Julie Collins (Franklin, Australian Labor Party, Shadow Minister for Ageing and Mental Health) Share this | Link to this | Hansard source

I want to say at the outset that Labor will be supporting the Aged Care (Single Quality Framework) Reform Bill 2018. However, we do have a number of concerns that I will raise through my speech in relation to quality standards for aged care in this country. I thank the minister for arranging a briefing on this bill. The minister talks a lot about trying to have bipartisanship on aged care. This was the first time that I'd actually had a briefing on this issue. I do appreciate it.

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 aged-care providers under the Aged Care Act. The bill also varies the function 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 three different areas of care. They include four standards for residential aged care, two standards for home care and two standards for the Aboriginal and Torres Strait Islander Flexible Aged Care Program quality review. The eight standards across all areas of care will be effective from 1 July 2019. I understand that the government wanted a start date of 1 July 2018 but has ceded to concerns raised by the sector that they need time to get ready for the new quality standards and time to do the necessary preparatory work.

The new standards will focus on quality outcomes for consumers rather than provider processes and have been driven by the sector and other stakeholders. These quality standards have been on the drawing board and have been worked on since 2015, so it's great to see the legislation finally come into the parliament. I do want to put on record Labor's support for the people who work in the aged-care sector. When you're talking about quality and standards in aged care, this is of course delivered by aged-care workers and people working in the sector. The quality of care that they provide to residents of residential facilities and the people at home receiving home care is of enormous importance to older Australians, their families and loved ones. The personal care workers—the nurses, the physiotherapist, the occupational therapists, the GPs; all of those people—working in aged care in Australia today are highly valued by this side of the House and by the community.

That is in stark contrast to what we heard from the Prime Minister in question time yesterday, where the Prime Minister said that people working in aged care, an aged-care worker, should aspire to get a better job. Aspire to get a better job! I couldn't believe my ears when I heard that yesterday. Talking to aged-care workers today in an aged-care facility here in Canberra, the aged-care workers themselves couldn't believe that they have a Prime Minister who would say this about aged-care workers. They actually provide a hugely valuable service to our community. Their jobs are hard. They are rewarding, but they are not easy jobs—and they're certainly not well-paid jobs for the hard work that these workers are required to do.

As I said, the government has taken quite a lot of time to get these standards into the parliament. The explanatory memorandum to this bill talks about changes to the Freedom of Information Act 1982 to ensure that documents containing protected information acquired by the agency in the course of its functions are exempt from disclosure. I need to put on the record that, whilst we understand that the agency's investigations might need some protection, I am concerned about the extension of these FOI exemptions in this act. I'm worried that consumers might not be able to get access to the information that they need as part of any quality agency's investigations and I don't want to see important information being kept from consumers. So I'm putting the government on notice that we'll be looking at and closely monitoring this change to make sure there are no incidences of people not getting access to the information that they should because of this exemption.

As I said at the beginning of this speech, we talk about bipartisanship in aged care and the Living Longer Living Better reforms, but we haven't actually had much cooperation from the government as a whole when it comes to aged care. The government seems to want to make aged care a budget issue and an election issue—from what we saw in the budget and what we've seen since from this government—trying to talk up the funding for aged care in this budget when there is not one new single cent over the forward estimates for aged-care services in Australia in the budget. I have never seen a government promise so much to older Australians and deliver so little. It's quite appalling. We've seen billions of dollars ripped out of aged care under this government over the five years. When Labor implemented the Living Longer Living Better reforms, we put in real, new money. We had a 10-year plan for aged care in this country. It'd been worked on, we consulted and we had bipartisanship on it because we worked hard to achieve that and we actually worked with the other side. It's a shame we haven't seen that from this government.

There are a number of reports that the government has sitting on its desk in relation to aged care and the quality and standards that are affected by it. In particular, I want to talk about the University of Wollongong and Applied Aged Care Solutions reports, which the government isn't yet acting on. At last count, there were over a dozen reports sitting on the minister's desk, as I said, from the Living Longer Living Better reforms, and there's some expert advice in the Wollongong report about how to fix the Aged Care Funding Instrument.

I've been visiting aged-care facilities around the country in the last few months and weeks, as shadow minister, and I'm hearing from aged-care providers that the government's cuts, in the 2015 MYEFO and the 2016 budget, of the Aged Care Funding Instrument are having a real impact on quality of service and resourcing in residential facilities right across the country. The Wollongong report, which considers changes to the ACFI, was made public by the government a year or so ago. I've been very clear, from Labor's side, that we think the ACFI is broken and the government needs to act. To date, the government doesn't seem to have made any formal response to the ACFI, and a separate review by Applied Aged Care Solutions about the ACFI seems to have been shelved. It would be good if the government would clarify where it is in terms of changing the ACFI, because the ACFI relates to funding for residential aged care, and funding is related to quality and standards. You can't deal with one in isolation from the other. On 19 April 2017, the minister said:

These two separate but important pieces of work will help inform the Government's deliberations over the future direction for funding reform.

But, as I said, we have seen very little action, and providers are reporting that these cuts are impacting on them.

The other significant review that the government is sitting on at the moment is the Carnell-Paterson review, which of course talks about quality and standards and was initiated by the government after the Oakden situation that occurred in South Australia. We've seen numerous media reports since that time of other incidents around Australia in other residential aged-care facilities. We welcomed the review and we welcome the government adopting the recommendation to establish a joint agency to merge the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner into one. We're curious, though, about where this is at. We haven't seen or heard anything from the government about legislating to merge these two agencies. I'm hoping that the government will update us and provide some briefing on what is happening with this merger.

