Emma McBride (Dobell, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Aged Care (Single Quality Framework) Reform Bill 2018. This bill amends the Aged Care Act 1997 and the Australian Aged Care Quality Agency Act 2013 to make provision for a single set of aged-care quality standards that will apply to all aged-care providers under the Aged Care Act. The bill will also vary the functions of the chief executive officer of the Aged Care Quality Agency to reference the Aged Care Quality Standards.

In my community on the Central Coast of New South Wales, aged care really matters. We are an older population. One in five of us living on the Central Coast is aged over 65. And one in six of us, or 19,000 people, is employed in health care and social assistance. It's the biggest workforce on the Central Coast and it is the workforce I come from. I'm a pharmacist and have worked in health for almost 20 years. I will never forget my first visit to an aged-care facility. It was 1998 and my first year as a registered pharmacist. I was delivering medications to a psychiatric nursing home in the inner western suburbs of Sydney. I walked in, and it was a picture of misery. I walked out and took some time to pull myself together before going back into the facility, as the week's medications just had to be delivered.

Last week, I spoke at a forum on the Central Coast organised by the Health Services Union—my own union—called 'Our turn to care'. We heard stories from aged-care workers that took me right back to that first visit that will never leave me. I heard that aged-care workers had been told to wait until a person's incontinence pad was 70 per cent wet before it could be changed, that they were only allowed one pair of gloves per shift because the second pair would be too costly, and that the money spent on each person per day in an aged-care facility is sometimes just $6 per day. Older Australians deserve to be cared for with dignity and respect. Aged-care workers deserve support and resources to care for people with dignity and respect. Clearly, we must do more to make sure that all aged care is quality aged care.

Currently, there are standards that cover three different areas of care. They include four standards for residential aged care, two standards for home care and two standards for the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. The eight new standards across all areas of care will be effective from 1 July 2019. This is an amended date as there were concerns from the sector that the original 1 July 2018 start date would give stakeholders and providers little time to do the necessary preparatory work.

The new standards will focus on quality outcomes for consumers rather than provider processes, and they have been driven by the sector and other stakeholders since 2015. The Review of national agedcare quality regulatory processes, also known as the Carnell-Paterson review, handed to government on 25 October last year, had a focus on quality care. The review made 10 recommendations, one of which was to establish an independent aged care quality and safety commission. The government adopted this recommendation back in April but is yet to provide details in relation to this new quality and safety agency. Labor welcomed this announcement by the government, but we are concerned it has not given consideration to the delivery of care across multiple settings.

I have worked across multiple settings in my professional life as a pharmacist, but it was when my father was diagnosed with younger onset dementia that my view of health care was turned upside down. When you're sitting across the consult table as a daughter and a carer, rather than as another allied health professional, your world view shifts. I think we have to be very mindful that there are different demands and different requirements across different settings. Through my late father's experience, I've now had firsthand experience of residential care, in-home care, respite care and day centres, and each setting has different requirements. That is something the government should be really mindful of when this detail is worked through.

The minister's announcement seemed to be focused on those providers delivering care in a residential aged-care environment, and I think it needs to be less narrowly cast. What hasn't been at the forefront of any discussions is the protections for people who choose to age at home. My father passed away in February, and we were very fortunate to the end to be able to care for him within our own home and to have palliative care at home as well. If families are supported properly to do that, it's something that more families may do. It gives people at the end of their life the dignity that we would want for ourselves and for those we love.

The government must give consideration to the growing delivery of care in the homes of older Australians. As I said, I recently lost my dad, who lived with younger onset dementia. In helping my mum care for my dad, with my brothers and sisters, I saw a different side of the health system to what I'd seen in all my years working as a pharmacist in community and hospital settings. Labor is keen to understand how the government will ensure the quality of care delivered in the homes of those who choose to receive part of their care at home, through home care packages, as well as the quality of care delivered in residential aged-care facilities. And Labor looks forward to hearing how the government will integrate home care into the newly established commission. This new agency is due to begin on 1 July 2019, so the government has much work to do to make sure it gets this commission right, and we will do all we can to support them to do this.

Making sure that all aged care is quality aged care is not just a function of standards, although standards really matter. Quality aged care can't be achieved without proper funding. Yet, despite all the rhetoric in the lead-up to the budget, there was not one extra dollar for aged care in this year's budget. What the government has done is pretend to put new money in aged care, but the reality is there isn't any additional funding for aged care. Money has gone from residential care to support home care packages. There's no new money. This is after the Abbott-Turnbull government has cut aged-care funding by billions over the past five years. Every Abbott-Turnbull government's budget has cut aged-care funding. We've seen funding cuts to the Aged Care Funding Instrument and funding cuts to residential aged care, billions of dollars that are no longer supporting older Australians in residential care. It is now clear that the build-up to the budget and the government's rhetoric about aged care did not match what was finally announced, sadly. What the government did in its budget was simply cut money from residential aged care to pay for home care packages.

Over the past five years, the Abbott-Turnbull government has slashed billions of dollars from aged care, and it is solely responsible for the growing waiting list that exists for in-home care. We know that across Australia there are over 100,000 people currently waiting for home care packages. We know that many of those people have accepted packages below the level that ACAT has assessed that they require. We know that in my community of the Central Coast there are currently 750 people waiting for home care packages—a third of those people with high needs, dementia or those type of conditions. How can the government find $80 billion in tax cuts for big business, including $17 billion for the big banks, but not find one extra dollar to invest in the care of older Australians, of our mums, our dads, our grandmas and our grandpas? It is extremely disappointing that the Turnbull government did not use this year's budget to invest in the care that older Australians deserve.

Older Australians need the government to act now. What I haven't seen from the government is any sense of urgency. There doesn't seem to be an understanding that this is something that can't wait, that people that need this care aren't able to wait, that their families can't wait and that they are under enormous strain. Funding just 14,000 new home care packages over four years—it was a hoax; it really was, because 3,500 places a year isn't even enough to keep pace with demand. The waiting list grew by 20,000 in the last six months of 2017 alone. It's particularly cruel after promising older Australians that they would address the wait list. The people that I have met through my dad's experience, particularly people living with younger onset dementia—there's a particular set of circumstances when you're caring for somebody with this type of diagnosis in their 50s or in their 60s, when their primary carer is typically someone who is still in the workforce and still paying a mortgage. There are particular demands on these people that other people perhaps don't have, and it's something that we really need to shine a light on.

Even the Minister for Aged Care was forced to admit what we already knew, that the home care packages announced in last month's budget wouldn't come close to solving Australia's aged-care crisis. Responding to whether the new home care packages announced in the budget would be enough to solve the crisis, the minister could only say that the Turnbull government would have to consider new measures. They need to act now. This is urgent. I really look forward to hearing what these new measures will be and when they'll be delivered, and so do many of my constituents.

In my community on the Central Coast of New South Wales there are 30,000 people who care for someone else every day. That would be mirrored in electorates across the country. Just one example from my electorate is a man in his mid-70s who lives alone. He lives with mental health and has difficulty navigating the aged-care system, which for anybody is difficult to navigate—it's overly complex and it's not straightforward. If you were in a situation of crisis, it's not something that you would have the capacity to do. He had been assessed by ACAT as requiring a level 4 package. He had been waiting three months in April, and his condition is deteriorating rapidly. He receives just one hour of cleaning per week. That is all the support that this person receives at the moment.

What is of further concern is that the government is now delaying the public release of the next quarterly data wait list for home care packages. The last package of data revealed that almost 105,000 older Australians are waiting for home care packages right now, with the average wait time for a high-level package now more than a year. As I've said, people who are assessed as needing a level 4 package aren't people that can wait a year; they're someone with complex needs, someone with end-stage dementia or someone at risk of a fall which would end up having them hospitalised and then going straight into residential care. These are the sorts of people that are assessed as level 4.

As we know, the demand for home care packages grew by 20,000 older Australians in the last six months of last year. The Minister for Aged Care must be honest with older Australians and immediately release the latest round of data on the wait list for home care packages. People need to know where they are in the queue. People need to have certainty. People need to be able to make decisions based on reliable and up-to-date information. As you would expect, most people go into residential care within 10 kilometres of their home. People want to be able to stay near their GP, they want to be able to go to the pharmacist that they've been going to for decades, they wants to be able to be visited by their family and they want to visit people who they know, their friends and family. But they need certainty, particularly people with complex needs, who know that the wait lists are longer for them because of the types of needs that they have.

With the latest quarter ending in March, this data is now well overdue. The questions Labor are asking this minister are: where is the data, why is there a delay, is there something that the minister is hiding, is there something that the public deserve to know and is there something that families and individuals need to know now?

If the Turnbull government is confident that its baby boomer budget will deliver for these older Australians, it should release the latest data on home-care packages immediately. It must be released to the public. People deserve to know. Families deserve to know. People waiting in limbo need to know. The Turnbull government created this aged-care crisis, the Turnbull government is ignoring this aged-care crisis and it's budget fails to fix the aged-care crisis. With some older Australians waiting years for the care they need, the government must take action now.

In conclusion, I know the experience in my community would be the experience of many communities across Australia. We have an ageing population. People are living longer. What that means is that we have a different set of circumstances to what we've had in our society before. What it means is we need to plan better to support people to be able to, firstly, live better at home, because that's what most people want to do. Most people want to be able to live at home with dignity and respect. That was my father's choice. He wanted to be able to live in his own home, the home that he designed and built. My dad was an engineer and a builder. That, to him, meant more than anything else. I think that's something that we need to do. We need to respect the wishes of older Australians. We need to give them dignity and we need to treat them with care. In order to do that, aged care must be properly funded. The people who work in aged care must be properly paid. They need better support to be able to care for people.

People who work in aged care do so because it's a vocation and they really want to help and support other people. All that people working in aged care are asking for is to be properly paid. All they're asking for is to have the resources to be able to care for people who are within their care. That's what this government is not allowing them to do. The government doesn't see the urgency, it hasn't properly seen the crisis and it really needs to act now. I implore everybody in this House to make proper funding of aged care and proper support for people who work in aged care a priority and to act now.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

It gives me great pleasure to speak about the Aged Care (Single Quality Framework) Reform Bill. I've spoken about these issues in this place many, many times. In 2004, when I was first elected, I had one of the oldest electorates in the country, and it remains so. That's why issues that deal with aged-care support and issues that deal with older Australians and the assistance they require in their older age are very important to my electorate—and to all of us on this side of the House, I must say.

What we know is that these people worked all their lives, contributing to and building our nation, making it one of the best countries in the world and helping the next generation to prosper. It is very important that we as legislators in this place do whatever we can to ensure that these people are given the services they require in old age in a way that gives them dignity and helps them continue their lives as best as possible. We need to put the services in place to ensure they are looked after in their old age. We look after children. We look after workers. We look after people who are unemployed. We look after people who go to hospitals. Aged care and aged-care services are no different. It should be a priority to provide every service we can to these people. I will always do my best in this place to ensure that I represent older Australians and that they're dealt with in a compassionate and respectful way.

We've heard different members from this side speak. I applaud the member for Dobell, who made such a passionate speech and told her father's story. There are thousands of similar stories around the country of people who have parents, uncles, aunts and grandparents who require care. This bill goes some way towards assisting them and ensuring we have a system in place that ensures services are provided in a proper way and there are mechanisms in place for checks and balances.

