue Boisen from Blue Care tells me that the project is progressing exceptionally well and they are now applying for development approval for the refurbishment and the new staff accommodation in the near future. It was fantastic to see that come to fruition.

At the end of the day, we have got some big changes coming through in the aged-care sector, with more to come. But we are absolutely committed to the consultative approach with the sector, because their input is critical in program design and implementation. Since the budget, we have worked closely with stakeholders, and we will continue to do so through 2016, with an increasing focus on communication and transition activities to support consumers, carers, providers, ACATs, health professionals and other stakeholders. I am also very happy to hear that our new Assistant Minister for Health and Aged Care, my good friend Ken Wyatt, will be visiting Cairns later this month to hold an aged-care roundtable. I am looking forward to bringing together stakeholders from around the region. We will certainly be having some robust conversations about future changes in this sector. I commend the bill to the House.

Keith Pitt (Hinkler, National Party) Share this | Link to this | Hansard source

I rise to speak today on the Aged Care Legislation (Increasing Consumer Choice) Bill 2016, which will bring flexibility and a more consumer-driven aged-care system for older Australians. With the number of people aged 65 and over projected to more than double, from 3.6 million in 2014-15 to 8.9 million by 2055, the need for a robust aged-care system is evident. My electorate of Hinkler has an older than average population. There are 32,953, or 32.97 per cent, of my constituents who are over the age of 65. Older Australians want to stay in their homes as long as possible before going into care. Sixty-eight per cent of Australians aged 65 years and over currently live at home without accessing government subsidised aged-care services. Twenty-five per cent of elderly people living at home receive some government subsidised aged-care services. By 2050, over 3½ million Australians are expected to use aged-care services.

The 2011 Productivity Commission inquiry found that older Australians do not want to be passive recipients of services dependent on providers. They want to be independent, able to choose where they live, which provider they would use and the way in which services are delivered.

The inquiry also found that consumer choice improves wellbeing, including higher life satisfaction, greater life expectancy, independence and better continuity of care. Moving to a market based system, which gives consumers real choice, is central to the coalition government's plan.

This legislation will amend the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 in three main areas. Firstly, funding for a home care package will follow the consumer, replacing the current system where home care places are allocated to individual approved providers in a particular location or region. This will provide more choice for the consumer in selecting their provider as well as more flexibility to change their provider if they want to do so. Providers will no longer have to apply for new home care places, through the aged care approvals round, significantly reducing red tape for businesses.

Secondly, there will be a consistent national approach to prioritising access to home care packages through My Aged Care—the government entry point or gateway to the aged care system. The prioritisation process will take into account the needs and circumstances of consumers determined through the comprehensive assessment undertaken by the aged care assessment team and the time that a person has been waiting for care.

Thirdly, there will be reduced red tape associated with providers who become approved under the Aged Care Act 1997. This will encourage new providers to enter the home care market, supporting greater choice for consumers. All providers will still need to demonstrate their suitability to become an approved provider and meet quality standards.

There is no doubt that reforms in the aged care system are needed. People want more choice and they want more flexibility. I have heard firsthand accounts from constituents about their frustrations in trying to navigate the aged care system. A gentleman contacted my office to raise his concerns about the current funding arrangements and he posed this question: 'Why can't a carer who has extensive experience in handling people's finances or business affairs be given direct access to the funds when there is no need for a care provider to be involved?'

Kevin Woods' life was changed in a matter of seconds when his wife, Wendy, suffered a severe stroke in February 2010. He went from working full-time to becoming a full-time carer looking after his wife and helping with her recovery. It is a 24-hour seven-days-a-week job. I take my hat off to Mr Woods and others in his situation who take on the sometimes difficult task of caring for a loved one with limited resources.