I am particularly concerned about the new agency and what it's going to do in relation to not just residential care but home care. I'm receiving increased reports about older Australians who are not getting the home care that they need and deserve. I'm not talking here about the massive waiting list for home care, which I'm happy to talk about a bit further on; I'm talking about people in their home who have a home care package, one that has been allocated to them. I am hearing reports of older Australians who may be on the end of elder abuse at home from some of the workers, so I want to make sure that the government has the standards right and that we are protecting older Australians in their homes as well as older Australians in residential care. There are a lot of regulations and standards around residential care; there are fewer around home care. I want to make sure the government is doing what it needs to do in relation to older Australians who are receiving home care. Particularly as we're expanding home care and wanting to give Australians more options to stay at home, it is very important that the standards and the quality that people receive at home are no less than the quality and standards people receive in residential care. I want to make sure that these announcements and changes that the government is talking about are focused not just on residential care but also on the growing sector of home care. I'm looking forward to hearing about how the new commission will deal with this.

The other review that is very significant is the Tune review—that is, the legislated five-year review of the Living Longer Living Better reforms. The Legislated review of aged care 2017 was tabled last September, and the government said that it would respond to Tune in the budget. We've seen some response to some of the recommendations, but, again, we don't know what the government is doing on at least 20 of those recommendations. The government did immediately reject two of the 38 recommendations. The government is now claiming that it has responded in full or in part to another 18, which leaves 20 recommendations—or 18, I suppose, by the time you take off the other two recommendations—not yet dealt with, so I'm curious as to when the government is actually going to respond to the other recommendations in Tune, because these also impact on quality and standards of care.

It is interesting that the government, in the budget, tried to claim that it was doing something about aged care when what we actually saw was the government take money from residential care and provide it to home care and an additional 14,000 home care places. Of course, we are happy there are more home care places. What we're not happy about is the government not telling Australians the truth about what it's done. It should be honest about what it has done. It should be honest about the previous cuts from MYEFO 2015 and budget 2016 and the impacts that these are having on quality and standards of care, the impact these are having on the resources available to provide care to older Australians in residential care. It's not good enough that we continue to hear excuses from the minister. We continue to have the minister say that our side of politics is not telling the truth. Well, the truth about the cuts that they have made is in their own budget papers and in their own MYEFO papers. They have made cuts to aged care worth billions of dollars over the last five years. That is the truth, they are the facts, and the government needs to stop pretending that that's not the case.

When it comes to home care packages, we have the government's own website saying that as at December last year more than 100,000 older Australians were waiting for home care. More than 100,000 older people are currently waiting for home care. We don't know how many are waiting today, because that figure is as at December. The March quarter figures were due to be released, but we haven't seen them yet. I don't know what the government's sitting on or why the minister won't tell us how many Australians today are waiting for a homecare package. Perhaps he's hiding something, or perhaps he's sitting in his office trying to cobble together something for those hundreds of thousands of people who are waiting for home care today.

What those opposite should do is be honest with Australians about the issues, be honest with Australians about how long we're going to have to wait for home care. People who are waiting for level 3 and 4 packages are still having to wait for more than 12 months for care. They were waiting 12 months prior to the budget, according to the government's website, and post the budget they're still waiting for more than 12 months. Indeed, as I said yesterday, we are actually getting reports about this from people all over the country. In particular, children of older Australians are saying: 'I can't get my mum and dad a package. How long do we have to wait?' That is what they are saying. They are crying out for assistance for their parents, for their loved ones, to get home care because this government promised something in the budget and people thought things were going to change. But they aren't. I think it's pretty cruel to try to pretend to older Australians, their families and their loved ones that you've done something rather than be honest and tell the truth about what is actually going on in aged care in this country today.

Given the numerous reports, given the fact that the government is still sitting on well over a dozen of them and not acting on recommendations, and given that progress in aged-care reform in this country has been very slow in the last five years, I'm pleased to finally see some legislation in this place to do something positive. But, as I've said, I do have some concerns. I do have some concerns about whether or not these standards are going to be achieved; whether or not this government is going to be able to implement it; whether or not the government will be able to implement the things that it has already agreed to do, let alone actually deal with the other recommendations from all the other aged-care reports still sitting on its desk.

We've had the Minister for Aged Care admit what we already know about the aged-care packages in the budget—that is, it's not enough. We know that he knows and that everybody in this place knows that what the government has done in the budget won't even come close to solving Australia's aged-care crisis. There's a crisis in aged care, there's a crisis in residential care, there's a crisis in the aged-care workforce, there's a crisis in home care—and this government has created it. It has been in government for five years, and to try and blame Labor for the last five years of inaction and cuts is an outrageous thing to do.

We had the Prime Minister come in here yesterday and tell us what he thinks about aged-care workers. As I've said, the aged-care workers that I met today were insulted by what they heard from the Prime Minister yesterday. For the Prime Minister to say to those workers, 'You should aspire to get a better job,' when we need to triple the aged-care workforce over the coming decades is outrageous. We've even had the sector put out media releases after what the Prime Minister said yesterday saying that this will discourage people from taking up a job in the aged-care sector. The government should be respecting and encouraging people to work in the aged-care sector. It is a valuable thing to do. It is a necessary thing. We are going to need more workers in aged care, not fewer, and we need a government that respects them, a government that's willing to invest in them and a government that's willing to understand the issues in aged care and be honest with the Australian public about the situation that we're going to have in aged care with the changing demographic.