The bill will also vary the functions of the chief executive officer of the Aged Care Quality Agency to reference the Aged Care Quality Standards. Currently, there are standards that cover-off on all three different areas of aged care. They include residential aged care, with four standards; home care, with two standards; and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program quality review, with two standards. The eight new standards in the bill, across all areas of care, will be effective from 1 July 2019. This is an amended date, as there were concerns from the sector that the original 1 July 2018 start date would give stakeholders and providers little time to prepare the necessary work.

So we know that it's already delayed by one year. The government has dragged its feet on this. The new standards will focus on quality outcomes for consumers. We know that since September 2015 the Department of Health has consulted with stakeholders and all other agencies to seek input into the content of the quality standards. Peak stakeholders have been contacted to garner their views. At this stage they are still assessing the bill and the explanatory memorandum that's with the bill.

I have to say that although we support the bill, there are a few areas of concern. Certainly, there are concerns that I have and that the opposition has. I mentioned earlier the length of time that it's taken the government to introduce legislation into the parliament. This was a 2015-16 measure. Here we are in 2018, and it won't start until 1 July 2019.

There are many areas that this particular government hasn't concentrated on. There are gaps in our aged-care reform bills and gaps in the regulatory system, and one of them is the home care that is required by so many retirees and older Australians around the country. We heard the minister announce 14,000 aged-care packages in the budget. I have to say that when I think of those 14,000 aged-care packages, as welcome as they are, it's the biggest con that I've seen in this House of Representatives. I say so because there are approximately 110,000 people waiting for packages currently. There is a list with 110,000 names on it for people who require packages. That list is growing by 10,000 to 20,000 every quarter. Every quarter it's growing, so we could have anything up to 160,000 or 180,000 on that list by the end of the year. Yet the minister announced the 14,000 new packages with a party-type atmosphere—hoo-ha, hurrah!—that this was the pinnacle of aged-care reform and would solve all the problems.

What a joke! It's an absolute joke, and a disservice to our older Australians. This is the biggest con since the movie Dirty Rotten Scoundrels. I can just imagine the minister sitting in cabinet with all the other ministers around him, telling him about how good this would be—the 14,000 new places—and all laughing amongst themselves because they knew it was a con. And it is a con. Every Australian can see through this. There are 100,000 people waiting on a list for aged-care packages, and the list is growing by 10,000 to 20,000 every quarter. And we announced 14,000! It is a drop in the ocean, and will do absolutely nothing to support those people who have worked all their lives, who have built the foundations of this nation and who have ensured that we live the lives that we live today because of their hard sweat, blood and tears in past generations.

I think that as a nation and as a government we can do better than that. As a nation, we should be doing all that we can for these wonderful people who are our mothers, fathers, grandparents, great-grandparents and people close to us who we love—our neighbours—because that's the way that it is here in Australia. These are people that we have to look after. We'll be measured in the future by the generations to come on the standards and on the support that we gave to older Australians, and I have to say at this point that we're not heading on the right track. It's getting worse, and it will be worse unless we make some drastic changes.

We heard the member for Dobell say how we are becoming an ageing population. We are living a lot longer, and that's a great thing. But if we're living a lot longer we also have to put services in place that will look after our older Australians. And the services, I have to say, are not there. We're not funding them properly and not providing adequate packages to keep people at home, and we know that people want to stay at home. If you ask the majority of Australians, 'What do you want to do when you get older and frailer?' they will say, 'I want to remain in my house: the house that I've lived in my entire life; the house that's close to my family; the residence that's within my community—my community groups, my friends, my relatives and my neighbours.' It's a natural thing to want and to aspire to, and it should be natural for us in government and in parliament to try to produce some policies and a framework to make sure that that happens. But, to do that, we have to fund these services adequately, and, as I said, we're currently not doing that.

We have to think outside of the square and try to come up with a system that is funded properly to provide those services and to treat these people with absolute dignity, because, as I said, they're the people who worked hard and built the foundations of this nation that we stand solidly on today. We are a great nation. When you look at the history of Australia, we are one of the best nations in the world. That's due to our forebears who worked so hard. In many cases they fought in wars. They paid their taxes and, because of their blood, sweat and tears, ensured that today we have comfortable, good lives.

Residential aged-care facilities are mirrored in the homes of those who choose to receive care as part of the home care packages. We look forward to hearing how the government will integrate home care into this newly established commission as well. This new agency is not due to begin until 1 July 2019, so it has already been delayed by 12 months. The government has a lot of work to do to ensure that this commission is the right way to go and that the correct systems are in place. It's really unfortunate that this bill won't do much to address the home care package crisis, but it is important for me to mention it all the same. It's a topical issue. It comes up many, many times on talkback radio. There are letters to the editor. People talk to me when I'm having street corner meetings, visiting shopping centres and doorknocking. Constituents who contact me say, 'My parents'—or an aunt or grandparents—'are waiting for a package.' What happens is that, when you're waiting for 12 to 24 months, as people who have come to my office have told me, you become frailer and weaker. If those mechanisms aren't in place to support you, you will become frailer very quickly. What does that mean? It means you will end up in the acute emergency department of a hospital or in an aged-care facility, which then costs the government and every taxpayer a lot more. So isn't it better to ensure that we have the packages that people require to keep them at home and keep them healthier? They will also keep the expense down.

This is what will happen and what happens currently when people aren't getting the required packages: I've heard of people who've been on waiting lists for over a year and have passed away before they have even received their packages. I have many examples, which I have sent to the minister. I've sent all of them in writing. Unfortunately, we get back standard responses and nothing much is done about them. It is very sad to see people come to my office to talk to me about their parents who are very frail and want to stay at home. They want to give their parents the assistance that they require. They want to make sure that they do everything they can to care for them. What happens in many cases is those carers also then become ill and sick through the pressure and the work that they do. It's very disappointing to see that this particular area in this bill did nothing to address the home care packages.

A lot of good work has been done by Leon Byner on 5AA in South Australia. Leon is currently running one of the highest-rating programs on radio in Adelaide and he has been running a campaign on this for a long time. Many people call in and he refers them to us. We write letters to the minister, but unfortunately these falls on deaf ears.

I worry that this is the new norm with the government. There are issues that are pressing for our communities, issues that we need to deal with, and we just fluff them away, like we did with this particular announcement during the budget of 14,000 home care packages when we know that there are 100,000 on the waiting list and that that number is growing by 10,000 to 20,000 every quarter. This government funded the 14,000 new home care packages over four years in this government's budget, but it was nothing but a big hoax. It's particularly cruel, after promising older Australians it would address the waiting list. These were promises made by this government, but, to date, we haven't seen anything. Even the Minister for Aged Care was forced to admit what we already knew: the home-care packages announced in last month's budget wouldn't come anywhere close to solving Australia's aged-care crisis. It's certainly a crisis that exists within my electorate, being an electorate with one of the oldest populations in the country.

Responding to whether the new home-care packages announced in the budget would be enough to solve the crisis, the minister could only say that the Turnbull government would have to consider new measures. That is an admission in itself that it's not working, that the new announcements are not going to work and that we need to do a lot more in this area.

We also know the government's delaying the public release of the next quarterly data wait list for home-care packages. We know they're doing that, and we know why: because the list and the numbers on that list are growing. They're growing and we're not doing anything about it. We're asking the minister many questions. Where is this data? Why is it being delayed? Is there something that you're hiding? I don't think there is anything that he's hiding, because it's common knowledge. Everyone knows that this list is growing, and will quadruple before we know it.

The Minister for Aged Care must be honest with older Australians. I know the minister. I know that he cares. I know he has real empathy for our older Australians. But it's his own side that's letting him down, that's not assisting him or supporting him in coming up with good measures to ensure that we look after our older Australians. We know, through the estimates process in the Senate, that the Department of Health has previously committed to releasing data two months after the period that the data covers, yet the government won't do it. With the latest quarter ending in March, this means the data is already a fortnight late. Again we ask: what is the Minister for Aged Care hiding in the latest round of data? The last package of data revealed almost 105,000 older Australians were waiting for packages, and they know that those numbers are blowing out each year.

As I said, the demand for packages grew by 20,000 in the last six months of 2017 alone. As our national demographic ages, we know this will become a bigger issue. We know that the Turnbull government has promised the world to older Australians waiting in the queue for these packages but they're getting nothing. I've already mentioned that, sadly, the Minister for Aged Care has already admitted the government will need to consider other interventions. That's an admission that you need other interventions to reduce this waiting list. I'm personally sick of waiting, and the minister— (Time expired)

Chris Hayes (Fowler, Australian Labor Party) Share this | Link to this | Hansard source

Mr Deputy Speaker:

You had to watch residents being abused by staff and know that even if it was reported, nothing would be done because they couldn't do without the staff member. People were lying in wet beds for hours on end because there were not enough staff to change them.

That's an extract from a recent survey, conduct by the Health Services Union's New South Wales branch, entitled 'Your Story'. I've chosen to utilise this extract to open the debate on this bill not because I'm proud of the current state of the aged-care sector but because I believe it succinctly puts into perspective the dire situation faced by many elderly Australians around the country today. It's stories like this that lead me to raise a voice for vulnerable Australians in what this House is doing this afternoon, although I do note the absence of many who want to contribute on the other side.

The Aged Care (Single Quality Framework) Reform Bill before us essentially makes a single set of aged-care quality standards that will apply to all aged-care providers under the Aged Care Act. As a consequence, the bill also varies the functions of the chief executive officer of the Australian Aged Care Quality Agency to reference the Aged Care Quality Standards. The implementation of the Aged Care Quality Standards will replace the separate existing standards applicable to residential, home care and flexible care services.

Situations like the one I recounted earlier are not unique. Media stories we hear on a regular basis, such as that of the Oakden facility in South Australia, highlight the inappropriate care outcomes facing many elderly Australians. It is for this reason that we will be supporting the passage of this bill today. We welcome the uniformity of a single set of aged-care standards and the shift towards quality outcomes for consumers rather than providers. However, we do so with some caution. We're not going to allow the community to be fooled into thinking that this government has a genuine care about elderly Australians because, if they did genuinely care about elderly Australians, you wouldn't have had to wait for two years after the 2015-16 budget for these measures to be introduced. In addition, the government has shown no willingness to work with our side of the House. It is not seeking to have a bipartisan position. At no stage has the government consulted the shadow minister prior to even introducing the legislation before us now. It shows that they are not determined to have a bipartisan approach adopted when it comes to aged care.

This bill reinforces that this government has misplaced priorities; you only have to take a look at the most recent budget handed down by the government. The government has not put the best interests of older Australians front and centre. It has, in fact, done the opposite. It has been said by many speakers before me that this government really has played a hoax on older Australians, pretending to allocate more funding to aged care when, in reality, as the government knows, not one single extra dollar was put into aged care. What they did in the budget was merge two line items—one for aged-care facilities and one for home care—and say, 'This is the injection of new funds.' I felt very sorry for the minister. Whether they told him or not before budget day, I'm not quite sure. He is a minister who has a good reputation among all of us. Trying to sell an approach that he wouldn't have known about then was completely wrong. Not one extra cent went into aged care.

