Bert Van Manen (Forde, Liberal Party) Share this | Link to this | Hansard source

It's indeed a pleasure to rise in this House and speak about what I'm sure all of us acknowledge is an extraordinarily important topic, and that is the topic of the quality of care that the elderly in our community receive on a day-to-day basis. The bills that we're debating today are designed to deal with some of these very important issues. They impact directly on the quality of care and the dignity of life of older Australians in residential aged care. We saw, over the past few weeks, the announcement of the royal commission into the aged-care sector. This royal commission will look into the quality of care provided in residential and home aged care for senior Australians, but importantly it will also include young Australians with disability living in residential aged-care settings.

We've all in this place seen the many stories on Four Corners, but also, I'm sure, we've received stories and representations in our various offices about the quality of care provided in residential aged care around our electorates. As a community, we rightly expect high standards of quality, care and safety for those in residential aged care and also in home aged-care situations. Our government shares those expectations, and that is the purpose for the royal commission, because it will be about proactively determining what we need to do in the future to ensure those expectations are met. Sadly, evidence to date has shown that problems are not restricted to any one part of the aged-care sector, whether it's the for-profit or not-for-profit sector, large or small facilities, or regional or major metropolitan facilities. The royal commission will look at the sector as a whole, without bias or prejudice, and it will make findings on evidence. Then, as a government and as a parliament, it will be our job to act on those findings to ensure that the care provided to older Australians is at the level that we would expect as a civilised society.

Whether you're a senior Australian contemplating entering an aged-care facility or are already a resident in such a facility, this bill in the House today is designed to be of benefit to you. If you're one of the many Australians with a parent, grandparent or other relative who is resident in or contemplating entering an aged-care facility or is an operator of or an employee in an aged-care facility, this bill is designed to benefit you.

In 2017, around one in seven Australians were aged 65 and over. We know from the statistics that growth in the number of people in aged care over 65 will occur very rapidly over the years to 2031. It will be roughly twice as fast as the total population growth. In fact, this group has grown in size over that period by 85 per cent, from a bit over three million to nearly 5.7 million people. The highest growth, however, will be in the 75-and-over age group, which is projected to more than double in size to over 2.8 million. These large increases are a result of a variety of factors, including the ageing of the baby boomer group, the decreasing of mortality rates, and the increasing life span. It's also worth noting that since World War II the average life span in Australia has increased in males by 12½ years and in women by 13 years.

Of course, as the number of older Australians in our population increases, so does the number of Australians utilising aged-care services and facilities. We are seeing that the range of medical conditions faced by these people is becoming more difficult and increasing the level of care required, particularly for those with conditions such as dementia. This government is fully committed to ensuring Australians in the aged-care system are better cared for, and this bill is an important part of ensuring this. These Australians who have given their lives to building this country deserve to get the quality care that should be expected in a country like Australia. At the heart of our aged-care system, ultimately, these are people and their lives that we are looking after—senior Australians seeking to live out their lives with dignity in environments where they know they are safe and will be cared for with compassion and professionalism, in places where their quality of life is enhanced and, perhaps most importantly, in places they and their families can trust to deliver the high standards of care that every single senior Australian deserves.

One of the reasons many Australians go into care is that their families can no longer take care of them themselves. It's for a wide variety of reasons, whether it's busyness with work or family lives—as many of us know, that's the case for many people today—or the fact that families may be living far away from where their parents are living today. This is a way that they can ensure their parents are properly looked after. Other reasons are matters of personal security and safety because they can't look after themselves properly at home anymore. Thankfully, there are many terrific community groups that do seek to help elderly Australians remain in their homes longer, by doing such things as little maintenance jobs around the house like mowing their yards. But ultimately that is not enough to meet their needs; hence the need to move into aged care. This is why we're committed to ensuring that families can rest easy knowing the right standards of quality and professionalism are maintained across the system.

This bill gives effect, from 1 January 2019, to the government's announcement in the 2018-19 budget on establishing the new commission. This reform is part of a two-year agenda to strengthen and enhance aged-care regulation in order to protect and assure the quality of care provided to aged-care consumers. The commission's objectives are to protect and enhance the safety, health, wellbeing and quality of the lives of aged-care consumers, to promote confidence and trust in the provision of aged care and to promote engagement with aged-care consumers on the quality of care and services.