We need to be up-front and honest with Australians about what this will mean going forward. We need to know in 10 years time how many home-care packages we're going to need. The government hasn't done any modelling on it. I asked, 'What will the wait list be at the end of the forward estimates after the funding in the new packages?' The government won't tell me or can't tell me. I think it's a bit of both: (a) it doesn't know and (b) it doesn't want to know. It does not want to know, and it does not want to plan for the changing demographic—that is the truth of it—because they don't want to be up-front and honest with Australians about what is happening in the sector. They should be ashamed that they are perpetuating untruths and mistruths and pulling a cruel hoax on older Australians when it comes to what they have or haven't done in this budget and previous budgets in the last five years. We can clearly see that the government's poor implementation of any reforms—the slowness of it and the funding cuts—is now hurting older Australians. That is clearly evident from what this government has done. I am really concerned that older Australians, their loved ones, their carers and their families are not able to get the care that they need and deserve. I'm also very concerned that this government doesn't seem to want to act fast enough to deal with it.

We really only have to look at how the government has been acting over the last five years to get an indication of where it will go. I am prepared to talk to older Australians. I am prepared to work with the government on how we deal with this situation going forward. I have been up-front with the government about sitting down and talking about the issues in aged care—talking about the issues with regard to a future workforce that we need to plan for and talking about the future funding issues in relation to providing enough services for those who need it. Instead, what we got from this government was a promise to consult, a promise to brief, and nothing before the budget. We now know why, because there was nothing in it, despite what the government's pretending.

This cannot go on. If the government is serious about improving quality and standards in aged care and if it's serious about providing services for older Australians, we need to work together on it. We need a bipartisan position when it comes to dealing with aged care. This should not be a three-year election cycle. This should not be political point scoring from the government, trying to pretend it's done things when it hasn't. This should be about older Australians, and, sadly, it has not been. To say that I'm disappointed in this government and this minister is an understatement. I think older Australians are disappointed in this government. The workers are disappointed in this government, and the workers are certainly disappointed in this Prime Minister after what we heard yesterday.

We heard from the senior minister, the Minister for Health, Greg Hunt, prior to the budget—I am trying to remember his seat, Deputy Speaker Vasta, but I can't, so I will say the Minister for Health.

Jason Clare (Blaxland, Australian Labor Party, Shadow Minister for Resources and Northern Australia) Share this | Link to this | Hansard source

Flinders.

Julie Collins (Franklin, Australian Labor Party, Shadow Minister for Ageing and Mental Health) Share this | Link to this | Hansard source

The member for Flinders. He said that it was going to be a very good budget this year for health, and for aged care in particular, and he said that on 6 May. But what we saw on budget night, as I said, was not one new single dollar for aged care over the forward estimates—not one. That is not good enough and it's not sustainable when you talk about the growing demographic and when you talk about the ageing population in this country. We should see the ageing population in this country as a positive. Yes, there are challenges with it, but, as I said, we should be open and honest with the Australian people about what those challenges are. We should have a grown-up discussion from both sides of parliament about how we're going to fix this and how we're going to deal with it in the future. We cannot afford, and older Australians cannot afford, for this government to play silly games or for this government to come in and try to pretend it's done something and try to score political points. We need to be serious. This is a big deal for older Australians, their families and their loved ones, and this cannot be allowed to go on.

The sector has talked to us about the government's budget cuts and its disappointment with the budget. The sector also came out after the Prime Minister's comments yesterday. To say that this sector is concerned about the way this government is managing aged care would be an understatement. This is a sector that doesn't usually say very much, because it knows it has to work with governments of both persuasions and it knows that government is a major funder of aged care in this country. Indeed, there is $100 billion over the forwards for aged care. This area does cost a lot of money, because the primary service deliverers of aged care are people. These are hardworking people. They deserve our respect and they should be valued by this country.

We really need to make sure that this government actually takes seriously these issues. I cannot believe that we've got to a position where the aged-care sector is concerned about the government and has been brave enough to come out on some occasions to tell the government that what it's doing is not good enough. This government should be ashamed of where it's got to with aged-care reform.

Having said that, we are supporting this bill. We are supporting the change to the standards. But this government is going to have to be put on notice about delivering on these standards and ensuring that the aged-care sector has the resources it needs and the respect it needs to actually be able to deliver on these standards. I am concerned about some of the FOI changes and I am concerned about making sure that people at home get the same protections and the same quality of care that people in residential care should be entitled to. In the most part they are getting that, but we also know that, in some cases, they aren't. These standards need to protect them both at home and in residential care.

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

In rising to speak to the Aged Care (Single Quality Framework) Reform Bill 2018, I want to acknowledge the amount of work done by the Minister for Aged Care, Ken Wyatt. He's very committed to the aged-care sector, and we see that every time Ken speaks. Ken wants to see quality in services. That's what this bill is about. That's what the government is about.

When I have talked to the minister and when he has been in my electorate talking to seniors, what does he say he wants to see? He says he wants to see happy, healthy and active people. He wants to see people as active and as engaged as possible, irrespective of their age. That's what the government is working on. That's what the minister is so passionately committed to, and that is where he spends his time. The Minister for Aged Care knows that how we treat our elderly people is a great reflection on us as a society. He is committed to aged care.

Planning and providing for our ageing population is increasingly important, and this is an opportunity that we've taken through this bill. The measures that we're taking will make it easier for people to make educated decisions about their aged care. The Aged Care (Single Quality Framework) Reform Bill is part of the government's decision to work with the sector to develop a new, unified quality framework. This framework includes a single set of consumer focused quality standards that will apply across all aged-care programs. This will make it simpler and easier for people and help them to make really good decisions about their aged care. This will apply to the Commonwealth, which, of course, will have consumers at its centre. This is what the Minister for Aged Care has always been working on—having people at its centre and at its core.

The Minister for Aged Care is absolutely committed to people who need aged care and is giving them the tools to choose the best type of care for them and also the best type of care where they live. It's a significant shift away from the top-down institutional level of information. This bill is part of the reforms being progressively implemented in aged care to very much create a person-centred, competitive system where consumers will actually drive quality and where red tape—that evil red tape—is reduced for providers of aged care.