Mr Woods' wife is eligible for 12 hours support per week in their home. Over the past six years Mr Woods has had to jump through hoops and fight tooth and nail to get additional support and care items for his wife. Mrs Woods needed a replacement second skin sleeve for her arm so Mr Woods approached their service provider and was told there were not any funds available. Mrs Woods needed a brace for her leg to help her walk. They, again, approached their provider and, again, were told there were not any funds available. In March 2014, Mr Woods was told by an occupational therapist that his wife should be showered in a wheelchair for her safety. Again, he went to their service provider and was told that there were no funds available.

After three weeks of phone calls and negotiations the service provider finally agreed to pay for their chair. To use Mr Woods' own words, there were 'nearly three weeks to get it organised, a lot of stress and three days delivery'. Why should it be this hard for someone to get equipment or aids that are clearly needed and, in this instance, deemed necessary by the consumer?

Once again, to quote Mr Woods, 'This is a woman who has lost the use of her right arm, can only walk under supervision with the assistance of a walking stick and a brace on her right leg and foot. She can understand what you are saying but cannot communicate her thoughts. She needs assistance from her supposed carers but is being blocked at every turn at the local level of an organisation supposed to be dedicated to supporting their clients.'

Mr Woods believes that capable carers could put the allowances to much better use by employing people to do many more hours per week in regular organised support and carrying out other work around the home. He believes that if he were managing the funds, directly, from the government he could access twice the number of hours per month at half the cost to the government.

I am pleased to see that under the proposed legislation the individual will get to decide which provider they want to deliver the services and then the government pays the provider on their behalf. The funding will follow the consumer, giving them greater choice to choose a provider that is suited to them and to direct the funding to that provider. A home care package will be portable for the consumer if they wish to move location or change to another provider. The package, including any unspent funds, will move with the consumer to their new provider. Currently, any unspent funds remain with the provider, which can be a significant financial disincentive for the consumer to change providers.

Consumers will be able to access information about their home care service providers, through the My Aged Care website, by contacting the My Aged Care contact centre and from the My Aged Care Regional Assessment Services and ACATs. Providers will be able to display relevant information on the My Aged Care service finder to enable consumers to choose their preferred provider. This will help ensure that special needs groups, including people with dementia, will have access to providers who cater to their specific needs. My Aged Care will be able to support consumers to choose a provider through a match-and-refer service—although it is important to note that the consumer will make the final decision about their preferred provider. Some consumers may require additional assistance to make an informed decision about their choice. A range of supports will be available to consumers depending on their circumstances, including the Translating and Interpreting Service and advocacy services through the National Aged Care Advocacy Program.

With this legislation—for the first time—there will be a consistent national system for prioritising access to subsidised home care. This will allow a more equitable and flexible distribution of packages to consumers, based on individual needs and circumstances, regardless of where they live. The Aged Care Legislation (Increasing Consumer Choice) Bill is an important step in reforming aged care in Australia to give older Australians more choice and flexibility. I commend the bill to the House.

Jane Prentice (Ryan, Liberal Party) Share this | Link to this | Hansard source

It is almost 14 years since the Howard government released the landmark Intergenerational report. It was the first report of its kind and the first time the Australian government budget process was forced to look across the generations and identify the challenges that lie ahead. One of the biggest challenges all levels of government and the wider community were forced to think about then, as now, was how we are going to house, service and care for our ageing population.

Clearly, the best outcome for most people is to grow old in their own home, in the neighbourhood that they know and within easy reach of their family, friends and community centred support networks that have developed around them over the years.

Independence is something we all value; and key to supporting people to stay in their homes when they become elderly and frail are services—such as those provided by our volunteers and community organisations like Meals on Wheels and some of our local church groups. In the Ryan electorate we are fortunate to have some of the best community-spirited volunteers who work for Meals on Wheels, including the Western Suburbs, Kenmore, Ashgrove and Mitchelton organisations. However, sometimes our older, sicker and frail family and friends need a level of care that can only be delivered in aged-care facilities or a nursing home. In the federal electorate of Ryan, for example, 13 nursing homes and care facilities are now home to some of our senior citizens—part of a fabulous generation who helped make our local community the wonderful place that it is today.