In the budget, the government announced its response to the recommendations of the Carnell-Paterson review. Establishing the independent Aged Care Quality and Safety Commission was the first of the recommendations. The commission will consolidate the regulatory functions currently split across three aged-care regulators in order to improve clarity, regulatory accountability for providers and their staff, and certain rights and responsibilities for aged-care consumers and their families. The bill to establish the commission represents the first stage of a two-stage process of reform. The commission, from 1 January 2019, subsumes the existing functions of the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner.

It's disappointing, in some respects, that we seem regularly in this place to have to legislate for entities and organisations in our communities to do the right thing by their fellow Australians. Be that as it may, when we do identify these issues it is our responsibility to put in place legislation and regulation to deal with the shortcomings we are seeing in our community.

I commend the government for its work in this space and for its ongoing work to ensure that we provide the safety, security and level of care necessary for older Australians, who have contributed so much over the years to our community. The work we're doing both with this legislation and with the royal commission will go a long way, I hope, to dealing with the issues that we have seen articulated in the public arena. I commend the bill to the House.

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

As previous speakers have noted, Labor supports these bills while expressing our strong concern about the government's slow introduction of this legislation into the parliament. The purpose of the Aged Care Quality and Safety Commission Bill is to establish the new Aged Care Quality and Safety Commission from 1 January 2019. The new commission will be tasked with helping to restore confidence in aged-care services, given widespread public concern. Whilst this concern was highlighted by last month's Four Corners report, these issues, sadly, aren't a surprise to those with loved ones in aged care or seeking aged care or those working in the aged-care sector.

Many older Australians who now need aged care have lived lives very different to mine and to many of us in this House. They grew up in the Great Depression, served in and lost loved ones in the Second World War or, in the case of many postwar migrants, experienced the hardships of war. They worked and raised families in the early postwar years without many of the things we take for granted today. Free universal health care didn't arrive until the 1970s, women earned less than men doing the same work and occupational superannuation was limited to a lucky few—mostly men—until the introduction of the superannuation guarantee in the 1990s, well after many of this generation had reached the end of their working lives. They just had to trust that there would be an adequate age pension and proper aged care to support them later in life. This is a generation who are reluctant to ask for help, even when they really need it, and are even more reluctant to complain when the standard of care falls short of what it should be or what we would expect. It isn't fair that, when the circumstances of day-to-day life and caring responsibilities become too much and they need help, that help isn't there, or the quality of that help or care doesn't meet what we would want for our parents, our grandparents and loved ones.

The report of the Review of National Aged Care Quality Regulatory Processes, also known as the Carnell-Paterson review, was handed to the government on 23 October last year. It had a focus on quality care. The review made 10 recommendations, one of which was to establish the independent Aged Care Quality and Safety Commission. The government has taken a long time to do the work around establishing this new commission, and it has yet to respond to a number of the other recommendations included in the Carnell-Paterson review.

The new commission will provide a single point of contact for older Australians and aged-care providers in relation to the quality of care and regulation. It will be responsible for the accreditation, assessment and monitoring of Commonwealth funded and other aged-care services, and for complaints handling. Although these bills would be considered non-controversial, there are a number concerns, particularly the time it has taken the government to introduce legislation into the parliament. The Greens have referred the bills to the Senate Community Affairs Legislation Committee for inquiry, with a reporting date of today. We on this side of the House hope the Greens' actions will not hold up the passage of this important legislation. These bills are a missed opportunity for government to give the new commission stronger arbitrary powers, given the widespread public concern.

Labor puts the government on notice that there must be no change to the cost-recovery process and/or fee charges to ensure the ongoing support for smaller providers. Although the advisory council is set to continue, the government is yet to fill three vacancies. Given the responsibility this council has, you would've thought the government would have urgently filled these vacancies. This new agency is due to begin on 1 July 2019, so the government has much work to do to get this commission right.