Providing a single set of standards that apply across all aged-care programs will lead to a range of achievements. These changes are intended to drive the improvements we all want to see in the quality of care delivered to older Australians. Secondly, they'll decrease that regulatory burden on aged-care providers. Thirdly, they'll actively encourage innovation, excellence and continuous improvement.

Currently the system of quality standards is complex. It's very difficult for ordinary people to understand and manage. There are four different sorts of standards: accreditation standards, home care standards, transition care standards and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. All of these are different standards. It's a part of the framework. With the amendments in this bill, provision will be made for the same set of quality standards to apply across all types of aged-care services for the first time.

I congratulate Minister Ken Wyatt for his work in this area. The minister has listened to consumers of aged-care services and providers of aged care. The new standards will reflect the contemporary evidence and community expectations of the quality of care and services. It's the first time accreditation standards have been updated for 20 years. That's a great achievement for this government. This will increase consistency across the services, making it easier for consumers—and for their families, their carers and their representatives—to make good choices about care and services as their needs change.

We'll focus on quality and safety for consumers but also encourage providers to offer care and services to promote quality of life and wellbeing. We'll place a greater emphasis on consumer choice, identity and the idea of partnering with consumers in the care that they choose. This is putting consumers fairly and squarely at the centre of the aged-care process. The minister is very determined to make what can be a difficult time in people's lives that much easier. This is very much part of what the minister is dedicated to.

I want to take this opportunity to talk about some of the aged-care facilities in my electorate that do provide very good care for people needing that level of care. I want to talk about Hocart Lodge in my home town of Harvey. What's happened repeatedly in regional and rural areas is that the community has got together to provide aged-care services and a facility for people to live in. A residential care service often has been provided by the community itself where there was a need. Hocart Lodge started as a small weatherboard home of a local family, the Hocart family, in Harvey. They donated that to the community because there was a need for residential care for our aged citizens. There were some local government representatives who were very committed to providing aged care in Harvey, where there wasn't any.

I remember that the land was donated to the community by the Hocart family but a lot of earthworks were needed. It was my own father who provided that. He lived in Brunswick but he knew that we needed a central location in Harvey and desperately needed a residential aged-care facility. Because this was a community-led, community-driven and community-funded effort to provide this type of aged-care service, the community drew on those who could provide all sorts of in-kind help and support. My dad was an earthmover in the transport and logistics space with a lot of tractors and trucks at his disposal, and he donated all of that to develop that site. It was a significant commitment. I think he spent three months working on the site and getting it up to the standard it needed to be to be built on. That was the beginning. I see this repeatedly in my electorate, where the community makes this happen. Years later, when Hocart Lodge needed to be expanded, I'm very proud to say that it was my dad and my brother, again, that donated the gravel, the sand and the earthworks. Actually, I think my brother spent six weeks carting sand out of what was then the rubbish dump area to provide the sand for this project.

As a government, we understand that the community actually gets involved in—and often drives—what needs to be done in rural and regional areas. But it is the community who are the people that we are here to serve, and that's what we're doing through this bill—to better serve people and their needs, no matter whether they are in a city or a small community like Harvey.

One of the things that I'm particular proud of as well—perhaps in continuing a family tradition—is that through the ACAR round, when Hocart Lodge needed to increase its capacity to 60 beds, it received funding from the federal government: $11.23 million in capital grants to help them rebuild and expand. Mr Deputy Speaker Vasta, you can imagine just what it meant for me to be there for the opening of that new part of Hocart Lodge. I could look back at what my father, my brother and the whole community had done, and then see the federal government able to support the next stage of providing wonderful residential care in a small community. That's what this government does particularly well.

There were people who had been involved from day 1. I just wanted to mention a gentleman by the name of Gary van Burgel, the chair of the voluntary committee that helps to run Hocart Lodge. The other one is Ron Newby, particularly on the building side—he is a builder by trade. The skills and the passion that these two gentleman brought to this project to make it happen took 10 years or more of work. It took that long to get the momentum and for the project to get to the point that it did. I can only commend them on the extraordinary amount of care and effort they put in.

Hocart Lodge offers dementia care and various forms of health care. It's a 60-bed facility now, and it was developed in a couple of stages by Perkins Builders from Bunbury. When you see that this work is being done locally, that's what really matters. The facility is provided to local families, and to have a reasonably local builder from Bunbury able to build this was even better.

I look around at so many facilities. I look at Tuia lodge in Donnybrook—again, another fabulous community effort. This was driven by the community. There wasn't a provider that was in the space at the time, so the community got together and said, 'We need aged-care facilities in Donnybrook.' Of course, it's named after the Tuia family who did so much in this space. It's still offering wonderful care.

I look right throughout the area, and when you walk into these particular aged-care facilities they are like homes. They're a home for our people; they're a home for us when we get to that age. I just think that it's so important that the government is supporting these types of facilities in rural and regional areas so that people can actually live in the communities and they can actually find residential care in the community they've spent their life in. People who have known them all their lives can come and visit. They can continue to be so much a part of the community.

Capecare Ray Village in Busselton is another one. It has such a strong community board and group that have fundraised to make Ray Village what it is. Capecare, with its permanent residential section, is just wonderful. I went there recently and they now have their own coffee shop as part of the residential aged-care area. Your family can come on in, and you can actually sit down with your family member who's in Capecare. You can sit there and have a coffee as though you were out in the community. There is a section outside and there are umbrellas. It's a wonderful environment, and it's a home away from home. That's the lovely part about what's provided by these wonderful residential providers in so much of Australia.