While our aged-care system is world class, more Australians are living longer as a result of better health and better care. The government recognises that we need to make some fundamental changes now to ensure that the system is more sustainable and affordable in the future. The coalition has already implemented a range of measures to address weaknesses in the current aged-care system, including some that were started by the previous government, but we now need to move to a system that is more in line with the Productivity Commission's recommendations. That is why the government announced significant reforms to aged care in last year's budget: to support older people to remain living at home.

I welcome the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016, which gives effect to the first stage of the home care reforms. I congratulate and thank the minister for bringing this bill forward. As I said before, the best outcome for most Australians is for them to grow old in their homes and their own neighbourhoods. Moving to a market-based system, giving consumers more choice and allowing providers to run their own services is central to the government's plan for the future. Tomorrow's aged-care system must be agile, innovative and creative. In harnessing the combined strengths of small business, industry, public and not-for-profit care providers, Australia's aged-care sector will deliver a sliding scale of efficient, high-quality services that will meet increasingly diverse levels of care, demand and affordability.

This bill will provide consumers with more choice and control over their aged-care services and will reduce red tape and regulation for providers. Most home care providers are small businesses or not-for-profit organisations, so they will welcome the reduction in red tape. From February 2017 home care packages will be assigned to assessed consumers, who will be able to direct government funding to the provider of their choice. Consumers will have the flexibility to change their provider if they want to; or, if they move to another district or even another state, they can take their package with them. The changes also establish a consistent national approach to prioritising access to care through the My Aged Care gateway.

I note that the government's policy changes have received widespread support and the implementation arrangements for these changes were developed in close consultation with key stakeholders, including the National Aged Care Alliance and groups representing consumers, carers and providers.

It was about five years ago that the Productivity Commission identified a number of key weaknesses in our aged-care system, including that it was difficult to navigate, services and consumer choice are limited, and coverage of needs, pricing, subsidies and user co-contributions were inconsistent or inequitable. This was an enormous call to action for government, and I congratulate this government for doing more than just studying a problem. Doing nothing should never have been an option—especially when you consider that government has known that the ratio of old to young in our society was growing rapidly since the first Intergenerational report in 2002. As John Stuart Mill best put it in his 1859 essay 'On liberty':

A person may cause evil to others not only by his actions but by his inaction, and in either case he is justly accountable to them for the injury.

Unlike Labor, the coalition recognise that, if we ignore moderate changes now, longstanding issues and concerns will grow into even bigger problems. The decisions will get harder and the solutions will slip beyond our reach. About five cent of people who live in the electorate of Ryan have at least 75 years of life experience behind them, and the other 95 per cent of my electorate are already marching slowly, year by year, on their own journeys toward their senior years. Today, that life journey is expected to go well beyond their 75th birthday. The latest Intergenerational report, for example, found that life expectancy was currently 91.5 for men and 93.6 for women—and this will increase to 95.1 years for men and 96.6 years for women in 2054-55. In less than 40 years about five per cent of Australia's population—nearly two million Australians—will be aged 85 and over.

People are living longer as a result of better health and better health care, and the demands on Australia's aged care system are changing. Older Australians want more choice and more control over the care they receive, and this demand will only increase as the baby boomers and future generations require aged care services. The changes proposed in this bill are an important step in reforming the home care system so that older Australians have more choice and flexibility to receive care and services at home. At the same time, these reforms will strengthen the aged-care system to provide high quality and more innovative services through increased competition.

As most people with a background in business know, increased competition also helps drive down price. The changes also lay the platform for future aged-care reforms, which will be informed by and developed with the Aged Care Sector Committee roadmap for reform. Whether it is an older friend who might need care in the near future or a family member who is getting older, having conversations about aged care can be difficult for most Australians. The sooner more Australians start talking about getting older—and, importantly, planning for it—the better the outcome for them, their families and their friends. The most important thing older people and their families can do is to learn about the choices available, so they can plan and make the right decision for them.