On top of this, keep in mind the Abbott-Turnbull government's previous cuts to aged care that robbed the industry of billions of dollars. We've had an MPI debate only today that largely centred around the Prime Minister's view about aged-care workers and what sort of tax entitlements they would be entitled to compared to what tax benefits a millionaire would get. I think it was particularly offensive—and I saw many of those opposite put their heads down when he said it—that he said that maybe they could aspire get a better job. Resulting out of his comments in that regard, my brother—who is, by the way, the general secretary of the Health Services Union—wrote: 'In Mr Turnbull's world, your worth is measured by your earning power, not the difference you make to people's lives. The aged-care workers I know are deeply caring and empathetic people who are driven not by money but the desire to make older people's lives better. Of course, thanks to Mr Turnbull and his government's savage cuts to aged-care funding, this job is so ridiculously underpaid and getting harder every day.' Whilst my brother might be a trade union official, I think he probably echoes the view of many workers in the healthcare industry, who we come to rely on but we all know are hopelessly underpaid at the moment.

While all this is going on and while they're not putting one extra dollar into aged care, they are absolutely committed to giving big business a $80 billion tax cut—and to big banks. We all know the view that they have taken for the last couple of years on a royal commission into banking. As the royal commission starts to roll out its findings, the government know what's happening in the financial sector, but the big banks are still going to get a $17 billion tax cut—and yet we cannot find enough money to put in to cater for elderly Australians. I think that says much about their misplaced priorities. Thinking about trickle-down economics, all that is wonderful, but I am sure people who represent the Liberal and National Party side have elderly Australians in their electorates too. I am sure they have people in their communities whose relatives care about getting the best care they can, whether it is in residential care or in-home care or from flexible care services. We too share that. I think those opposite should be more committed to the people who have contributed so much of their lives for the betterment of our country, have paid their taxes and have been ideal model Australians in their older years. They are going to be subject to this cruel hoax of being told that the government is investing more in health care only to find out there's not a dollar more going in.

I will quote again from the Health Services Union, which summed up the ramifications of the government's persistent attack on the healthcare sector. The union said:

What is undisputed among providers, unions, consumer advocacy groups and residents is that cuts to aged care funding by consecutive federal governments are having a significant and adverse impact upon the provision of quality care to older Australians.

That's not something this parliament should be proud of. We should be doing better. It is now clear that in the build-up to the last budget there was a bit of fanfare. There wasn't much in that budget that wasn't leaked out in advance. Maybe that's a modern political tactic—I'm not sure. But there was plenty that went out about aged care. The government promised much and delivered little. They over promised and underdelivered. That's not the way to actually satisfy a healthcare sector. It's not the way to satisfy those who are prepared to invest in a healthcare sector. I think those businesses do it very tough too. The ones I know, particularly in my community, are there and, it's true, they have a profit motive. But they are there to deliver services as best they can to elderly Australians.

At a doorstop a few days before the Treasurer brought down his budget, the health minister said:

It's going to be a very good budget for health and aged care in particular.

Nothing could have been further from the truth. So, whether or not he knew—I'm sure, as a senior cabinet minister, he would have known what the provision was—the reality is that it was not there. The government decided to fan up speculation about it and failed to deliver. You could put that down to political spin or whatever. Maybe it's just contemporary politics—I don't know. But to do that at the expense of elderly Australians, people who probably are the most vulnerable in our communities, I think is just thoroughly reprehensible.

The funding of 14,000 new home care packages over four years is a cruel hoax, quite frankly. I can only think of my own electorate. Mine is not a rich electorate. It's very multicultural and is one we are very proud of. I know how significant aged care is in my electorate. I attended the opening of the AVACS aged-care centre only a few weeks ago—AVACS being the Australian Vietnamese Aged Care Services. We are seeing what is occurring even in multicultural communities. I know the strain that the aged-care sector is under. I know the providers are seriously working hard to deliver for residents and cater for people in care, but we can do better by ensuring that the appropriate resources and finance go in to ensure they can deliver better services to their clients and residents. The Turnbull government's poor implementation of its own home care reforms and funding cuts to the aged-care budget are hurting older Australians.

The government's response to older Australians is an insult. It does nothing to address the aged-care crisis, which has effectively been created under their watch. The government has a proven track record of cutting funding and underinvesting in aged care. The Turnbull government has created an aged-care crisis. It has ignored the very crisis it created. And now it has brought down a budget which fails to address, in even a small way, the nature of that crisis.

This government has not shown much compassion for older Australians. We have a government that expects Australians to work longer—to work until they are 70 years of age. We have a government that has taken away the energy supplement for over two million Australians, of whom 400,000 are aged pensioners. Despite what then Prime Minister Abbott had to say about there being no cuts to pensions, we have seen a continual erosion of the dollar value of the pension and of what people can live on in their older age.

I would strongly suggest that we all have a responsibility to ensure quality aged-care services are available to all Australians of senior years, to ensure that there is a real and positive change in this sector. If you cannot spend enough time and resources to look after elderly Australians—Australians who have contributed so much to this country—then I think it is not only a reflection that we have failed; it is a reflection on all of us that we have failed to address appropriate priorities whilst having the honour of representing our communities in parliament.

I call on this government to reverse its continued attacks on the aged-care sector. This government should stop taking care of its friends at the big end of town and, for once, ensure that care and resourcing is directed to the most vulnerable Australians, and, in this instance, I would suggest, the most vulnerable of all are elderly Australians.

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

I rise to also contribute to the debate on the Aged Care (Single Quality Framework) Reform Bill 2018. In every single budget, this government has attacked older Australians and ripped out funding from critical aged-care services. Since they've come to power, the Liberal government have cut more than $2 billion from aged care. On their watch, the waiting list for home care packages has ballooned to over 105,000, and older Australians have been left to languish for well over a year to access packages that they have already been approved for. Some have been forced into residential care too soon, and, in some circumstances, against their wishes, when they simply couldn't wait any longer or their families were in no position to lend further support. This is a tragic outcome. It decreases the quality of life for older Australians. It hurts their families and the extended networks that these people belong to within their neighbourhoods and communities. It is also, of course, a much, much bigger impost on the federal budget to place people into residential aged-care facilities, when it was, firstly, not their desire, and, secondly, in many cases, a premature move into residential aged care.

In May, it looked like the government was finally going to invest properly in aged care in the 2018 budget. We were told that there were great things to look forward to. Well, what an absolutely cruel and shameful hoax that turned out to be. In fact, it very soon became clear that there was no new money for aged care. Instead, the government was funding the new packages by ripping funding out from other parts of the aged-care budget. The government could not find a single cent to solve the aged-care crisis, yet it had time to find $80 billion to give tax cuts to big business, to those multinationals and to the four banks. Talk about twisted priorities! Not a single cent for aged care, but it can give tax cuts to those who, frankly, don't need them and haven't even requested them.

The bill before us today establishes a single set of aged-care quality standards for all providers that are covered under the Aged Care Act. They represent a change in focus, moving from provider processes to the quality of outcomes for consumers. These update a number of standards that currently apply to different sorts of care, including two for home care, four for residential aged care and two more for the National Aboriginal and Torres Strait Islander Flexible Care Aged Care Program quality review. These changes will come into effect in July of next year, 2019, which, of course, is an extension already on what was the government's planned start date of July 2018. This is to give providers the time they needed to prepare. There was no way that the government could achieve its initial intentions, and already we have moved into having to get extensions of time.

These changes are because of the results of some consultations that took place with the aged-care sector and other stakeholders. Those consultations have been taking place since 2015, so some three years ago. Most of those consultations were not controversial, but, in fact, we are only seeing this legislation now, three years later than first announced, and that is completely unsatisfactory. It is a massive time lag between intention and delivery into this House. And over those three years we have seen waiting lists grow longer for those aged-care packages, with people struggling with increased out-of-pocket expenses to access care. All of these issues have been compounded at a time when inaction becomes, sort of, the default position of this government.

There is, of course, a tendency for this government to drag the chain when it comes to important aged-care issues. In October last year, the Carnell Review of National Aged Care Quality Regulatory Processes was given to the government. The review, which focused on quality care, put forward 10 recommendations. One of the most notable of these was a recommendation to establish an independent aged-care quality and safety commission, which Labor thoroughly supports. While the government has agreed to this, we are yet to see any details of the commission, which is due to start on 1 July next year.

We are also concerned that the minister seems to be very focused on residential aged-care providers at the expense of those Australians who choose to stay at home. This is a critical point. The government needs to pay as much attention to ensuring that the same quality aged care that Australians get in residential facilities will also be available to those who choose care as part of their home care packages. And, of course, we still need more information about how home care will be integrated into the new commission, because, quite frankly, with the botch-up the government has made of home care so far in its tenure, we have good reason to be concerned. The Australian Medical Association were right when they said:

… much more needs to be achieved to ensure older Australians receive the care they need and deserve in their later years.

But I suspect that calling what the Turnbull government has done to home care in this country a botch-up is way too kind. Those opposite have known about the relentless growth in the waiting lists for home care packages for a long time. Instead, they went ahead with their decision to spend $80 billion of precious public money on tax cuts for corporations rather than fixing this appalling aged-care mess of their own creation.

As I mentioned earlier, in the week leading up to the 2018 budget, Australians were led to believe that the terrible crisis facing aged care was finally going to be addressed, that there would be a substantial investment to reduce Mr Turnbull's home care package waiting list. On 6 May, the Minister for Health even went on the record to promise, 'It's going to be a very good budget for health and for aged care in particular.' On this side of the chamber, we were cautiously optimistic at the early budget news. Regretfully, our hopes were thoroughly dashed on budget night when we learnt that the figure that had been referred to was already in the forward estimates. There was absolutely no new money at all. Not a single dollar. Nothing. Zero. In fact, more than 21,000 residential care places are set to be cut over the next three years to pay for the very modest increase in home care packages that has been made available.

Independent budget analysis by Macquarie University Centre for the Health Economy found:

The Australian Government must also invest more in home care packages and residential aged care places. The additional high level home care packages falls way short of the 82,237 consumers currently awaiting an approved high level package. There is also a projected 94,200 gap in residential aged care places by 2025.

Not only did the government not spend a single cent extra in aged care; they tried to pull a swift one by trying to convince us that aged care was actually the good-news centrepiece of the budget. The absolute gall is breathtaking. Let's be very clear: this is a hoax, pure and simple. The government knew that not a red cent more of funding was being given to aged care in this budget. They knew that their so-called investment was being shamelessly ripped out of other parts of the aged-care portfolio. They certainly knew that this shuffling of money wouldn't result in any net benefit to older Australians, yet they still proudly backgrounded journalists with leaks of billions of dollars in extra funding. The government's utter duplicity was confirmed once and for all in Senate estimates last month, when department officials confirmed that there is no new funding and agreed that the funds had all come from existing resources that were spent otherwise. This is appalling. Government members have treated older Australians with utter contempt, and they should hang their heads in shame.

At this point, I would like to point out that there is only one government member to speak on this legislation. One single member was willing to back in their own government's action in this important area, and I think that speaks volumes. One solitary person on the government benches volunteering to justify the inexcusable. It is unbelievable. Actually, it is quite believable, really, because government members would know as well as I do that their budget announcement was a rort, a cynical attempt to make people believe they were doing something about a crisis without having spent a dime. They would be acutely aware that their leadership has again backed in big businesses and the banks ahead of older Australians. They would know exactly what this continued negligence is doing to their older constituents in the communities and their families, because, just like me, government members will be seeing the real-world impacts of the Turnbull government's neglect of our aged-care system in their electorate offices every day.

In Newcastle, I am regularly contacted by older people or family members who are at their wit's end—people like Richard from Elermore Vale. Richard is in his 70s and requires permanent oxygen. He wants to stay at home, but he needs help to do so. A level 4 package would give Richard access to a portable oxygen tank to use when he has to leave his home, when he attends his medical appointments and when he goes about regular day-to-day business that we would all take for granted. It would help Richard maintain his independence and ensure that he was able to get to external appointments without ever worrying that his oxygen was going to run out.