I see this in my electorate repeatedly. There's one after another of these residential aged-care providers that are doing a fantastic job and the people who work there are very committed to the residents. I want to thank them for everything they do for the residents. They become very attached. When my own mother died of the complications of Alzheimer's in a residential aged-care facility, the people from the residential facility who looked after her most came to her funeral. They cared so much for her that they came to her funeral. I will respect that forever and I respect the wonderful care they offered my mother. There were nights when I'd leave her and I'd think, 'I'm so pleased that the people who are working tonight are there,' because they looked after her so beautifully. And I think of Wattle Hill Lodge in Bunbury. It is another place offering very personalised care for people.

As we ourselves get older, we have to think very carefully about where we would want to be and what we would want to do. I've done a number of advanced care planning processes with people. It's one of the toughest discussions you will have with your family, talking about where you want to be and who you want around you and what options you have. But it's a very serious discussion that people need to have. Please, everybody, do your aged-care and advanced care planning now with your families so that everybody knows where you want to be and what's right for you—what care you would like, where you would want to be, the things you do and don't want, the treatments you do and don't want. Make sure the arrangements are all in place so that you are actually making decisions. If you're a young person, please make those plans as well. None of us is guaranteed tomorrow, so let's decide and put plans in place. It takes so much of the angst and pressure off families if, when we do get to a critical situation, our own plans are there to guide our families so that they make the decisions we need and want them to make. They can do that in all confidence, knowing that they're reflecting our needs, what we as individuals want, when we get to that point. I want to thank all of those who are providing that level of care in my community.

Anthony Albanese (Grayndler, Australian Labor Party, Shadow Minister for Tourism) Share this | Link to this | Hansard source

I'm pleased to have the opportunity of contributing to the debate on the Aged Care (Single Quality Framework) Reform Bill 2018. In 2002, as the shadow minister for ageing and seniors, I spoke here in this parliament about the need for the government to provide a real vision for an ageing population. I said at that time:

What we actually need, if we are about building a cohesive society, is hope, a positive vision and positive action to ensure that we are indeed in a position to meet the economic and social challenges of the future.

Today, more than 16 years later, these factors remain just as important if we are to address the needs of our ageing population. I think some of the debate about the ageing of the population sees the demographic changes which will occur over coming decades as a problem. It is actually an opportunity. It is a challenge, but it's an opportunity, if we get it right, to value the contribution of those who have helped to make Australia the great nation that it is today by providing respect to, but also learning from, those people who have real life experience. The fact is that inclusive and cohesive societies don't discriminate against people on the basis of their age, nor on the basis of their gender, their sexuality, their race or their religion. A positive vision recognises the contribution that older Australians have made to our nation. It appreciates that the federal government must take positive action that directly improves the lives of these Australians who need care, either at home or in an aged-care facility. Most importantly, it inspires hope that all Australians will be afforded respect in their later years and can live with the dignity they deserve.

The Aged Care (Single Quality Framework) Reform Bill amends both the Aged Care Act 1997 and the Australian Aged Care Quality Agency Act 2013. In effect, these amendments will apply to aged-care providers under the Aged Care Act and make provision for a single set of Aged Care Quality Standards. This includes changing the function of the chief executive officer of the Aged Care Quality Agency to reference the Aged Care Quality Standards. Labor supports these changes, which will occur on 1 July 2019.

Importantly, the new standards focus on quality outcomes for older Australians living in aged-care facilities, and they reflect years of advocacy from the sector and other stakeholders. The truth is that Australia has seen shocking examples of elder abuse. Instances such as Oakden nursing home or Mitcham Residential Care Facility revealed appalling abuse of vulnerable aged-care residents. We must learn from examples such as these and always push for change so that abuse becomes a thing of the past.

During the time I was the shadow minister I had the opportunity to visit aged-care facilities right around the country, in regional areas like Rockhampton and in our cities, including all of the capital cities. What I saw was a workforce, particularly the dedicated aged-care nurses and aged-care assistants, who work with a commitment that one has to admire. They're really helping people who need that support. But the truth is that, not just in aged-care facilities but unfortunately often even within families, elder abuse—essentially using the power imbalance that exists where an older Australian has health issues and is not able to physically or even intellectually defend themselves—is a tragedy that happens all too often.

This is about respect for our older Australians. It should be the case that quality outcomes for older Australians are part of the federal government's policy agenda. We must invest in measures that ensure that older Australians can live with dignity in communities all around the nation, whether that be in our cities, our regional areas, or our rural communities. We simply can't afford not to do so. The advancements in health and science mean that we now live longer. In 2012 people aged over 65 made up 14 per cent of our population, but by 2061 this figure will increase to 22 per cent. From 14 per cent in 2012 to 22 per cent just 50 years later is an extraordinary increase in the make-up of the population. Moreover, the proportion of Australians aged over 85 will also rise from just two per cent of the population in 2012 to five per cent in 2061.

Just this month I went to visit my mum's grave at Rookwood Cemetery. She died in 2002 aged 65. She was spent, essentially, at the age of 65. She had spent an enormous amount of her last 35 years on the planet in hospital—particularly with rheumatoid arthritis, but the drugs to assist with that problem had created a range of other health issues for her. When she passed away, at age 65, that was in many ways a decision that she probably made—that she was done on this earth.

With today's care, the generation of which I'm a part, let alone those younger generations, will not be in those circumstances in most cases. People have better access to health care. People do get that assistance. But with that comes the enormous responsibility that we have as a parliament to provide that leadership, to make sure that the investment is there and to make sure that the long-term planning is there to cater for what will be a vastly different make-up of the population than exists today, let alone existed 10, 20 or 30 years ago, when people were regarded as very senior when they got to 60 years of age. That requires a comprehensive plan, and it's one of the reasons why I was very attracted to the portfolio of ageing and seniors, to deal with, importantly, not just aged care, which is what the portfolio was called for a long period of time. It requires planning in terms of not just health but also housing—it requires a whole-of-government approach. Adaptable housing is one of the things that we need to consider in terms of the changing make-up of the population if we're going to allow for people to stay in their homes for longer, which, by and large, overwhelmingly, is what people want to do. We need to consider the nature of the way that communities are built, to make sure that people are in facilities where they're not isolated and left alone. Those awful cases that happen from time to time, where someone has passed away and is not found for weeks, or, in some cases, even longer, are an indictment of our society. That should not happen.