Moving to a market-based system gives consumers more choice and allows providers to run their own services. This is central to the government's plan for the future. This bill will enable the aged-care sector to provide more choice. These changes will provide consumers with more choice and more control over their aged-care services. It will deliver a national system for prioritising access to care and a new funding model that will actually follow the consumer. Importantly, it will also reduce red tape for care providers.

I commend this bill to the House.

Nola Marino (Forrest, Liberal Party) Share this | Link to this | Hansard source

The aged-care system in Australia is a world-class system. It is well respected, with high-quality services that work to meet the needs of a very diverse population. It is the envy of much of the world. However, as people are living longer thanks to better health and better health care, the demands on Australia's aged-care system are becoming greater.

Older Australians want more choice and control over the care they receive—something that meets their needs. This includes the around 12,000 residents of Forrest in my electorate who are over 70 years of age. This demand will only increase as the boomers and future generations require aged-care services. The demand for care will rapidly grow in the near future because of two major drivers: the rapid increase in the proportion of the population who are aged, and the exponential increase in demand for services by the aged population.

The increase in demand for services is an issue that all levels of government have struggled to come to grips with. In my parents day, when you got old and you perhaps had arthritic pain, it was to be endured. Today, those creaky joints are often replaced, and the expectation for such procedures and more advanced procedures is growing.

The Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016 will create the legislative framework for a more flexible, consumer driven aged-care system that will support older people to remain living at home. The greater percentage of people want to live at home until they simply cannot. This bill will give effect to the first stage of the home-care reforms announced in the 2015-16 federal budget, amending the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 to give effect to the first stage of the home-care reforms announced at that time.

These changes will provide consumers with more choice and control over their aged-care services and, importantly, will reduce red tape and regulation for aged-care providers—something you hear about when you walk through their doors. The changes will also lay the platform for future aged-care reforms, which will be guided by the Aged Care Sector Committee road map for reform, which was jointly developed with the sector. The government has a strong track record when it comes to aged care. The changes announced in the budget will build on our successful record and set the platform for future reform.

The 2011 Productivity Commission's report Caring for older Australians identified a number of key weaknesses in the system, including that it is difficult to navigate, that services and consumer choice are limited, and that coverage of needs, pricing, subsidies and user co-contributions are inconsistent or inequitable. The government have implemented a range of measures to address these weaknesses. Some were started by the previous government but this government have landed those changes and are going further—moving the system more in line with the Productivity Commission's recommendations.

The reforms will be implemented in two stages. In the first stage, commencing February 2017, funding for a home-care package will follow the consumer. This will enable the consumer to choose a provider that is suited to them and to direct the funding to that provider—the choice is in their hands. The consumer will also be able to change their provider if they wish, including if they move to another area to live. Once these changes come into effect, providers will no longer have to apply for home-care places through the Aged Care Approvals Round, significantly reducing the red tape burden for businesses. The changes will also establish a consistent national approach to prioritising access to care.

Building on this first stage, the government has also indicated it will move to a single, integrated care-at-home program. This is a major policy change which has received widespread support, and the implementation arrangements for these changes have been developed in close consultation with stakeholders, including the National Aged Care Alliance and groups representing consumers, carers and providers.

The second stage 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—further simplifying the way that services are delivered and funded. The government intends to introduce the new integrated program from July 2018.

In January this year, the government transferred responsibility for the aged-care complaints scheme from the Department of Health to the Aged Care Complaints Commissioner, creating a more independent and robust approach to complaints. The My Aged Care gateway is now supporting people to find their way through the aged-care system. In spite of some initial difficulties, it is now undertaking assessments for those people who need low-level care at home. It is increasing its role as the one identifiable place to go for information and support to access aged care.