I couldn't think of something more terrifying than to be timing all of the business you have to do outside of your house on the basis of how long your oxygen tank can last, but that is what Richard faces every day. If he were able to access the level 4 package, which he is entitled to, he would be able to have a portable oxygen tank that would give him so much more independence in our community. He's been waiting for more than eight months for this level 4 package. When he calls My Aged Care, he is told that he is the 'highest priority' and that he will have a package within one to three months. So far every month has passed with no good news and no package.

This is not good enough and the government must fix it. Instead, they are devoting their energy to pretending that it is being fixed. It is no surprise that the government seem to be sticking with their chosen strategy of spin and obfuscation, because now we see the government trying to dodge scrutiny by delaying public release of the quarterly waitlist data for home care packages. Australians deserve to know where that data is. Why is there a delay in releasing this data? What is the government hiding?

It is time for the government to come clean with older Australians and immediately release that waitlist data. We learnt during estimates that the department has committed to releasing the information two months after the end of the quarter. Given than the most recent quarter ended in March, we should have had that data in May. It is now 19 June and no data has been made available to the Australian people. One might be cynical enough to think that perhaps this data is not going to see the light of day before certain by-elections that might be occurring around the country.

It's not good enough. It has been a cruel hoax on older Australians to pretend otherwise. The government needs to do the right thing, invest properly in these home care packages, release this data and come clean with all Australians.

Lisa Chesters (Bendigo, Australian Labor Party, Shadow Assistant Minister for Workplace Relations) Share this | Link to this | Hansard source

A few weeks ago in this place, a series of meetings were held with aged-care workers. We had United Voice members and HACSU members who came to parliament to brief people who work in this place about the crisis facing aged care, and to launch their campaign Our Turn to Care. Before people jump to conclusions and think they were here to talk about their wages, they weren't. I will get to the quality of wages for aged-care workers in a moment. The workers came to start sharing the crisis in what they are seeing happening at aged-care facilities and the need for there to be radical investment and radical reform of the sector.

These are the people at the front line of delivering aged-care services, and they do it because they love it. That was one of the first things that they said: 'We're here to tell you what is happening to the residents in our care, in our places of work. We're here to tell you that this is a ticking time bomb. And, unless the government acts quickly, the scandal and the crisis that is occurring in aged care is about to blow up.' They talked about the fact that some of our aged-care for-profit providers have meal budgets for residents as low as $6 a day. Regardless of what the resident is already paying in their aged-care fees and to live in the facility, the budget to spend on food for that resident is $6 a day. What can you buy with $6? These are people who require a nutritious meal. These are people who require regular meals. These are our older Australians who require respect and dignity in their later life, and they are not receiving it currently in some of the facilities in Australia.

And it's not just about food. Day programming: many of the programs, many of the activities that aged-care residents have enjoyed in some centres have been cut. There are fewer and fewer resources available for those facilities in some of the for-profit agencies that we have in this country. Workers talked about if one of their co-workers was sick, that person would not be replaced, putting safety at risk. I have met with people in my own electorate who say: 'We don't blame the staff. People get sick; they are not able to go to work. But why wasn't that person replaced? Where was the relief worker to turn up so that my mum got showered that day or my dad was taken for his walk that day?'

There are really two tiers of delivery within our aged-care services. I want to acknowledge the work that the not-for-profit sector is playing in ensuring that their quality of care is up there. We have one service in my electorate, RM Begg, which says that under the current model, unfortunately, it is slowly going broke. The staff do not compromise on quality and they do not compromise on care. If you are an older resident who might have quite developed stages of dementia, one thing they like to do is keep you active in a safe way. When I was last out there, I actually watched a nurse and an aged-care worker supporting an older gentleman who had late-stage Alzheimer's go for a walk with his walker around the centre. I said, 'What are you doing?' They said, 'We find that it helps to calm him down, he quite enjoys it and he can sleep better at night.' There are not too many facilities in Australia that could spare two workers to do that at the one time because we have no staff-to-resident ratios in our aged-care facilities. Unlike early childhood education, there are no ratios around how many people are required to work in a facility.

So from this briefing, which was backed up by a lot of visits and conversations with people working in the sector, backed up by conversations with family members, there is a real problem with staffing on weekends. We don't have enough people working in some of our aged-care facilities on weekends. You do have to pay a little bit more for people working on weekends because this is a low-paid sector where many are on the award, meaning they do get penalty rates. So rather than employing people to work on weekends, some of the for-profit providers just don't roster people on. There are no standards. We have no rules around how many people working on weekends make it safe or not safe,

The fact that aged-care workers came to say, 'It is our turn to care', and spoke about the need to reinvest in the quality of the care that is delivered in giving older people dignity and respect showed me something that really needs to be recognised. This is a workforce that is undervalued. They have skills. They require levels of education, whether it be TAFE or university, to work in an aged-care facility. They are upskilling themselves as a sector and they tell you straight out that they do it because they love the work. But love doesn't pay the bills. I want to take a moment to reflect on what the Prime Minister said in question time about aged-care workers. His comment yesterday that the aged-care worker in Burnie, the 60-year-old, should aspire to a better job demonstrated that the Prime Minister has never actually met any aged-care workers. Most of the aged-care workers I have met tell me how proud they are to work in aged care. They love the role that they are doing. They aspire to work in aged care. That's their role. That is what they love. But this government has not invested and valued their work fairly. They are undervalued. They don't aspire to be bank managers. They aspire to work in a sector where the residents have resources, where the residents have care, where the cooks have food in the cupboard, where they are spending more than $6 a day on meals, where they are able to take them out on excursions, where they are able to have sing-a-longs, and where they are able to do arts and craft with arts and craft material and not just newspapers. Their aspiration is for their sector and that is what the Prime Minister doesn't understand. Not everybody in our society wants to be a banker. And thank you to all of those aged-care workers who do put their hand up to say they want to work in this sector. Thank you for your compassion and willingness and commitment to take care of our older Australians, giving them the dignity and the respect that they deserve. I just wish that we had a Prime Minister who acknowledged their work, acknowledged that it is undervalued and worked collaboratively and collectively with the unions in that space to see an investment go into their wages.

If we're going to solve the crisis of care in aged care, we need to look at what people are being paid. We need to lift the wages and the conditions of people working in the sector. Aged care has one of the highest staff turnover rates, and part of the reason for that is that the job is demanding and complex. Workers are asked to do more and more. They are with people when they're passing, which is incredibly emotional. They form incredible bonds with these people. Yet, they are paid some of the lowest award wages in our country.

The bill before us does look to establish various functions, like a chief executive officer of the Aged Care Quality Agency, and it also talks about the Aged Care Quality Standards. It does create a single set of standards that will apply to providers under the Aged Care Act. I'm just a bit disappointed that, within this reform that's before us, we're not looking at those two critical issues that I've raised—we're not looking at wages and the undervaluing of the sector and the people who work in it, and, when we talk about quality, we're not looking at the meals, the delivery of care or the liveability of aged care and people's experience of it.

But we shouldn't be surprised that the government is again just tinkering at the edges when it comes to aged care. In this budget, we saw significant cuts, again, to the sector. For all of the talk and the huff and puff of those opposite in the lead-up to the 2018-19 budget, there weren't any new dollars for aged care. They basically overpromised and underdelivered again. They said that there was $100 billion that the government would lead from, but, on closer inspection, on budget night, Labor discovered that it wasn't new money; it was already in the forward estimates. They also talked up that there would be a significant investment in new home care packages, but they've only funded 14,000 new home care packages over four years in this budget, going nowhere near the gap that we currently have. The waiting list, just in the last six months of 2017, grew by 20,000, and other members have already highlighted the significant shortfall.

Data reveals that almost 105,000 older Australians are waiting for home care packages, with the average wait time for high-level packages blowing out to more than a year. I've had people in my electorate come and speak to me about their parents being advised that they're going to have to wait three years, that there are no new packages for complex care, for level 4 care, coming online in our region for at least three years. Another person was told, 'Look, you're just going to have to wait for a few people to die before you get access to a home care package.' That is outrageous! We've known for a very long time that the retiring baby boomers and the people a little bit older were ageing. And now that they're putting their hand up, having been assessed as needing support, we're saying, 'Sorry, you're going to have to wait for someone to die before you get access to a package.' It is wrong. People who choose to live in their home should receive the support that they've been assessed as needing.

Another problem that people in my electorate have raised with me about home care packages is when one person in a couple is assessed to be level 2 and the other is assessed to be level 4. They can get access to the level 2 straightaway, but they have to wait for the level 4. Then it comes down to billing—who's responsible? Who do they charge the cleaning to? They're a couple. Can they split it? They don't quite know how to manage the package. It's complex. It's based upon singles, not couples. So, there's a real problem with how the government is delivering home care packages.

The government also needs to lift its funding for HACC services. In regional Australia, particularly in Victoria, our councils are still largely responsible for delivering HACC services. The market is just not going to go there. They can't make enough money by delivering HACC services out in Ravenswood in my part of the world. Or go to electorates like Murray and Mallee; the council still delivers it. The federal government needs to genuinely partner and put more of its funding into these HACC arrangements. To their credit, ratepayers and local governments have really helped to fund the sector by filling that gap.

But this government's attack on our older Australians doesn't stop there. This government wants to have a higher retirement pension age than any other country in the OECD, lifting it to 70. How can you expect nurses and bricklayers—people who work in physical professions—to work until they're 70. This is one of those issues where, when I'm out in my community or speaking to people in regional Australia, they just shake their heads. It's easy for a politician on a green bench or a red bench to sit there until they're 70. It's not easy to be a nurse. It's not easy to be a teacher. It's not in any way respectful to expect older Australians to work until they're 70.

The government has also axed the clean energy supplement for around 400,000 age pensioners and, all up, two million Australians. That's a straight-out pension cut. Let's just call it what is: axing the energy supplement is a cut to the pension. Pensioners are spending more today on energy bills than ever. Last week I held a couple of discussions with pensioners in my electorate—first in Bendigo and then in Kyneton. I spoke to them about how tough life is today. Maggie shared her story. Her pension day was on Monday, and on Friday she realised she didn't have much money left in her wallet. A friend lent her 30 bucks, so she went to Coles and bought a few things to get her through the weekend before pension day on Monday. She bought one carrot, one capsicum and one potato. For a moment, everyone gathered there just stopped and said, 'When have you ever just bought one potato?' and she said, 'Yes, and it cost me $1.04.' The fact is that she is counting every single dollar and she is watching exactly what she spends. Maggie, who has worked hard her whole life, has retired and is now trying to survive on the single pension. Rather than more support from this government, what she's got is a cut. The government is trying to cut the age pension again by axing the energy supplement. Maggie doesn't know what she'll do if she loses that. She said she'd rather starve than go cold. Central Victoria is a cold place, particularly at the moment. The idea of starving is unacceptable and the idea of going cold because you can't afford the heating is unacceptable.

In conclusion, this bill seeks to establish a single quality framework, but I question the government's commitment to quality.