We need a public policy response to these issues. These issues are not partisan. These are issues in which the parliament needs to engage and needs to engage constructively, in a way that commits us to the long-term thinking that long-term demographic change requires. The nature of our transport infrastructure needs to take into account the changing nature of the population. We have seen enormous advances in the way that infrastructure has developed—the fact that buses can lower themselves to make it easier for people to get on and off—but we still have huge issues of accessibility. Why are we still building train stations that don't have lifts, that require stairs? Why is that occurring? We need to incorporate this thinking into the whole-of-government response and indeed whole of government, because it requires cooperation from federal, state and local government.

I think the problem that the government has at the moment in this area is that it's taking retrograde action rather than proactive action. It waits for issues to be evident and then has a response. It has failed to provide the positive vision for older Australians that's required. Indeed, billions of dollars have been cut from aged-care funding since the election of the coalition government in 2013, and it was very disappointing that the rhetoric of the government in the lead-up to this year's budget was not matched by actual investment—very disappointing indeed. It claimed a $100 billion funding boost for the aged-care budget in the pre-budget leaks, but the truth is that there wasn't new money in this budget—not a single dollar. It was more spin than substance. The government failed to match its rhetoric with reality.

At the same time, we know that the waiting list for home-care packages is now 105,000 people. Of these, 20,000 joined the list in the second half of 2017 alone. It is ridiculous, frankly, given the size of that waiting list, for the government to suggest that announcing funding for 14,000 new in-home aged-care packages over four years is a solution to this problem. We need to do much better than that.

A number of aged-care providers across the country are already doing everything they can to support older people, and I want to acknowledge the many aged-care workers who dedicate themselves to this. In my electorate of Grayndler, a number of aged-care providers have implemented policies that enable older Australians to live with the quality care that they need and to feel respected. I want to mention just a couple. The Marion, located in Leichhardt, has invested in safety through the Footloose Falls Prevention Expo, providing residents and staff with information and strategies to prevent dangerous falls, resulting in a 57 per cent decrease in fall-related injuries. The Montrose Aged Care Plus Centre, located in Balmain, is a specialist care home for men living with mental health challenges. The dedicated team at the centre won an award last year for its pioneering approach, which focuses on residents' abilities rather than their limitations. That is a tremendous achievement and a great example of how we can ensure that older Australians are awarded the dignity and respect that they deserve.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

I'd like to commend the member for Grayndler for his comments. It's probably salient to say that I am 65, and this was brought home to me the other day when I was shopping with my wife and, while we were waiting to have the bill paid, the shop assistant asked me for my Seniors Card. But this demonstrates that our population is ageing and that our aged-care needs are increasing, and many people, as they get older, do suffer from chronic illness and require quite significant treatment, even in aged-care facilities.

Parliament, however, as you can see, Mr Deputy Speaker, can do some very strange things to people, and we see evidence in this place every day. It does certainly seem strange to me that, after 40 years practising as a paediatrician, I have finally graduated to aged care. In my role as the member for Macarthur, I have visited a number of retirement living and aged-care facilities in my electorate, and I must say I've been very impressed and very pleasantly surprised.

I rise today to talk on this bill, but first I would like to commend the many aged-care workers who live and indeed work in my electorate and some of the aged-care facilities in my electorate, of both for-profit and not-for-profit organisations, for their ongoing care of the older Australians in my electorate. In particular, I'd like to commend Estia Health, the Mount Gilead retirement living complex, the IRT aged-care facilities and the Frank Whiddon homes for providing excellent care to older Australians in my electorate.

So I rise today to speak about Australia's aged-care arrangements and, more specifically, about the Aged Care (Single Quality Framework) Reform Bill 2018.

This bill was tabled in this House on Thursday, 24 May 2018 and has been brought on for debate today before the Parliamentary Joint Committee on Human Rights, the Senate Standing Committee on the Scrutiny of Bills or the House of Representatives Standing Committee on Health have discharged their respective inquiries on how the bill may affect individual rights and liberties and standards of care. This is both unfortunate and not a practice that I would generally think should be encouraged in debating bills in this House. I'm not here to disparage this bill or unduly delay its passage, but I do have concerns about at least one of the measures proposed and the timing of today's debate.

This is a short bill, but one which has taken the best part of three years to prepare. Streamlined accreditation and quality control arrangements applying to the provision of aged care were first announced on budget night in May 2015, a long time ago. The bill deals with incredibly important and increasingly pressing issues, as we've seen with some of the press reports of elder abuse et cetera in aged care. It's a bit of an overreach, however, by the minister to suggest this bill lays the foundation for the introduction of a single set of aged-care standards. If it has taken three years to lay the foundation, one wonders how long it might take to raise the superstructure, because this is less a case of laying the foundations and more like just locking the front door before the adequate measures have been developed.

The bill neither sets out new quality standards nor puts them into effect. Those are the hard bits and they are apparently still under consideration—or else they ought to have been sent to us in time for this debate, which they haven't been. I'm also concerned and unclear as to the scope of and the precise effect of the provisions in the bill limiting access under the Freedom of Information Act to protected information, including information provided by aged-care providers under the quality agency act to government officials. It is very unclear. I am keen to know what sort of information this Freedom of Information Act exclusion contemplates. Does the bill, for instance, target inhibited access to the accreditation records of aged-care providers? We don't know. I would be grateful to the minister if he could address that question on the proposed scope of the freedom of information exclusion later in this debate.