Given the number of times my colleagues and I have raised aged care in this House, I welcome the government's royal commission into the abuse and cover-ups in aged care, but the government can't wait for the royal commission to report. Older Australians need action now. Labor has been saying for a long time that the aged-care system is in crisis. When the Leader of the Opposition said this in the parliament in May, the government likened it to elder abuse. We are relieved that the government is now listening and has changed its mind. The quality standards and reporting system isn't working. There aren't enough aged-care workers, and they aren't given proper pay, respect or support to do the work they do helping others.

Last year I received a sad letter, which goes to the heart of this matter, from a constituent, Heather, regarding the standard of care her husband, Reg, received in residential care in my electorate. Heather told me that Reg entered respite at the facility in May 2017 and passed away just 7½ weeks later. When Reg was first admitted, he was well, mobile and cheerful. He had some health problems, but they were managed. His placement was due to his dementia. Heather was finding it increasingly difficult and exhausting to look after him at home and needed a break. One morning Heather arrived at the facility to find Reg in discomfort and pain. Reg was in the same position that he'd been in when she had left him the day before. She called the ambulance herself. When they arrived to take him to hospital, the officers noted that Reg had been lying in a bed of stale urine. Upon admission to hospital, Heather was told that Reg was very sick. He had septicaemia from a stage 4 bedsore. The care and treatment Reg then received while in hospital was professional and respectful, exactly what he should've received at the facility but did not. Unfortunately, the septicaemia did not respond to antibiotics, and Reg passed away four days after admission. His death certificate stated the cause of death as sepsis from bedsores.

As Heather said, this should not have happened. The royal commission needs to examine the impact of the government's years of cuts. You don't fix aged care by cutting the funding to aged care. Billions of dollars have been cut from aged care in the last five years. The now Prime Minister cut almost $2 billion in his first year as Treasurer. With three ministers in five years and billions of dollars in cuts, the government has ignored dozens of its own reports and reviews on what is needed to fix the problems we do know about in aged care.

I'll now turn to home care packages. There are now 121,000 people on the home care package waiting list, including 95,000 people with high needs, many living with dementia. I have raised a number of examples of the impact of this waiting list on my constituents in this place. There are 774 people on the Central Coast in the queue, almost two-thirds of whom are waiting for high-level packages. These are people like Gladys, who requires in-home care. She applied for support through My Aged Care a year ago and was approved for a level 2 package, but she is still in the queue a year later. Her daughter Robyn works full-time and helps as much as she can, but since she has been waiting her mother has had four falls, the most recent of which fractured her wrist, further limiting her mobility. Gladys is in desperate need of extra assistance around the house and with personal care.

I wrote to the minister about Gladys. I do appreciate his assistance, but his response was for the family to call My Aged Care for regular updates. She has had four falls whilst in the queue!

When he suggests that people are 'entering' and 'exiting' the queue on a daily basis, sadly we know what that means. Older people are dying before they access an aged-care package.

The royal commission should also look at the difficulty older Australians have—and their family members have when trying to assist them—in navigating My Aged Care. It's complex and it's difficult, and for someone in crisis it can sometimes just be too hard. Patricia, from my electorate, entered residential aged care in September last year. It was a crisis, as many of these admissions are. She had been living at home with a family member whose own health problems had become overwhelming, and they could no longer care for her, despite wanting to. Unfortunately, the original income-and-asset summary provided to the aged-care facility by the Department of Human Services incorrectly included the house as an asset, but this was later changed to exempt the home for two years on account of her family member, a disability pensioner, living in the home. What followed was an administrative nightmare.

Because the original assessment cannot be re-issued, the aged-care facility charged an accommodation levy that should not apply, and Patricia's life savings were taken in fees—incorrectly taken in fees. Her daughter has faced nearly a year of fighting the facility and the department to have the error fixed. Even with the assistance of my office, nearly five months passed before the issue was resolved, and again I'm grateful to the minister for the assistance of his office in this case. No-one really wants to put their loved one into residential care, and families like Patricia's need support in order to do so. They don't need months and years of distress because the system is broken and doesn't work. We can't call ourselves a fair and generous country until older Australians have the love, care and respect they deserve.

As a pharmacist who worked at Wyong Hospital in my electorate for almost a decade, I'm a proud member of the Health Services Union, and I strongly support their Our Turn to Care campaign for better conditions for aged-care workers and the people that they care for. As part of the campaign, the HSU surveyed over 300 of its members. The survey showed that the No. 1 concern of workers, above remuneration, is short-staffing. They said:

You've normally got two staff to 35 people including those with chronic needs and palliative care. You're pushed with work, you can't fulfil all your duties in the 7.5 hours. It's not fair on the workers [or] the residents.