Luke Gosling (Solomon, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Aged Care (Single Quality Framework) Reform Bill 2018, which Labor supports. It amends the Aged Care Act 1997 and the Australian Aged Care Quality Agency Act 2013. Earlier today I made a contribution in this place on the Prime Minister's comments yesterday about an aged-care worker aspiring to management, and later in my contribution I will refer to some observations from my electorate. Before I do that, I want to recognise that the member for Dobell, in her contribution a little while ago, gave a really excellent insight into what it was like for her—someone who herself was a health professional before coming into politics—when her own parents were faced with these challenges. I really learnt a lot from listening to that.

What I've seen with my own eyes in my electorate is that the people who work at the coalface—the aged-care workers who care for our elders, our seniors—are doing an absolutely vital job. It's not necessarily an aspiration to become a manager that might, in some cases, be screwing those workers by not paying them much and not doing the right thing in terms of conditions of work—having them in casual, insecure work and having them look after too many of our elderly and so becoming stressed themselves. I've seen that happen. Perhaps the Prime Minister needs to get out a bit more and have a look at how people are working and operating and how the actions of some for-profit residential aged-care providers are conducting themselves.

When I visited a residential aged-care home in my electorate, I was, quite frankly, shocked at the way the management was conducting their business. At the same time, I was incredibly impressed with the way the aged-care workers were conducting themselves—giving of themselves and loving their job, which is incredibly important when looking after our seniors in the latter years of their life. That was a good experience for me. I now have a better idea about what we need to do in this sector having visited that residential aged-care home and having listened to the shadow minister, the member for Franklin, and heard her passion—and I'll reflect on that later.

Focusing on our seniors who are receiving aged care—whether it be in their own homes or in residential aged-care facilities—rather than focusing on the provider and the provider's processes is incredibly important. The fact that we have new standards is a good thing—and, as I said, we support the bill and the establishment of these new standards. But, like some of the other contributors from our side, I am a bit concerned, as I've seen with my own eyes the crisis that aged care is in and have learnt from my colleagues and from talking to people in the sector that there is pressure on facilities and pressure on providers. More beds are needed, more places are needed and, in short, action is needed. Unfortunately, what we've seen from the budget is that this government is not aware of the gravity of this situation or doesn't care. I'd like to think it's the former—that they aren't aware—but I hope they get up to speed quickly.

We're supporting this legislation in a bipartisan way, and my contribution is made in the spirit of bipartisanship. I do acknowledge the work of the Minister for Aged Care. I think he does mean well and has been trying hard. My impression, though, is that either he has not been persuasive enough in gaining the support of his colleagues or his colleagues are just not listening. I know, Mr Deputy Speaker Hastie, that he is a compatriot of yours from the west. Being from the north and from a regional part of Australia, I hope that he is being taken seriously and being listened to. However, it appears that the government, under the Prime Minister's leadership, is not seeing the aged-care sector as the priority that it should be. As I said, from the experience that I've had, urgency is certainly needed, and the fact that there has not been an extra dollar put into this sector is of incredible concern.

As some of my colleagues have mentioned previously, the Australian population is ageing. Newsflash! The Australian population is ageing; there are more and more people who need support. The bankers are going to be all right. The bankers are making record profits, so with $17 billion going to the banks they're going to be okay. What's in the budget about priorities? What you've said to our Australian elders—to our parents and grandparents, to those who have paid their taxes—is that you're not going to put an extra dollar into the system that provides them with dignity in their later years in life, but you're going to help out the banks and just shovel billions of dollars their way, even though they're doing very well. I don't know how you reconcile that, but there you go.

There is a crisis in aged care. We want to know how the government intends to ensure quality care for those who are remaining at home. We are very concerned that there is no real plan for aged care across multiple settings. But, as I said, what we do know is that there is not one extra dollar for aged care in this year's budget. In fact, under the last two governments—the Turnbull one and the one before that, the Abbott government—there has, in fact, been a cut of funding to aged care by billions. Cutting aged care and giving billions to the banks doesn't compute with me and my value system, nor, obviously, with the principles of those on this side of the chamber.

The government sort of pretended that there would be $100 million more for aged care in this year's budget. There was not. The $100 million was already there, provided in the forward estimates. We've heard a lot of talk about the new packages—14,000 new packages over four years. Now, these new packages, 3,500 a year, are not enough to keep up with demand. The waiting list grew by 20,000 senior Australians in the last six months of 2017 alone. I know that there is a big waiting list in my electorate, and if you're not aware—if you do not have friends or family in this situation—just two days ago I had a phone call about it with a family who is fifth-generation Territorian. This lady's children are fifth-generation Territorians, but she is contemplating leaving the Northern Territory because she can't get care for her elderly and very unwell mum. That is significant—that is incredibly significant. The Territory is a tough place; to be a pioneering family that is so deeply connected to the Northern Territory and to consider moving south so that your aged mum can get the care she needs tells us that there is a crisis. It is just one example of this crisis.

It's just unacceptable for people—for our elders who have given us so much. This family is one example. They built modern Darwin and, unfortunately, because of the lack of resources, the lack of priorities and the lack of value that this government has given to this sector over five years, real people like them—real families—are being affected.

I mentioned before that I have been visiting an aged-care facility. I went to visit the lady at the request of her family. She's passed on now, but her kids are very determined that there is going to be more scrutiny in this area, more accountability for some of these providers, because the crisis is really affecting families. When I read the minister's second reading speech, unfortunately I didn't pick up any hint of concern about some of these underlying issues in our aged-care system. When Labor were in government, we delivered significant improvements to aged care through our Living Longer Living Better reforms.

By the way, when we were in government we increased the pension by a record amount. We wouldn't contemplate cutting the pension and taking $14 a fortnight off seniors, for example, because we understand the lived reality of people on the age pension in this country. We just would not take resources off them because we understand the costs for people to live in a comfortable environment. In my electorate—it's up in the tropics—a lot of Territorians on the age pension don't even run their aircon, even when it's really sticky and really humid, because they can't afford it. So they are better living with their electricity bills when they're running their fans. These are real people, and ripping $14 a fortnight off them is not helpful. I digress, but I wanted to use that as an example of the priorities that must be given to making sure that our seniors are respected and are cared for if they're in residential care facilities. We need to make sure that the workers are respected and valued—not valued only if they aspire to management, but respected for the job they do, which is caring for our elders.

In the time I have available, I want to quickly flag that we have a lot of postwar migrants. In my electorate there are a lot from southern Europe, and Greece in particular. We need to be very aware of that so that, as that postwar population goes into aged-care facilities, we make sure they have the services they need. It's the right thing to do, so let's start looking after our people in aged care a lot better. (Time expired)

Tony Zappia (Makin, Australian Labor Party, Shadow Assistant Minister for Medicare) Share this | Link to this | Hansard source

The Aged Care (Single Quality Framework) Reform Bill 2018 amends the Aged Care Act 1997 and the Australian Aged Care Quality Agency Act 2013 to make provision for a single set of aged-care quality standards that will apply to all aged-care providers under the Aged Care Act. The bill will also vary the functions of the chief executive officer of the Aged Care Quality Agency to reference the aged-care quality standards.

With respect to those standards, there are currently three different areas. They include residential aged care, where there are four standards; home care, where there are two standards; and the national Aboriginal and Torres Strait Islander Flexible Aged Care Program quality review, where there are two standards. I stress the term 'standards' because none of these standards come into effect until 1 July 2019, which is still over a year away. And while we on this side of the House will be supporting this legislation, it is somewhat concerning that it has taken so long to bring these matters to the parliament and, indeed, that it will take yet another 12 months before the effects of this legislation are felt out there in the community.

There are currently some 235,000 Australians in around 2,700 aged-care facilities around the country. A similar number of employees work in those facilities, which are a combination of for-profit and not-for-profit centres. The reality is that all of them are trying to keep their centres viable, and that means they're all striving to make a profit. Indeed, if they are unable to, it would be only a matter of time before they would have to cease operations.

This legislation arises from a failure of the health department, the Aged Care Quality Agency and the Office of the Aged Care Complaints Commissioner to protect vulnerable people, mainly older Australians, from mistreatment, inadequate care, physical abuse and medical neglect in some residential aged-care facilities. I stress the word 'some' because clearly there are some very good operators out there and there are also very good services and people who provide home care. But it's not always the case and it hasn't been the case for years. Indeed, over the last two decades I can recall regular media reports, scathing media reports, exposing the maltreatment of people within residential care facilities.

In 2015-16, there were 2,862 notifications of assault to the Department of Health. In 2017, there were 4,713 complaints to the age commissioner. This is with respect to residential aged-care facilities. Those numbers, however, do not reveal the true extent of the concerns that would be generated by those facilities; they might not complain because of fear by the residents themselves or by the families of the residents, or fear of retribution towards the resident should they complain. Indeed, there are even allegations that lawyers acting on behalf of the facilities are bullying those people who dare to complain about any service that they are unhappy about.

Perhaps of even greater concern is that they cannot and would not ever represent the true level of concerns we should have about these facilities because, as we know, around 53 per cent of people in residential aged-care facilities have dementia or Alzheimer's disease or an illness that prevents them from being able to communicate or formally lodge a complaint. So the reality is that we're dealing with the tip of the iceberg with respect to the number of concerns that come out of those facilities.

We also have a report that was undertaken over a 15-year period by Professor Joe Ibrahim with respect to deaths that occur in residential aged-care facilities. His report covered a 15-year period where he looked at coroners' reports in respect of the people who died whilst in a facility. He found there were some 3,000 deaths over that 15-year period that were avoidable. He means they were avoidable because they occurred through things such as misdiagnosis, poor care or communication errors. In some cases it was assault of one resident by another, which included choking. Sometimes it was because of medication errors. There were other factors, but those were the kinds of factors that were occurring. These deaths could have been avoided had the care been there in an improved way.

The reality is that the sector has been dogged by negative stories, criticisms, scandals and damning statistics which for too long have been conveniently ignored by many of the operators of those centres and by the government departments we trust to oversee those centres and ensure they comply with the standards and regulations that are set. However, the most damning proof that the system is failing is that in the last two decades we have had numerous inquiries into the aged-care sector or inquiries that relate directly to the aged-care sector. The most recent ones we often talk about are the Productivity Commission report, the Australian Law Reform Commission report, the Carnell-Paterson review and the current ICAC investigation in South Australia into the Oakden facility, which also led to a Senate inquiry. We now also have the Standing Committee on Health, Aged Care and Sport conducting an inquiry into the aged-care sector in this country. The fact that there are, and have been, so many inquiries tells its own story. Inquiries are not held unless there is a problem. In this case, the problem goes back years, and it has been ignored for much, much too long.

Over recent years, I have visited many centres. Indeed, only last week I went to a centre and spoke at length with the manager of that centre. But I've also met with family members who have talked to me about the experiences they have undergone with respect to members of their families who were in centres, and I have met with aged-care workers, including those whom I would describe as whistleblowers who came to see me in confidence and who don't want their names provided publicly. They told me about how they saw the industry from the inside. Indeed, some of the people that I met with were at management level. They were not just personal care workers or nurses; they were people that worked at senior management level. It's clear to me that the aged-care system in this country is in crisis and that we can and should be doing a lot better.

I accept that the government is aware of the concerns that I have raised and has met with and listened to the same kinds of people that I have been speaking with. The government's response to doing a lot better appears to me to be simply moving the deckchairs. It may be necessary to change the rules, change who is responsible for the rules and change the way bureaucracy carries out its responsibilities and functions. Clearly, this legislation does that, and we support it. But it seems to me that that is not going to solve the real problems that we're confronted with. What is required is a cultural change both within government bureaucracies that are entrusted with the responsibility to oversee the aged-care system of this country and within those providers who are not living up to the standards that we set for them. Until we get that culture change, I suspect that no amount of regulation or changing of the rules is going to make enough difference to prevent the kinds of mistreatment that we have seen for too long.