Having said all that, let me explain why I think it is worth giving this bill a second reading, notwithstanding the criticisms I've just got off my chest. First, by the time this bill finds its way to the Senate, some of the defects in process that I've identified may well have been addressed—for example, the Parliamentary Joint Committee on Human Rights and the Senate Standing Committee on the Scrutiny of Bills will have reported and, hopefully, will have given the bill a clean bill of health and a tick. If not, then the Senate will no doubt take the appropriate steps—we hope. With luck, any lingering concerns about freedom of information access issues will have been addressed by then as well.

Next, to be fair to the minister, and the department as well, I recognise that they are striving to have the new quality assurance arrangements fully phased in by 1 July 2019. I must say, the minister is trying his best with limited resources to do the right thing. From what I can gather, the arrangements and the new single set of aged-care quality standards have been subject to extensive and multiple rounds of consultation and testing, but we really don't have all the information. The draft proposed standards released for comment in early 2018 attracted support from both providers and some user bodies; although some user bodies were very critical of the arrangements. I note also that the government has allocated $50 million in the 2018-19 budget to residential care services to help to transition to the new standards; although how it's going to be used is still again unclear.

The new quality standards will be enacted through amendments to the quality care principles developed initially in 2014, and will therefore be subject to direct parliamentary scrutiny and possible disallowance. More government can be good.

My second reason for supporting a further reading of the bill is that I really do think this is an area where government needs to take the lead and really get cracking on the substantive issues. This is a role for government. We have seen already how laissez-faire approaches to aged care have led to damage and even to the deaths of older Australians. At the present time, there does not appear to be a great deal of transparency to some of the aged-care quality standards involved.

If we're lucky, we'll all make it to an age where, as individuals, we cannot care for ourselves and will have to call on relatives, family and friends to provide care for us. This may well be one role where government needs to take overall responsibility for scrutiny. Government or independent third-party involvement later in life is necessary sometimes. However, life expectancy and quality of life in retirement are determined by the opportunities we've had when we were young. Access to education and access to good early health care can often prevent or delay access to residential aged care. However, for many of us, it still will be required, and we must trust in our government to provide adequate standards of care for us.

When we're young, we seldom seem to think about a plan for a time when we can't care for ourselves, and most of us operate on the maxim that God and fate often laugh at those who make plans too long into the future. Nevertheless, many of us will require residential aged care, and sometimes we reach an age where we can't make those decisions for ourselves and we rely on government to provide supervision of our residential or in-home aged care. It's one reason we've now got compulsory superannuation. That is a role for government, as is aged care.

Government has a role in redressing the imbalances in the lives of many of us as we end up in residential aged care, so it is very important that aged care is fair and equitable. Predominantly, our retirement choices are made in much the same way that we make our choice of doctor. It is rarely an exercise of informed choice and often not entirely of our own free will. We rely on hearsay at the present time and we rely on the help of our relatives. As economists often say, health information is often very asymmetrical in that there are power differences. It's very important in residential aged care that we have a more transparent ability to choose the facilities that would best suit our needs and provide the best standards of care. That is why this bill is so important.

In the medical field, the recent Four Corners program on out-of-pocket charges in health fees and hidden doctors' fees demonstrates that there is a role for government in the regulation and oversight of these important health decisions. The same is true in aged care. We know that there are huge levels of community concern about the quality of residential health care, and I think that will always be the case. But this bill can help allay some of those concerns by having a transparent way of assessing quality and making it available to not only the providers of aged care but also the consumers of residential aged care and in-home aged care and their relatives.

Regarding community concerns, there are also areas of little comfort when we see the types of things that have been happening with elder abuse that have been presented in the press before our regulatory agencies have had the opportunity to present this information to the public. These are sometimes matters of life and death. When it comes to these matters, the community rightly won't be placing its faith in what some people would say is a light-touch form of regulation. If we do have oversight of residential aged care, it is very important that the information that is presented to the public is freely available, transparent and of the highest quality. These are indeed matters of life and death, and many of us will face a time when, as we age, we will need to be cared for in aged care, and it is very important that we have the information freely available to us and our relatives.

Aged care is heavily regulated because it is heavily funded by the taxpayer, and the taxpayer wants, deserves and has a right to know that they're getting value for money. The Commonwealth government provides close to 95 per cent of public aged-care funding for all Australians aged over 65 and for Indigenous Australians aged over 50 who can no longer live without support or care in their own home. Overall spending on aged-care services currently stands at $18 billion for the 2018-19 budget and is set to rise steeply over the next four years to over $22 billion in 2021-2022, largely reflecting demographic factors, including increasingly large numbers of baby boomers, like myself, entering some form of residential or in-home aged care.

The government is in the field because people need to know that adequate regulation is in place, and they want it to be there. The government is there to make sure that the myriad rational decisions that work for the majority of individuals don't oppress the minority, or aggregate the poor or the disadvantaged into a collective decision that is against their best interests.

I'm also keen to have this bill go forward as soon as practicable because we are running out of time to get changes made as our population ages. If you want a parallel in other policies, just think about climate change. This government won't be helping if it turns aged-care policy into an ideological battleground. That would be a real pity, because over the last decade we have fallen significantly behind in our provisions for aged care—and we only have to look at the waiting lists to see this. Politics has the potential to derail good aged-care policy, and both the major parties need to work together to get the best results for our older Australians.