These are common concerns. These were concerns expressed when I held an aged-care roundtable with Labor's Medicare taskforce, with Dr Mike Freelander and Sharon Claydon, the member for Newcastle. One of the things that particularly struck me and stayed with me from that forum was an older person who was at the roundtable, representing people who were members of a local group for older people. She wasn't at the time looking for care herself, and nor was she seeking care for someone else. But during the roundtable she said that the stories that other people had shared had left her terrified. One thing we need to be very, very mindful of is the impact that this has on older Australians and their families and those who look after them—the fear that they have of entering aged care because of some of the stories and some of the things that have happened.

I was proud to stand with my community at the rally at Central Coast Leagues Club recently on the Central Coast to call for more funding and better pay and conditions for aged-care workers. The Secretary of the HSU, Gerard Hayes, told the rally, 'We are creating an existence for older Australians, not a life.' This is just not good enough. Older Australians are at the time of their life where they need care, where they need residential care or they need respite care or they need a home care package, but the support just isn't there.

In February this year, I lost my father, who had lived with younger onset dementia. I am very grateful for the care that my father received, both respite care and in-home care. There were many things that my dad and his friends experienced, and I do want to mention the YODSS group—the Younger Onset Dementia Social Support Club. A lot of people are aware of dementia, but they're not necessarily aware of younger people living with dementia. They have particular needs that must be looked at and must be properly funded. Their partners are often working people who are trying to juggle care, whether it's in-home care or respite care, whilst working. There is a particular set of circumstances and demands on families of people living with younger onset dementia. So today I do want to mention YODSS and Bev and Steve of the YODSS group on the Central Coast and the work they do to help support younger people living with dementia.

We know that one of the largest groups of people waiting for higher-level packages is people living with dementia. I particularly want to say to those in my community that we on this side of the House are working as hard as we can to make sure that you get the care that you need when you need it. Carers often need help, particularly in crisis, and there is an urgency that this government doesn't seem to understand or hasn't really heard. I call on everybody in this House to work towards better-quality aged care so that people and families seeking care or in care have the confidence and assurance to know that their grandparent, their parent, their loved one is receiving the care that any of us would ask for for someone that we love and care for.

Tim Wilson (Goldstein, Liberal Party) Share this | Link to this | Hansard source

It's my privilege to be able to rise to support the Aged Care Quality and Safety Commission Bill 2018 on the basis that we all in this place care about the challenges, the vulnerability and the needs of Australians dependent on aged care. In fact, many of us will know the story and the experience of putting a loved one, in my case a grandparent, into aged care after having lived a happy and full life, sometimes beyond the life of their spouse, in their own home and then having the task of relocating them in their sunset years into the care of others. That's certainly my experience with my grandmother, who currently resides in aged care in Mount Eliza after the death of her husband many, many years ago. Now she is cared for and supported by others.

I know that all members here and all Australians have similar stories and experiences. Deputy Speaker Andrews, you know, as I do, that when you entrust loved ones to the aged care system there are many issues that go through people's minds. One is obviously the care and support for person that they are seeking care for. Some of it is about the financial challenges that can come with making sure we support people in aged care. But, critically, at the forefront of everybody's consideration is always the health and safety of their loved one in aged care and the need to make sure that they are treated with dignity and respect and at the standard that we would want at least for ourselves. The task for us as legislators is how we provide a system that provides the highest degree of support, care and guarantee to Australians so that they can rely on the system to care for them.

There are a lot of technicalities and legalities around how the system is designed. Some of those challenges are very serious. But at the heart of it has to be a well-regulated sector where people are held to account for their conduct should there be misdeeds or misconduct. Those who are vulnerable need to have a pathway of complaint and need to know that their concerns will be acted upon and that standards that we would wish for ourselves are set for others.

This bill is part of a package of legislation seeking to address those issues. The commission brings together the functions of the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner from 1 January 2019, and it will enable a clearer line of accountability and responsibility to government agencies from those who care for Australia's loved ones. It's a simple measure that is part of what this government is doing to support people in aged care and to address the shortcomings in the system.