It is not right and it is not acceptable to mistreat any vulnerable person of any age. I suspect that if these were children that we were dealing with there would be much more community outrage about the issue. Yet the reality is that many of the people that either are in need of home care or are in residential care are as vulnerable as the little children that we also strive to protect whenever we can and in the best way we can. I have visited centres in my electorate over many years and I have seen the changes within them myself. Indeed, some time ago I met with a delegation of about 15 or 20 family members of residents of a particular aged-care facility within my electorate who talked about the declining nature of care that was being provided to their family members. It's clear to me that there has been a decline in the level of care that is being provided to people in these facilities. Whether that is because of financial pressures I don't know. Perhaps in some cases it is, but the reality is that there has been a declining level of care.

The level of care has been declining because staffing numbers have dropped. It's been declining because the numbers of registered or enrolled nurses within those facilities have been reduced and replaced by personal care workers or not replaced at all. It's been declining because allied health services to those centres have also been cut. It's been declining because the standard of food provided to those residents has also deteriorated. There are other areas that I could refer to, but what's clear is that the level of care is declining. All of this points to cost-cutting measures carried out by the operators of those centres, who, in many cases, would say, 'That's because there have been cuts to the aged-care sector by government, and we are simply trying to operate within the means we have.' Again, it's not for me to comment on whether or not that is true, but that is the response we are getting.

One of the problems resulting from of all those cuts—and I've already talked about people who died because they were given the wrong medication—is that when patients who can't properly communicate are misdiagnosed within those centres they ultimately end up having to be transferred to public hospitals. Operators will do that, rather than bring in registered nurses or enrolled nurses to care for them, because it is an easy way out for them. That in turn adds to the cost of our public health system. The reality is that the facilities they are in should be able to—and in the past would have been able to—care for them without transferring them to a public hospital. It is something that needs to be factored in every time we look at this issue.

The last issue I want to speak about is the home care packages the government has provided. It claimed in the budget that there will be an extra 14,000 packages over four years, which is 3½ thousand a year. The reality is that in the last six months of last year alone there were applications for another 20,000 home care packages, so 3½ thousand a year will not even pick up the growth in numbers. But, just as importantly, if those people do not get the home care packages that they need then one of the options that they will be forced to consider will be going into a residential aged-care facility. Family members at home without the package will not be able to help them, so they will have no choice but to look at residential aged-care accommodation. If that ends up being the case then, again, it will come at a greater cost. Indeed, sometimes, when families try to look after them at home, it ultimately results in the person going into hospital as well. It's a false saving.

It's time the government acknowledged the problem for what it really is. It's an important problem. It's a serious problem. It will not be fixed by simply moving the deck chairs or by not allocating a single new dollar to the aged-care system, as this government has done—that is, it has not allocated a single new dollar to the system. It has simply said, 'We will change these responsibilities and then that might fix the problem.' It won't. We are an ageing country. We have an ageing population, particularly in South Australia. If we don't address it, the situation is only going to continue to deteriorate.

Cathy O'Toole (Herbert, Australian Labor Party) Share this | Link to this | Hansard source

I stand in this place this evening with some experience of the aged-care system. I come to this place with a passion to see our elderly citizens relieved of some of the burden and complexity currently impacting their lives. My father tragically lived with the devastating disease dementia. It's a disease that does not discriminate in who it attacks. It's a disease that robs a person of their independence and requires him or her to seek services in the aged-care sector. The reality is more than 413,106 people are living with dementia now. It is thought that there'll be about 536,164 people living with dementia by 2025 and about 1,100,890 by 2056. Dementia is the single greatest cause of disability in Australians over the age of 65 and the third leading cause of disability burden overall. Dementia is the second leading cause of death in Australia.

My parents were both in their 80s. As my father's health deteriorated, my mother was forced to seek support from the aged-care sector. Now, I worked in the community sector for some time, so I was not unfamiliar with government systems, but the aged-care system was a whole new experience. It was so very complicated and complex. I want to be very clear at this point: all of the staff we dealt with were extremely helpful, kind and caring people, but the system was just so complex. It was very difficult for my mother to ask for help, because she did not want to be seen to be not coping.

The assessment was thorough, and very emotionally difficult for my mother. Luckily, I was able to be there to support her. We need a system that is designed to understand that this is a very emotional and difficult time for families because they are confronted with the reality of their loved one's condition and the fact that life will never be the same again. The nurse who did the assessment was very compassionate, but we were not able to access the level 4 home-care package that my father needed. However, we were offered a level 2 package. It took more than 18 months for my father to secure a level 4 package. This put undue stress on both my mother and my father. Sadly, my father had a bad fall, which meant that he had to enter an aged-care facility. This broke my mother's and father's hearts, as they had been married for nearly 61 years.

Entering an aged-care facility just creates another level of stress on everyone concerned. The system is, once again, complex, and the care very expensive—if you can get a room. Just to make matters worse, at this time my mother also had a fall whilst visiting my father and broke her pelvis. So she now needed an aged-care assessment. This was done in her home but on an online iPad. It took five hours, and, when the nurse hit the submit button, all of the information went blank on her screen. So the assessment had to be done again at another time, and this was incredibly stressful for my mother.

That is a very brief overview of my personal story of dealing with aged care in this country. But my story is just one of many, of the people in Herbert. As you can see, it is not a very pleasant or happy story. That certainly is not the fault of the nurses, doctors or staff. And, certainly, in my instance, it was not the fault of the provider. They went above and beyond their duty to assist my parents.

The difficulties and stresses that I have identified must be fixed by this out-of-touch Turnbull government. Right now, there are 323 people waiting to receive home-care packages. Nationally, there are more than 100,000 older Australians waiting for packages. The Turnbull government should be absolutely ashamed of this fact, but, sadly, the public has come to expect situations of this nature from this government.

When you're sick, you see the cuts to hospital funding and also the attempt to privatise Medicare. When you need access to higher education, university funding is cut. When you're a pensioner and you're living below the poverty line, the pension is cut and your energy supplement is taken away. When you live in Townsville and you need a job, the government refuses to fund vital infrastructure. So, needless to say, when you need access to aged care, what does this government do? It cuts funding to aged care.

You only have to look at the Turnbull government's budget handed down last month to understand that those opposite have not put the best interests of older Australians front and centre. There was not one new extra dollar for aged care in Australia in this year's budget; instead, there was a pretence of giving new money to the sector. But the reality is that there isn't any additional funding for aged care. The reality is that the Abbott and Turnbull governments have collectively cut aged-care funding by billions over the past five years. Collectively, these LNP governments have cut aged-care funding in every budget. Every single year, the LNP have cut aged-care funding. There have been cuts to the Aged Care Funding Instrument and funding cuts to residential aged care—billions of dollars that are no longer flowing to support older Australians in residential care. All of this talk about funding aged care is just that—all talk.

In the lead-up to this year's budget, the Turnbull government began to frame its message around aged care, particularly the support it would give older Australians choosing to age in their own homes. Even the Minister for Health said on 6 May that this would be a good budget for aged care. Minister Hunt said:

It's going to be a very good budget for health and for aged care in particular.

That was on 6 May 2018. There were also big figures leaked to the media by the government, to the tune of $100 billion. Closer inspection, however, highlighted the fact that the $100 billion was not an increase of funding across the forward estimates. There was no new money; the $100 billion was already in the forward estimates. Closer to the budget, there were more reports that the government would be investing new money into home-care packages. But again this did not happen. It was just political spin. And, whilst this government is spinning its web of myths, there are vulnerable older Australians who are left waiting for access to aged-care services.

This country has had three ministers for aged care since 2013 and not one has done anything about fixing this national crisis over the past five years. In fact, it has only become worse, because we are an ageing population. Older Australians will not be fooled by this uncaring government. The Turnbull government budget has cut money from residential aged care to pay for home care packages. This government is, in fact, robbing Peter to pay Paul. Just because you rob from one to pay another does not mean that you are fixing the problem. In fact, all the government has done is fund 14,000 new places in new home care packages over four years, and 3,500 places a year isn't enough to keep up with the demand. The waiting list grew by 20,000 in the last six months of 2017 alone. We need 105,000 beds yesterday, not 3,500 beds a year.

This commitment is nothing but a cruel joke. It's particularly cruel after promising older Australians it would address the waiting list. So, after all the rhetoric by the Treasurer and other ministers, it turns out that there is, in fact, no new money at all in the budget to fund in-home care and residential aged care. Smoke and mirrors were used to pretend that there was a plethora of money being allocated to aged care. Clearly, the Turnbull government overreached and underdelivered and has let our most vulnerable citizens down. Over the past five years, the Abbott-Turnbull government slashed billions of dollars from aged care and has been solely responsible for the growing waiting lists that exist for in-home care.

This government would rather give an $80 billion tax cut to big business and the banks than properly fund our most vulnerable citizens who need aged care. Our older Australians deserve a fair go and they certainly deserve better than they're getting. During their years, they worked hard to help build this great country and, when they need support in their hour of need, this government is letting them down. But the Treasurer is all too happy to find not just one, two or three dollars for big business and the banks. Again, I say that he is very happy to find $80 billion in a tax cut for them. Yet, he can't even find an extra cent for our failing aged-care sector. Shame on this government!

And then have this bill on the table, a bill that, once again, keeps older Australians waiting for months and months. This bill seeks to amend the Aged Care Act 1997 and Australian Aged Care Quality Agency Act 2013 to make provision for a single set of Aged Care Quality Standards that will apply to all aged-care providers under the Aged Care Act. The bill will also vary the functions of the chief executive officer of the Aged Care Quality Agency to reference the Aged Care Quality Standards. Currently, there are standards that cover three different areas of care. They include four standards for residential aged care, two standards for home care and two standards for the National Aboriginal and Torres Strait Islander Flexible Aged Care Program quality review. The new single sets of standards will apply across all areas of care and will be effective from 1 July 2019. These new standards will focus on quality outcomes for people rather than on provider processes and have been driven by the sector and other stakeholders since 2015. This is the beginning, but we certainly cannot stop here. More needs to be done and, certainly, more funding is needed.

At this point I would like to raise the fact that the funding around aged care is now what we call person-centred or customer-centred. We need to ensure that people actually understand what that term means and what that service looks like. It doesn't simply mean that you have the person sitting in the room while everybody talks around them. It means that education needs to be provided to staff to actually engage the older citizen in the conversation and engage them in the processes that are occurring around them.

A very fine example of this I experienced with my father, who was in an aged-care facility. He would not eat. The person coming to get him for his meal would come and say, 'Come on, it's time to come and have dinner.' He would say, 'No,' and sit there crying, and the person would walk away. I was there one evening when this happened. I said, 'You can't do this. My father needs to eat.' She said: 'Oh, this is person-centred care now. If they say they don't want to eat then we don't make them eat.' I said: 'He has dementia. He's not particularly well. He needs to be engaged and talked with. You need to build a rapport with him and encourage him to come down to the table and have his meal.' For my mother, who was in her 80s, to be there for three meals a day to ensure that he ate was an unfair burden on her, and it certainly wasn't keeping her healthy.