The House of Representatives Standing Committee on Health, Aged Care and Sport, of which I am a member, has been inquiring into aged care and the effectiveness of quality arrangements. We've taken many, many submissions and we are still to make our final findings known. This was prompted by reports of poor care in residential aged care in particular, and it means that this bill is urgently needed. We need to get a formal policy and appropriate guidelines as soon as possible to provide for the care of some of our most vulnerable Australians.

So I do commend this bill, with the reservations that I've stated, and I thank the members for their statements. (Time expired)

Pat Conroy (Shortland, Australian Labor Party, Shadow Assistant Minister for Infrastructure) Share this | Link to this | Hansard source

Demand for aged-care services is accelerating across the country, with an ageing population, longer life expectancies and the increasing prevalence of conditions such as dementia. Nowhere is this more apparent than in Shortland, with more than 20 per cent of my electorate being over the age of 65—more than 30,000 constituents. My office deals with complaints about the My Aged Care system, with concerns about the transition from the NDIS and with people who have been on home care package waiting lists for far too long every single day. Providing an accessible, affordable and high-quality aged care system is one of the greatest challenges facing Australia over the coming decades.

That's why I'm glad to speak in support of the Aged Care (Single Quality Framework) Bill 2018, which makes clear the high levels of quality expected from aged-care providers and encourages the accountability of such standards. Getting this right is a step towards providing a dignified life for older Australians and allowing them to contribute their valued experience to our communities. If we get it wrong, we let down a generation of people who have built this country, and we put far too much pressure on hospitals and residential care to provide services. As the Western world confronts the rising issue of ageing populations we have seen many worrying instances of elder abuse, neglect and hopelessness become all too common, both here and abroad. We have a chance now to put in place frameworks and policies that will ensure a sustainable and quality future for all Australians, no matter their age.

In 2016, there were 3.7 million Australians aged 65 and over, a significant increase from the 1976 figure of 1.3 million. We have struggled to keep up with this increase, and with projections indicating that this demographic is set to grow by another five million people to nearly nine million people, or 22 per cent of our total population, by 2056, the lack of policy leadership shown by this government is worrying. It is essential that we have sound, consistent frameworks in place to deal with the inevitable increase in demand for home care packages and residential care over the coming years. There are two main priorities in this area. The first is a guarantee of quality which gives older Australians the dignity they deserve. The second is accessibility, which at the moment is sorely lacking.

The difficulty in accessing aged care in this country is unacceptable. Whether it is sitting on endless waiting lists for the packages you need, being left behind by transitions to new funding models, or the continuing failures of the My Aged Care portal, many Australians feel fed-up. Of all the mainland Labor states, my electorate has the highest number of residents over 60, and my office has been hearing about these issues over and over again. While we always try to help those who come to us with issues, the volume of complaints demonstrates that there are systemic issues that require legislation if we are to see consistent improvement in aged care.

One of my many constituents failed by this government was Joyce Simmons. Joyce initially received care of five to six hours according to her approval for a level 2 home care package, with her daughter Beverley taking on the rest of the caring duties herself. As of March 2016, Joyce had been approved for an upgrade to a level 4 home care package, but this approval was never realised and, after waiting a full year, her daughter contacted my office seeking help. Joyce, who had recently turned 99, had fallen and cracked a vertebrae, making the provision of level 4 care all the more essential, yet My Aged Care was unable to provide her with this care and was unable to provide any information regarding her position on the waiting list. With some assistance from my office and great persistence by Beverley herself, Joyce was finally granted the hours of care she was entitled to in April 2016, over a year since her initial approval yet only a matter of weeks after my office became involved.

My office has also spoken with Hilary Wills and her daughter Kathy Smith about their ongoing struggles to be upgraded to a level 4 home care package. After being unable to get any assistance from My Aged Care, Kathy reached out to my office for assistance. A representative from My Aged Care phoned both Kathy and my office to inform us that Hilary should be upgraded to a level 4 package within four weeks. Having heard nothing from them for a number of weeks, Kathy followed this up only to be told that no-one had mentioned the four-week time period and all they could do was place Hilary on a priority waiting list. This directly contradicted advice given to both her family and my office and has left her family and us feeling very frustrated with the system yet again. It has now been a year and Hilary is still waiting for her package to be upgraded. It should not be this hard. When the only way to get sufficient aged care services delivered is by contacting your local MP's office, something is wrong with our system. We have dealt with many complaints and frustrations like Hilary's and Joyce's, and I'm determined, like all of my Labor colleagues, to fight for a system that will make this process easier.

Labor is committed to making sure that people have proper access to high-quality aged care in this country, and I support this bill accordingly. The coalition's recent budget did nothing to address these glaring issues. Not only are the measures it announced entirely insufficient to make any long-term impact, they are funded from within existing aged-care budgeted resources. This budget simply takes funding from residential care to pay for its home care packages. That's right; not one new dollar is being spent on aged care in Australia by this government. Taking money from other aged care services to fund a mere 14,000 new home care packages over four years is a cruel hoax on those who have been already waiting too long. This represents funding for only 3½ thousand new packages per year, when we know that demand grew by 20,000 in the last six months of 2017 alone. So, despite the song and dance this government has made about new packages in this year's budget, it will not even tackle the current issues faced though seeking quality aged care, let alone provide effective long-term policy for this country. We have over 100,000 people in this country on the wait list for home care packages. This is disgraceful. This is unacceptable. The people in my region, as do people in every part of this country, deserve a better system. They deserve a system that gives them a dignified retirement, that treats them appropriately and that recognises the great contribution they have made to this country.

As I said, I represent the electorate of Shortland, which has the highest number of people over the age of 60 of all mainland Labor seats. My residents, my constituents, deserve better than a government who use smoke and mirrors to hide the fact that they are not taking aged care seriously in this country. This bill goes some way to improving quality in this sector, but much more needs to be done. Unfortunately, I have no expectation this government will take it seriously.