The recently announced royal commission is in recognition that some vulnerable Australians experience horrific tragedy. Yes, there have been reports from individuals through different agencies over the years. One of the bodies I used to serve on was the Australian Health Practitioner Regulation Agency, which supports the Nursing and Midwifery Board, and I heard firsthand how sometimes, sadly, there was misconduct or abuse against people who were in no position to defend themselves by those who were responsible for their care. Many members in this place will have seen the, in some cases, horrific stories on recent episodes of Four Corners. Those cases do not sit in isolation. There have been cases that have been revealed before and they tell a worrying tale. That's what the royal commission is designed to address—to turn a light into those dark corners and to make sure that truths are exposed so that those who have turned a willing blind eye will be held accountable. It's part of a broader package of what this government seeks to do to make sure that Australians can have confidence in our aged-care sector.

Funding for aged care is at record levels. In 2017-18 alone, aged-care spending is estimated to reach $18.6 billion, and over the next five years funding will grow by $5 billion to $23.6 billion. Some $1.6 billion has been provided to create an additional 20,000 higher needs home care packages since last December. In excess of $50 million has been provided every year for dementia-specific programs. A further $5.3 million has been committed over four years to pilot improvements to care for people living with dementia, with an emphasis on the use of innovative technologies. And that's the point. While dollars and cents do matter, and no-one's trying to pretend they don't—we can always have a discussion about what and how much and whether it should go up or down and whether we should find new ways to spend it—the outcome is what matters. The realisation and the value of the public money spent is through the improved human condition of those receiving care.

One of the broader trends, as anybody in the aged-care sector will tell if you talk to them, is that the system where people would go into care for prolonged periods in their twilight years is changing. We, of course, are providing more home care packages so people can stay in their homes longer—to have the choice to do so, to get the care where they want it, to live in the community that they know and love. What's happening is that people are going into aged care later and for shorter periods of time, with much higher care needs. That creates challenges for the system, in terms of design, capital and infrastructure, based on the prolonged periods of time that people stay there.

But more critically, when people go in with higher care needs, they face bigger and more unique challenges. The expansion in the need for dementia support services is a critical part of that story, because people often go in, as I said, in their sunset years, increasingly not knowing as much of the world around them, with a declining memory and with an increasing distance to their reality. Our task is to make sure that we have a system that can care for and support those people at that stage of life so that they continue to enjoy not just comfort, though that is important, not just health and safety, though they are important as well, but dignity, not only within themselves but also dignity for their families so that they can preserve the memories as best possible of the people that they love and care about. And that, ultimately, is what this legislation and this government's package of reforms are seeking to achieve. It is, of course, not the end.

I'm under no doubt that the royal commission will uncover stories that will shock the nation, because what people will see, as we have seen before, is that, tragically, there are times when people are in the care and assistance of others at no greater or more vulnerable stage of their life and they are taken advantage of by those who should know better. Our task in response is to soberly and cautiously go through the evidence and the conclusions of the royal commission when it is completed. It is not simply enter into a discussion around dollars and cents and think that that will solve all problems because, as I've outlined already, while that may be important as part of the story—and it is—what will deliver the improvements for the Australian people and the aged-care sector is a sense of safety and dignity for their loved ones.

More critically, what we can't allow this royal commission to do is cast a dark light, a shadow, over so much of the good work in the aged-care sector done every day because, for every one person who wrongs, there are thousands who do right. There are so many nurses, support staff and carers who every day, through sacrifice or love, turn up in community and commercial aged-care facilities and provide ongoing love and compassion to those people who need that care with the admiration of those they care for, of their families and their communities, who form a central part of the nucleus often of rural and regional communities as well.