I urge the Turnbull government to fund aged care properly and to fund it now. The Turnbull government has been part of the creation of this aged-care crisis. It ignored the fact that aged care was in crisis and that the budget does not fix the aged-care crisis. The Turnbull government hasn't shown much compassion for older Australians on this account. The Prime Minister is expecting Australian citizens to work until they're 70. He has also tried to axe the energy supplement, as I mentioned earlier, to two million Australians, including approximately 400,000 age pensioners. On behalf of the 323 people on aged-care waiting lists in Northern Queensland, I demand action from the Turnbull government. We must pay respect to our older citizens because they deserve no less.

Milton Dick (Oxley, Australian Labor Party) Share this | Link to this | Hansard source

When it comes to aged care in this country, we know those opposite are nothing more than a sham. I'm delighted to follow on from my colleague the member for Herbert, who is a terrific advocate for seniors and pensioners in North Queensland and has been a strong advocate in making sure that seniors in my home state are looked after. We know that, whilst the government are handing out billions of dollars to big business and the big banks, over 100,000 elderly Australians are languishing without appropriate aged care. All the spin, all the substance that the government like to put out—the smoke and mirrors that the government like to whirl around when it comes to question time or the minister talking about so-called record funding—won't change the fact that 100,000 elderly Australians are languishing without appropriate aged care. In my opinion, this is a government who simply don't have their priorities right. Rather than ensuring our elderly and vulnerable are provided with appropriate aged care and the dignity they deserve, the government persist with looking after their mates at the top end of town, suppressing wages, cutting school funding, cutting hospital funding and, despite what they might say, doing nothing for aged care in this country.

As we've heard already, just prior to the year's budget we had the health minister parading out in front of cameras, telling us how the government were going to look after elderly Australians. In the doorstop on 6 May, he said, 'It's going to be a very good budget for health and for aged care in particular.' As someone who represents a large and diverse community, when I heard that statement, I was looking forward to seeing real reform and, more importantly, real funding to deal with seniors and the difficulties that I've come across in my electorate in accessing aged care. I know members opposite have also had constituents, loved ones and families contact their electorate offices across Australia to complain, to worry anxiously, about whether their loved one—their parent, grandparent, husband, wife or partner—would have access to an aged-care place. Hearing that statement from the minister, I was heartened to think that the government had heard that message. We've all known about it; we've heard it day-in, day-out. But what is the minister's idea of a good budget for aged care? If he thinks no new funding is a good budget, I would hate to see what a bad budget looks like. Around the same time as the health minister was bragging about the so-called good budget for aged care, there were also big figures leaked to the media, including the astronomical figure of a supposed $100 billion of new money for aged care. On closer inspection, it became evident that this was also not an increase in funding across the forward estimates. In fact, there was no new money.

Speaking to the finer points of the Aged Care (Single Quality Framework) Reform Bill 2018, the bill is a result of the Review of national aged care quality regulatory processes, also known as the Carnell-Paterson review, which was handed to government on 25 October 2017 with a focus on quality care. The review made 10 recommendations, one of which was to establish an independent aged-care quality and safety commission. The government adopted this recommendation back in April this year but is yet to provide details in relation to this new quality and safety agency. On this side of the House, we welcomed the announcement by the government, but we are concerned that the government has not given consideration to the delivery of care across multiple settings and that the minister's announcement seemed to be very focused on those providers delivering care in a residential aged-care environment as opposed to elderly Australians who choose to receive care in their own home.

I thought to myself: 'Why is this the case? Why would the government be more focused on residential aged care than home based care?' I can tell you why. It is because, under the Turnbull government, there are over 100,000 elderly Australians who are on the wait list to receive appropriate aged home care. These numbers are startling. Included in this figure of 100,000 elderly seniors, there are more than 300 seniors who have waited more than two years for their approved home care package, without any care whatsoever. But it doesn't stop there. There are a further 6,336 older Australians who currently have no care at all and have waited for care for more than a year. On top of the 100,000-strong wait list for appropriate home care packages, the latest figures show that the waiting list grew by more than 20,000 between 1 July and December 2017 and is likely to continuing growing without the release of more packages.

Those opposite have said that the funding for home care packages that they are delivering is somehow looking after elderly Australians—but this is nothing more than a sham. In the budget we found that those opposite had funded just 14,000 new home aged-care packages over four years, which amounts, as the shadow minister has said, to nothing more than a cruel hoax. That equates to a mere 3½ thousand places per year, which isn't even enough to keep pace with demand. As I just mentioned, we know that the waiting list grew by 20,000 in the last six months of 2017 alone, and the government's response is to allocate 16,500 packages short of what is required. What on earth is the sense in that? To put this into perspective, in my community, in the electorate of Oxley, that will mean just 23 extra home aged-care packages per year for the next four years for elderly Australians in my community—23 each year over the next four years.

Listening to the minister, he thinks that is a suitable and, more importantly, acceptable solution, but somehow wants to be congratulated for it. He somehow wants to be acknowledged that this government is doing something to deal with this crisis. What a sham! When it comes to aged care in this country, we should be doing all that we can to respect and look after those Australians who have worked hard and built this country over the last 50 and 60 years. These people laid the economic foundation for the prosperity we enjoy today, and the government should be doing more.

Government Members:

Government members interjecting—

Milton Dick (Oxley, Australian Labor Party) Share this | Link to this | Hansard source

I take the interjections from those opposite. They think that they've done enough for elderly Australians and they can put their feet up. Well, today I'm here to tell the government: stop resting and start working for older Australians. We know that this tired government is running out of steam, but I plead with members of the government to listen to what the community is saying. Help those seniors who need a hand—those seniors who helped build this country.

Every day I see what quality aged care means for people like my mother and all of her friends, who live in a fantastic local residential facility. I know because I go and visit them and I hear the great work of the people who work in the aged-care sector—and tonight I pay tribute to the aged-care workers in this country who do so much to protect and look after our loved ones. We know that it's essential that we provide first-class, world-class aid to those thousands of elderly Australians, just like my mum, who are living in the aged-care system. I want the best system for my mother, just as I want every other family member in this country to have quality aged care. This government is failing the community, time and time again. Despite the government proudly announcing 14,000 extra places and trumpeting how great this year's budget was, there was not one extra dollar for Australia's aged-care system in this year's budget—not one single cent extra. What the government has done instead is pretend to give money to aged care. But the reality is that there isn't any additional funding. This is after the and Abbott Turnbull governments have cut aged-care funding by billions of dollars over the last five years. Collectively, these governments, in every budget, have cut aged-care funding. We have seen cuts to the Aged Care Funding Instrument and funding cuts to residential aged care—billions of dollars that are now not flowing to support older Australians in residential care.

It is now clear that the build-up to the budget and the government's rhetoric and nonsense around aged care did not match what was finally announced. It over-promised and drastically under-delivered. Here we have today the government making adjustments to aged care through this bill without addressing the main issue. This bill will make provision for a single set of quality standards that will apply to all for aged-care providers under the Aged Care Act and vary the functions of the CEO of the Aged Care Quality Agency to reference the Aged Care Quality Standards. The new single set of standards proposed in this bill will apply across all areas of care and will be effective from 1 July 2019. But, like most things the government do, they couldn't get their house in order. This is an amended date as there were concerns from the sector that the original date of 1 July 2018 would give stakeholders and providers little time to do the necessary preparatory work. In bringing this bill to the House, the minister said:

The single quality framework places consumers at the centre of their care and focuses on giving people greater choice and flexibility. It is part of the reforms being progressively implemented in aged care to create a competitive, market-based system where consumers drive quality and where red tape is reduced for providers of aged care.

Of course we want elderly Australians at the centre of aged care and of course we want quality for those in the aged-care system, but the actions of the government do not measure up to these words.

It was only last week that I had the pleasure of visiting two new state-of-the-art aged-care facilities in the Centenary Suburbs in my community—Seasons Aged Care and the Wesley Mission's Sinnamon Village. Both of these facilities, I am very proud to see, place the residents at the heart of everything they do. I commend them for their dedication in doing so. However, even the managing director of Seasons Aged Care recognises and pointed out this government's deficiency when it comes to caring for our elderly Australians. In a letter I received from Mr Loudon earlier this year, he pointed out:

We have seen the national queue for home-care packages continue to grow to over 100,000 older Australians who have been assessed as needing care and support but are unable to access this care and support at their assessed level of need.

In a policy environment predicated on older Australians ageing in place close to family and friends and being part of local communities, it is unacceptable that a growing waiting list of 100,000 older Australians are unable to get the level of care they require.

He goes on further to state:

This situation impacts on the health and wellbeing of older Australians and results in higher costs to government in the form of premature entries into residential aged care and/or avoidable presentations to hospital emergency departments and/or unwanted hospital admissions.

When the industry is calling the government out for its lack of action on aged care, you know there is trouble.

Earlier this week I watched the interest of colleagues on this side of the House, and it is pretty noticeable that on this bill tonight we have one government speaker. No-one else from the government has bothered to actually enter the debate and talk about this issue. So I commend the shadow minister. I commend our leader on this side of the chamber, Bill Shorten, who is making quality access to aged care a major point of difference in how we on this side of the chamber deliver health care and what the government has on offer.

The member for Franklin, the shadow minister, rightly pointed out that the last package of data revealed that almost 105,000 older Australians were waiting for a home-care package, and the average waiting time for a high-level package has blown out to more than a year. However, the situation may be worse than this. The minister's department, as we know, has delayed releasing important data on those waiting for home care packages. Tonight I add my voice to the growing chorus from this side of the chamber, from the sector and also from the people entering into the residential aged care system. Why hide the data? Why not be up-front with the Australian community about how we are placed for dealing with some of the most frail and vulnerable people in this country?

I say: release the data, come clean, and be up-front with the Australian people. The Minister for Aged Care must be honest with older Australians and immediately release the latest round of data on the waitlist for home-care packages.

When it comes to delivering funding for the aged-care sector, when it comes to the crunch, this side of the chamber can be trusted and older Australians can have a guarantee that we will deliver that funding. Sadly, those on the government benches have proven through this budget alone that they are not interested in hearing the pleas of older Australians. The Turnbull government has promised the world to older Australians waiting in the queue for a home-care package.

We know this government is truly inept when it comes to driving aged-care reform. More importantly, it's been neglectful in not funding residential and home-care services. As I've mentioned a number of times today, there are 105,000 older Australians waiting for a home-care package. This is shocking and simply unacceptable.

Gai Brodtmann (Canberra, Australian Labor Party, Shadow Assistant Minister for Cyber Security and Defence) Share this | Link to this | Hansard source

My electorate of Canberra is the largest by population in Australia. I proudly represent a very large number of older Australians, older Canberrans and older people who look to government to make sure that as they live longer they also live better. At the last census more than 26,000 people in Canberra were over 65. That is 13.8 per cent of my electorate.

My mother is a feisty 78-year-old feminist and she lives by the mantra 'old ain't dead'. She is a fantastic feminist. She is a big fan of Betty Friedan. She read Betty from when Betty was a feminist in the seventies, in her 20s, 30s and 40s. Then Betty got older and started talking about the invisibility of women in their old age. My mother is a signed-up card-carrying member of the Betty Friedan fan club and my mother is very much out there being vocal. She's also a very strong campaigner. She's a fantastic campaigner. She comes out with me during elections and to help with pre-polling.

