Julie Collins (Franklin, Australian Labor Party, Shadow Minister for Regional Development and Local Government) Share this | Link to this | Hansard source

I move:

That this bill be now read a second time.

It is a well-known fact that Australia, like many other Western nations, has an ageing population.

There are currently around 3.6 million Australians aged over 65—and this figure will triple in the coming decades.

More than 1.2 million services are currently provided to older Australians and that demand is rapidly growing.

The need to provide quality, affordable and sustainable services for an ageing Australia is not a future issue—it has been upon us for some time now.

And that is why almost five years ago the former Labor government introduced a landmark package of reforms to transform aged care in Australia and to prepare for the challenges and the opportunities of an ageing population.

Labor delivered the biggest reforms to aged care and to ageing in a generation.

The $3.7 billion 10-year strategy known as the Living Longer Living Better package was formulated in line with the Productivity Commission's report Caring for older Australians.

Labor did the heavy lifting and tackled the provision of services for older Australians head on.

It included extensive consultation, which ensured that the reforms had broad public and sector support as well as bipartisan political support.

The Living Longer Living Better reforms provided a 10-year plan to build a better, fairer, more sustainable and nationally consistent aged-care system to meet the challenges of an ageing population.

The reforms delivered a clear vision that by 2022 Australia's aged-care system would:

Significant progress has been made regarding the provision of residential aged care, including:

Labor laid a strong framework to build the aged-care services that Australians who have contributed to our community for their entire lives deserve.

Unfortunately the instability and inaction of the Turnbull Liberal government—more focused on its internal divisions—is threatening the continued progress of these critical reforms.

Between Tony Abbott and Malcolm Turnbull the government has made ageing a dirty word and treated older Australians as second-rate citizens.

Of serious concern has been the government's failure to do anything to address the sustainability of government funding of residential care, specifically through the aged-care funding instrument.

Over the last two budgets the government has delivered an almost $2 billion cut to funding for residential care to 2020.

The government has attempted to justify these cuts on the basis of higher than expected growth in aged-care funding instrument expenditure, particularly in the care of older Australians with complex healthcare needs, which it states cannot be explained by an increase in the frailty of residents.

Unfortunately, in doing this the government has refused to release details around the projected growth or its full modelling on its proposed measures and cuts, despite requests from the aged-care sector and despite a FOI request from Labor.

The government stated that:

In developing the measure, the Government consulted with the sector to understand the areas of ACFI that could be better aligned with contemporary care practices.

The response from the aged-care sector and from aged-care consumers to these cuts and the lack of genuine action on the predictability of the Aged Care Funding Instrument would suggest that the government has, in fact, failed to consult on these measures—or worse, it did consult but ignored what it heard. Older Australians deserve fair, affordable, quality services to ensure that they can age well—in their homes and in their communities. Without funding transparency and certainty, the aged-care sector simply cannot deliver for our rapidly growing ageing population. The minister stated in May 2016 that she is:

… concerned the current Aged Care Funding Instrument (ACFI) model is too complex and not always clear about what can be claimed.

Indeed, a recent judgement of the full Federal Court found that the Aged Care Funding Instrument documents are 'riddled with ambiguous, uncertain and inconsistent language', and that they should be reviewed. A University of New South Wales study into the utility of the Aged Care Funding Instrument in care planning found that the current model is not effective in improving care outcomes. A 2014 survey undertaken by the Australian Physiotherapy Association found:

… ACFI is prescriptive, inflexible and allows only limited interventions that are passive and not supported by evidence-based practice.

Most critically, many providers have stated that the current structure of the Aged Care Funding Instrument delivers unintended consequences by encouraging treatment not based on clinical need for care outcomes but on funding outcomes. Leading Aged Services Australia, Aged and Community Services Australia, the Aged Care Guild, United Voice, the ANMF and a host of aged-care service providers have all called for a proper review of the Aged Care Funding Instrument and its connectedness to care outcomes. The architect of the Living Longer Living Better reforms and the then Minister for Mental Health and Ageing, Mark Butler, said, when introducing these reforms, that critical to ongoing progress in the aged-care sector would be:

… an independent review of the reforms within five years. This ensures that the momentum is maintained in those areas identified by the Productivity Commission as essential reform foundations.

He said that the reforms would be critical because:

We want to know what works and we want to know what does not.

As per the Aged Care (Living Longer Living Better) Act 2013, this review must be completed and reported to the minister by 1 August 2017. On 22 September this year, when the Assistant Minister for Health and Aged Care announced the appointment of David Tune to lead the legislative review, he stated that the review will assist the government to make aged care more sustainable and affordable. Despite this commentary, the assistant minister has given no clear commitment that this review will include an evaluation of the aged-care funding and alternative funding models or undertake a proper review of the Aged Care Funding Instrument as part of this process.

The aged-care services sector and older Australians simply cannot afford for this review to spend the next 10 months consulting about the future of aged-care services in Australia and then fail to report on the future funding needs of the sector. The only way we can develop a sustainable, transparent and predictable funding model that provides Australians with the care that they deserve into the future is through a proper review that brings government, consumers and the sector together. This legislation that I am putting up today will put residential aged-care funding front and centre of this review process and will allow an open and transparent discussion about developing a sustainable funding model for the benefit of all Australians into the future.

The way that this government and future governments fund aged care, the changes that they make and the quality of life are really important to every resident in aged care and every future resident. The Turnbull Liberal government's decision to support an open and transparent review about a sustainable funding model for aged care will determine whether people have the best end of life possible. This bill, if passed, will ensure that the review of Labor's Living Longer Living Better reforms includes a review of the Aged Care Funding Instrument that is needed. Labor calls on the Turnbull Liberal government to make the right choice: to back this piece of legislation and to put the care needs of older Australians first and foremost.

Tony Smith (Speaker) Share this | Link to this | Hansard source

Is the motion seconded?

Gai Brodtmann (Canberra, Australian Labor Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

The motion is seconded, and I reserve my right to speak.

Tony Smith (Speaker) Share this | Link to this | Hansard source

The time allotted for this debate has expired. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.