As I said earlier today, I recently went to the launch of the renovated facilities at Fairway Bayside Aged Care in Sandringham, just like I recently visited Vasey RSL Care Brighton East. These services provide the most incredible facilities for people seeking to age with dignity, support services that are highly attentive to their needs and that not only fully recognise the expectations the community has of them but also recognises the expectations of their clients and their families, and what they deliver is a service that we should be proud of. They should be held up as exemplars. While there are wrongs, there are so many rights, and the same is true of so many other facilities across Goldstein—and, I'm quite sure, across the whole of the country. Our task, as parliamentarians, and as part of the national conversation, is to celebrate their work, to thank them enduringly for what they do, and to uphold the integrity and the dignity of their profession, at the same time as scrutinising those who have not met that standard. Our task is to thank them every day for the incredible work they do to care, to love and to show compassion for this nation's most vulnerable.

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

I, too, rise to add my support to the Aged Care Quality and Safety Commission Bill 2018. The Carnell-Paterson review recommended bringing together the functions of the Aged Care Quality Agency and the Aged Care Complaints Commissioner. This was one of the 10 recommendations included in the Carnell-Paterson review. As the member for Hindmarsh—which is one of the oldest electorates in the country; I like to call it the wisest electorate in the country, because with age comes wisdom—I hear from constituents regularly who feel that they don't have a voice. They perhaps feel that they have worked all their lives, they've done everything for this nation, and now, in those twilight years towards the end, they are not getting the services that they require or that their loved ones are not receiving the services they require. So I sincerely hope that this bill will go some way to restoring the confidence of aged-care consumers and our senior citizens, in this period when they need these services.

Again, right up-front, I would like to acknowledge all the men and women who work in the aged-care sector. They include the carers, nurses, doctors, staff, kitchen staff and cleaners who keep the places going—especially the carers, because this is National Carers Week, which is celebrated between 14 and 20 October.

As I said, this bill is designed to provide a single point of contact for aged-care consumers and providers of aged care in relation to quality of care and the regulation that will be responsible for the accreditation, assessment and monitoring of, and complaints-handling for, aged-care services and Commonwealth funded aged-care services. The commissioner will be appointed for five years. The commission will regulate all areas of aged-care services, including residential aged-care services, home care services, flexible care services, the Commonwealth Home Support Program and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program.

About 1.3 million Australians are currently receiving some form of aged care, and that care is provided by approximately 400,000 nurses and carers. It's predicted that by 2056 the aged-care workforce will need to triple, and that takes us to around one million workers that will be required to care for and deliver services to the numbers of people—approximately 3.5 million older Australians—who will require those services.

Public expenditure on aged care is expected to double as a share of the economy by 2050. Billions of dollars have been cut—as we all know, from that horror budget of 2014-15. But we know that public expenditure is expected to double as a share of the economy by 2050. The Prime Minister, the then Treasurer, cut almost $2 billion in his first year as Treasurer. You cannot take $2 billion out of an industry and not expect it to suffer. Is it any wonder that the system is in crisis?

There are well over 108,000 people on the home care package waiting list, including 88,000 people with high needs, many living with dementia. As I've said in this place many times before, and as we've heard other speakers say, in the future we will judge ourselves as a nation by how we treated our elderly. We know that that figure of 108,000 blows out every quarter because there are more people going on the waiting list.

A classic example of this is a particular constituent who rang me the other day. We are trying to assist him, and we have written to the Minister for Senior Australians and Aged Care. He is looking after his aunty, an elderly woman in her mid-80s and who is on the list waiting for an aged-care package. She has been on that list for well over six months. She has now deteriorated and needs a higher-standard package, so she has to go through the assessment all over again, and there could be another six-month wait period. So she is waiting for another six months on top of the six she has been waiting for, which takes it to 12. She will deteriorate again before the package is handed to her. We're working with the minister's office to try to assist them and help them. When Philip rang me last week, he was beside himself. He wants to assist his aunty, who has no-one else to care for her and look after her.

Talking about the home care packages, there's a big debate about this in terms of people wanting to stay at home. If you speak to most Australians, they wish to stay at home, and with good services and good care packages they can achieve this. Unfortunately, there is not enough to go around. There is a desperate need. The release of the March 2018 data sadly reveals there are now more than 108,000 older Australians that are waiting on that list for a home care package. Many are deteriorating while they're waiting, so the package and the care that they will receive will not be up to scratch for their needs, and they will have to be reassessed and go onto higher packages. The waiting times are completely unacceptable. The numbers that we talk about are absolutely shocking. As I said, it's 108,000 and increasing every quarter. Many of these people are waiting with high needs, and many have dementia. Approximately 88,000 people who have high needs are on the waiting list.