Dr Mike Kelly interjecting—

No, you're not getting her, member for Eden-Monaro. You get a large chunk of the Canberra community helping you out in elections, but you ain't getting my mamma! As I said, Mum is a very feisty feminist. She is 78 years old and lives by the mantra 'old ain't dead'. And that's definitely the case. As Australians live longer they are living better. And we want them to live better. It's a sign of a great civilisation. It is a sign of a society that is prosperous and wealthy, and that is what we want for our future. This is what we want for our older Australians.

I also heard this message at my positive ageing forum that I held last year with the shadow minister for ageing and mental health and the member for Franklin—and I again thank her for attending that event and speaking at that event. More than 80 Canberrans turned up to discuss how older members of our community can stay fit and healthy and contribute to our nation's capital. Issues were very broad-ranging. It was terrific. It was quite exceptional in terms of the range of issues—from aged care and retirement villages to the role of pets. It is a very important thing—particularly if you're at home on your own, like my mother is—to have a companion animal. But there are also challenges with companion animals. For Mum, it is when she travels to be with her grandchildren and my sisters or comes up to see me in Canberra. If people are going into a home or aged care, what happens to the pets? So that was one thing we talked about: the role of pets in keeping people well and happy at home and feeling as if they are loved and they've got something to love.

We talked about the role of nutrition and how vitally important it is. The minister and other colleagues and I were recently at the launch of the fabulous Maggie Beer's book on the importance of nutrition for ageing Australians. It is vitally important. And I've seen it with my mum. My mother has a very good appetite and is well known for her appetite. But, as she has aged, her appetite has diminished. She is eating less than she used to. But she is very mindful of it. She has been living at home. She was a single mum and brought up three girls on her own, so she has been very mindful of the need to stay healthy through nutrition. So each night she cooks for herself a beautiful meal; she enjoys that and takes great pride in that. But she tells me, whenever I see her, that most of her girlfriends might have just a bit of grilled cheese on toast or a boiled egg for dinner, if they can be bothered; otherwise it's just some crackers and something very basic, rather than something nutritious and well-rounded and covering all the food groups. Nutrition is vitally important for older Australians.

Exercise is also vitally important for keeping those bones strong. What is the name of the classes that mum goes to? 'Move it or lose it'—and that's very much the case. Move it or lose it. You need to exercise. You need to get out there. She's doing zumba; she's doing ChiBall; she's doing swimming—she's doing everything. As you can probably tell, I absolutely adore her, and she is an exceptional woman, and a proud feminist who has brought up three very proud feminists. Access to sunshine is also very important, for vitamin D. All these elements are so vital to health and wellbeing.

Aged care is a significant concern. It comes up time and again at my mobile offices and the coffee catch-ups, and it also came up at this positive ageing forum. Unfortunately, some people who were at the forum were in tears about their experiences. There are the inconsistencies in standards and fees. There is the complexity of the system. Anyone who has dealt with the aged-care system will highlight to you the enormous complexity of it. There are the endless rounds of paper and the duplication—it is extraordinarily complex. There is the guarantor clause. There are the mountains of paperwork, and the lack of digitisation, in this day and age. There is the absence of clear guidance on the steps that need to be taken to get a loved one assessed or in care. There is the delay in processing to support staying at home.

And, of course, there is the cost. I know that, when we were looking at putting my late father-in-law in care, I was just gobsmacked by the entry fees and then the weekly fees and then the daily fees and then the exit fees. It's breathtaking. You've got to sell the family home to be able to do it; I don't know what other way you can do it. And then the fees are just constant.

So it's not only complex, and dogged by mountains of paperwork and a lack of digitisation and delays. There is also this expense. And there is also such variation between one aged-care service and another in terms of the cost—and not just the cost: some have entry fees and some don't; some have exit fees and some don't; some have weekly fees and some don't; some have daily fees and some don't.

There are more than 1,700 residents living in 18 mainstream residential aged-care facilities across Canberra, and I've had the pleasure of visiting many of them. I've spent a lot of time talking with residents, and I've spent a lot of time talking to staff, and I've spent a lot of time talking to families. There are also 20 different home-care providers supporting the many, many older Canberrans who want to continue to live in their own homes as they age.

And I've been blown away by how many Canberrans are actually still staying on in their own homes when they are over 100! They are over 100 and they are still living at home—it's quite extraordinary. I've been to many Canberrans to present them with their 100th birthday congratulatory messages and my own message and a bunch of flowers, and to join in their celebrations, and I am always astounded by the numbers of them who are living at home at 100, 101, 102, 103—it is quite extraordinary. And we want that. We want that for our community.

Canberra is fortunate to have many quality aged-care providers and services. However, we all recognise that the system needs to be constantly improved to meet changing demands and to meet our expectations that our loved ones are cared for and are able to age with dignity. That's vitally important, regardless of their choice, whether it is to live in residential care or their own homes. And I know, from speaking to the many people in my electorate in aged-care services and the providers, that there are three things of particular concern to my community here in Canberra. The first is the quality of care that is being provided in the aged-care sector. The second is getting off that interminably long waiting list to access the necessary home care and support they need. And the third is the financial cost associated with aged care.

The single quality framework bill we're talking about today has become associated with the neglect and mistreatment of residents at the Oakden facility in South Australia. The images we all saw were heartbreaking and I'm sure all of us here and so many Australians in every city and country town, right across the nation, were thinking, when they saw those images: 'What if that was my mum?' or 'What if that was my dad? or 'What if that was my loved one?' The bill provides a single set of aged-care quality standards that will apply to all aged-care providers under the Aged Care Act. The changes include four new standards for residential aged care, two standards for home care and two standards for the National Aboriginal and Torres Strait Islander Flexible Aged Care Program, all to be introduced by 1 July next year.

The new standards have all been driven by the aged-care sector—recommendations to improve the quality of care of our loved ones coming from the hardworking aged-care workers. How important is that, despite the comments that the Prime Minister has been making in recent days? He might think it's witty, but it's not, and he's being disrespectful to this hardworking community, people in my community. These people help us care for our loved ones—the people who have brought us up, cared for us and nurtured us—as they age. The new standards fought for by aged-care workers were signalled as a 2015-16 budget measure, so I think we have to ask: why have they taken so long to be introduced? If these standards were introduced earlier, could Oakden have been avoided?

A number of other changes in the bill are based on the 10 recommendations from the Review of national aged care quality regulatory processes. One of these recommendations was adopted by the government a few months ago, establishing an independent aged-care quality and safety commission, but unfortunately we're still waiting on the detail. And, as we all know, the devil is in the detail. One thing that I have noticed about this bill and the discussion around it so far is the focus on providers delivering in a residential aged-care environment. Where is the discussion on the protections for older people who choose to age at home? How will the quality framework in this bill be implemented, monitored and evaluated in the homes of those who choose to receive a home care package? How will the newly established commission integrate home care into its regulatory framework?

One Canberran who receives a home care level 2 package has asked me in a letter, and I also ask this question: what responsibility of the providers is there to ensure good care of their clients? After reading through this bill, I still don't have an answer. But that particular Canberran is lucky compared to the many others who are on the waiting list for home care, many having been there for some time. According to community organisation Aged and Community Services Australia, recent data shows the number of people on the waiting list for a home care package has grown to nearly 105,000 people, including 40,000 people who've been allocated a lower level package than what they've been approved to receive. Also, more than half of those waiting for level 3 and level 4 packages are in the queue for more than six months, and it's still not clear how current funding commitments will meet the projected need of about 140,000 packages by 2021-22, or an extra 66,000 packages.

Whenever I hear about the delays that people have in accessing home care packages, I remember a particular story from one of my constituents. I was contacted last year by Ian, whose wife was waiting for access to a level 4 home care package. Home care packages have four levels, from level 1, for basic care needs, all the way through to level 4, which is for high-level care needs. Ian told me that, at her assessment, his wife was assessed as being eligible for full-time residential care, respite care or a level 4 home care package. When Ian and his wife took up the home care package with the local provider, they were told there were no level 4 packages available, so they opted to receive support at a level 2 until one became available. Ian's wife soon developed a strange paralysis and was hospitalised for weeks until home modifications could be completed. Some of the much needed equipment could have been subsidised under the level 4 package, which Ian's wife was assessed as needing but would not get until the letter of advice came through from My Aged Care. They were on their own. A key frustration I shared with Ian throughout his experience was the lack of available information: 'How long is the waitlist? Where am I on the waitlist? How often is it updated? Who will keep me informed of my application status?'

Ian's frustration is felt by so many others in my community. These are issues that were raised with the shadow minister at the Positive Ageing Forum last year. When it comes to caring for older Australians, this government needs to do better; we all need to do better. We need to do better in creating a system that is designed around people and not process. We need a system that not only addresses residential aged-care facilities but also addresses the risks our older Australians could face with home care. We need to give it the Faye test, the mum test. I ask, 'Is it good enough for my mum? Is it good enough for fabulous, feminist Faye? Is it good enough for anyone in my family?' (Time expired)

Ken Wyatt (Hasluck, Liberal Party, Minister for Aged Care) Share this | Link to this | Hansard source

It's appropriate that you, Mr Deputy Speaker Andrews, are sitting in the chair, given the work that you've done previously for senior Australians; I want to acknowledge that. The Australian population is ageing and the expectations of older people are changing. In recognition of this, the Australian government is making fundamental reforms to the aged-care system. The reforms aim to promote high-quality aged-care services that meet consumer needs and preferences and to create a competitive market based system where consumers drive quality. The Aged Care (Single Quality Framework) Reform Bill 2018 provides for the making of the aged-care quality standards that will apply to all approved providers of Commonwealth funded aged care. The bill contributes to the establishment of a single consolidated and streamlined quality framework for all aged-care services, as announced in the 2015-16 budget. The aged-care quality standards, co-designed with consumer groups, representatives from the industry and experts in standards development, are focused on achieving quality outcomes for consumers by enabling consumers and carers to influence the design and delivery of the services in order to ensure that they are consistent with the consumers' preferences.

The strong focus on consumer outcomes in these standards is evident in the consumer outcome statements that introduce each standard. For example, the consumer outcome for standard 1 is:

I am treated with dignity and respect, and can maintain my identity. I can make informed choices about my care and services, and live the life I choose.

Standard 1 underpins all other standards so that this consumer outcome applies right across all of the new standards. The final draft version of these standards is available on the Department of Health website. The standards have been subject to extensive public consultation, and there'll be a 12-month transition period to give the sector time to adapt. Implementation of the aged-care quality standards contribute to the response of the Review of national aged care quality regulatory process, which highlighted the need to make improvements to aged care.

I note that there has been some discussion during the debate on this bill's amendment to the Freedom of Information Act 1982 which exempts certain protected information received by the Australian Aged Care Quality Agency from disclosure under the FOI Act. As part of its functions, the quality agency handles sensitive and personal information from people, including care recipients, the friends and families of care recipients, approved providers of aged care and the staff of approved providers. The proposed amendments will not change the current arrangements for the publishing of audit reports by the quality agency, including where they have found that a provider has not met the requirements of the relative quality standards. The quality agency will continue to be required to publish its accreditation decisions and the associated audit report under the requirements of the Quality Agency Principles 2013 as soon as practicable.

The proposed amendment will also not change the current process whereby the chief executive officer of the quality agency can decide to release protected information in cases where it is in the public interest, or where it is necessary to prevent or lessen a serious risk to a care recipient. The Aged Care (Single Quality Framework) Reform Bill 2018 enables the introduction of a contemporary set of Aged Care Quality Standards that will promote high-quality services that meet consumer needs and preferences. I thank all members for their contribution to the debate on this bill.

Bill read a second time.