There has been significant work done to address inconsistency and inequity in the pricing and consumer contributions to the cost of their care. The Productivity Commission's report also stated that competition rather than extensive regulation is the key to delivering innovative quality services and an efficient and sustainable system. The government maintains a crucial role in setting policy and in ensuring safety and compliance in aged-care services. It will be there to promote equity of access, provide support for vulnerable consumers and address market failures. But is has to be acknowledged that market-based solutions and consumer choice will increasingly be driven by and the driving force for quality, value and performance of services. Moving to a market-based system, giving consumers choice and allowing providers to run their own services is central to the government's plan for the future.

I want to talk about Capecare, one of the leading providers of care and accommodation services for seniors in the south west, located in Busselton, right on the shores of Geographe Bay. Capecare's board has always been very proactive. John Reid, the chair of the board has always been a hardworking passionate advocate and is an a persistent and effective leader who has a very clear commercial focus on Capecare as a business while never forgetting that he is there for the people he is seeking to provide services for—our very respected and valued senior citizens.

The facility and services have consistently evolved to meet the changing needs of their clients and the Busselton-Dunsborough seniors community. One thing that attracts people to Capecare is their multilevel service approach, with just one organisation that can manage the individual changing needs of their clients as they move through their lives, starting with completely independent living through to complete nursing home and dementia care for both high- and low-care residents. This gives the people who live at Capecare incredible confidence and comfort—knowing that, no matter what their aged-care needs are or may become in their lives.

Capecare has an innovative and proactive approach to providing for those needs. Care can be provided in their nursing home or hostel environments with 24-hour care, and people can have domestic assistance, therapy and activities included. For people who wish to remain living independently at home, Capecare offers in-home services as well as day respite. Capecare was founded by Jack and Maud Ray over 50 years ago. A new hostel wing was completed last year, with 54 new rooms. It is now the largest regionally based independent aged-care provider in Western Australia, employs over 200 staff and stays very closely connected to the local community, which is particularly important in aged care, through its more than 125 volunteers. I commend the bill to the House.

Sussan Ley (Farrer, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

I am very pleased to sum up the debate on the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. The government announced significant reforms to aged care in the 2015-16 budget to support older people to remain living at home. This bill gives effect to the first stage of the home care reforms. From February 2017, home care packages will be assigned to assessed consumers, who will be able to direct government funding to the provider of their choice. Even more importantly, they will have flexibility to change their provider if they want to or, if they move to another area or state, they can take their package with them. The changes will also establish a consistent national approach to prioritising access to care through the My Aged Care gateway.

Building on this first stage, the government has also clearly signalled its intention to move to a single, integrated care at home program. The second stage of home care reform will further simplify the way that services are delivered and funded, and will commence from July 2018. These changes will provide consumers with more choice and control over their aged-care services and will reduce red tape and regulation for providers. At the same time, the reforms will strengthen the aged-care system to provide high-quality and more innovative services through increased competition. This major policy change has received widespread support and the implementation arrangements for these changes have been developed in close consultation with stakeholders, including the National Aged Care Alliance and groups representing consumers, carers and providers.

I thank all honourable members for their contributions to debate on this bill, for the interesting and passionate stories that they have told about the aged-care facilities in their electorates, the people they know and the understandings they have about the system and their broad support for the changes we are making—all with the individual firmly at the centre.

Moving to a market-based system, giving consumers choice and allowing providers to run their own services is central to the government's plan for the future. In its 2011 inquiry, the Productivity Commission identified a number of key weaknesses of the system, including that it is difficult to navigate and services and consumer choice are limited. The government has implemented a range of measures to address these weaknesses. Some were started by the previous government, but this government has landed those changes and we are going further—moving the system more in line with the Productivity Commission's recommendations.

As people are living longer thanks to better health and better health care, the demands on Australia's aged-care system are changing. Older Australians want more choice and control over the care they receive. This demand will only increase as the 'boomers' and future generations require aged-care services. Government is developing an aged-care system that can respond to this demand for the current and future generations of older Australians. I commend the bill to the House.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.