It's now clear that the government and the minister have to do all that they can to curb that growing list and do whatever it takes to ensure that people receive the care that's required. We'll need to see a tripling of the aged-care workforce in the next 30 years to provide a high standard of living and care for this growing proportion of older Australians. Are we preparing ourselves for this? Is the government prepared? I'd say no. It's also predicted that the aged-care workforce requirements will need to increase from approximately 366,000 to around one million by 2050. Is the government prepared for this? Are we working towards this? I'd say no again.

Since government dumped Labor's $1.5 billion workforce compact and supplement after the 2013 election, we on this side have consistently called for the development of a comprehensive aged-care policy. We know that this government's been here for five years since 2013, and they will have been in government for up to six years before the next election comes. We know that the aged-care crisis has grown and become worse. It's been ignored. We on this side have said that it is an absolute priority that we should fix this. The last budget failed to fix the aged-care crisis. We saw funding for 14,000 new in-home aged-care packages over four years. This is cruel and made even worse by the fact that the funding is coming from within the existing aged-care budget. Those 3½ thousand places a year aren't even enough to keep pace with demand. It feels like this government tries to plug a hole and a great big crack opens and gushes out from another place. We're not dealing with it.

It's particularly worrying that the government promised older Australians it would address the waitlist when we know that it will not address the waiting list. We know that the government's promised the world to older Australians waiting on the queue for a home care package. As I said earlier, there are 108,000 people waiting, and every quarter there's another 15,000 to 20,000 going on that list. It was this side of the House that introduced the Living Longer Living Better ageing reforms in 2012. The opposition leader, Bill Shorten, said in his budget reply speech that an elected Labor government will make dementia and ageing an absolute national priority.

We've seen the government finally concede, after many months of discussions, media reports and newspaper articles, that a royal commission is required to deal with a crisis that has unfolded on their watch. They denied that anything was required, but now they have finally conceded. That's a good thing, and I'm happy to see that it will be based in my state of South Australia. I support the royal commission, as do all of us on this side, but after five years in government every one of those opposite must accept some responsibility for this happening and what's going on in the aged-care system. We can't call ourselves a fair and generous country until we give elderly Australians the love, care and respect that they deserve. After all, they're the ones that built this nation that we prosper in today because of their hard work and sacrifices.

What do we get from this government? It's failed to rule out any further cuts to aged care. The Prime Minister was asked this question directly a couple of weeks ago and he declined to rule out cutting further funding from the care of older Australians. Australians are rightly appalled by the shocking stories that we see, the horrendous images on TV, the Four Corners programs and the crisis that exists in our nation's aged-care system, particularly the standard of care being delivered in some nursing homes. Why won't the Prime Minister rule out further cuts to this area? As Treasurer, the Prime Minister cut $1.2 billion from aged care in his first budget. You can't cut that amount of money from a particular area and think it doesn't have an affect. His $1.2 billion cut in the budget came on top of the almost $500 million he cut from aged-care funding in the 2015 MYEFO. This money went out of the aged-care budget and it didn't come back. This cut hits older Australians in residential aged-care facilities. It hits them the hardest, with a 50 per cent cut to the indexation of complex healthcare subsidies. The royal commission must examine the impact of these years of cuts. You don't fix aged care by cutting it; you fix it by funding it.

To date there have been more than a dozen reviews. We've had hundreds of recommendations on this issue and they've all been ignored by the government. This isn't good enough. For all of the claims of the baby boomer budget earlier this year, the Prime Minister, then Treasurer, again cut further funding from residential aged care to try and fix the growing crisis in home care that was created by the government by cutting it to begin with. The Prime Minister and the Liberals can't be trusted to ensure older Australians get the services that they need and require. As we've heard from other speakers, the Prime Minister was the architect of those cuts, which have gutted aged care and put the sector under immense pressure. You can't rip out that amount of money, close to $2 billion, from an aged-care system over five years and not have an impact on quality. It's common sense.

As I've said, as the representative for an area that has one of the highest ageing populations in the country, I've met and spoken with many constituents and people in the sector, who often complain about the tin-ear approach of the agencies and the way this policy is set up through this government. The government must explain to the Australian people how these continuous cuts to the aged-care budget have contributed to the crisis that we now face in aged care. The Prime Minister, as I said, was then the Treasurer who signed off on all those cuts to aged care in the 2016 budget; then he complains that there's a problem. Can you believe it—you cut and then you complain about it? When you make those cuts, it has devastating affects. The Prime Minister needs to tell them what he did and why he did it and come clean that he did cut aged-care funding. It's on the public record. We argued this point during the last sittings. The Prime Minister said that it was a lie to say he had cut funding to aged care. But all you have to do is look at the budget papers that were signed off by the Prime Minister when he was Treasurer. These cuts that he's denying are right there in black and white on page 101 of Budget Paper No. 2. But we all know that the infighting and the divisions that were taking place would have been their priority instead of looking at aged care and these issues at the time. It's time that the government started doing better on this critical area of policy.

I've always said that we should judge ourselves as a nation by how we treat our elderly—the people who have worked hard, the people who can no longer look after themselves, the people who have brought up children, grandchildren and in some cases great-grandchildren. They have kept family units together and have done everything for Australia as workers and as contributors, and now it's our time to look after them. I think it's an absolute disgrace that we don't have confidence in our aged-care systems in place. We should do everything we can to absolutely fix this because these people deserve better.

David Gillespie (Lyne, National Party) Share this | Link to this | Hansard source

I represent the people of the Lyne electorate, which has one of the greatest aged demographics in the country. We have many aged-care facilities and many residents living at home relying on the aged-care home support package system. I must say that I have visited many of these nursing homes and residential aged-care facilities along the length and breadth of the Lyne electorate. From the north end around Wauchope and right down to Tea Gardens, we have many residential aged-care facilities.

The Aged Care Quality and Safety Commission Bill 2018 and the associated Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018 had their genesis in the coalition government's commitment to improving the quality and safety and the standards for senior Australians who receive aged-care services, both residential and in the home care mode. It is very timely, as you know, because of recent events and the royal commission, that these bills are coming through at this time, but the genesis of this happened long before recent events appeared on TV. In fact, our royal commission into the aged-care system was initiated before any of the recent media coverage of this industry. These bills reflect the recommendations of a longstanding review of the national aged-care system's regulatory processes by Kate Carnell and Professor Ron Paterson.

In summary, this legislation merges the roles and responsibilities of two organisations and puts them into a unified one-stop shop so that both providers of aged care and people who are consumers—namely, the aged people who reside in these facilities or who receive care at home and their families—will know who is controlling standards and who they are to bring up any concerns with. Currently, these roles are divided between the Australian Aged Care Quality Agency and its CEO, and the Aged Care Complaints Commissioner. These bills establish the Aged Care Quality and Safety Commissioner and the Aged Care Quality and Safety Commission. The bills transfer the operations of the existing bodies into the new commission. They will also transfer existing members of the Aged Care Quality Advisory Council to the new Aged Care Quality and Safety Advisory Council. The bills also describe the appointment processes for the commission, its council members and the commissioner himself or herself, and the reporting requirements are outlined. They describe how the information can be used or disclosed and what is protected. The commission will commence operating on 1 January 2019.

As I mentioned at the opening of my comments, aged care is a large part of the economy of Lyne because it is such a labour-intensive industry. During my time representing and caring for the members of the Lyne electorate, I have stressed the need to increase aged-care facilities across the nation. The mid-north coast of New South Wales has had an ageing demographic for decades longer than the rest of the country. We have a cluster of ageing people, many more than what you see in metropolitan Australia. So I have been very pleased to see a growth in aged-care funding across the Lyne electorate.

When I first was given this responsibility, the aged-care combined budget was about $90 million annually. It's now up to $130 million annually. The number of aged-care beds has grown. Recurrent spending has grown. We have had increasing numbers of capital works projects that have been delivered inside the Lyne electorate. Underway at the moment there is a massive expansion at the Pacific Cape facility at Forster, with 144 new high care aged-care residential places. We've had expansion at the existing facility in Largs at the southern end. Over on the coast, at Hawks Nest and Tea Gardens, we've had an expansion at the Peter Sinclair Gardens. In the regions of Taree and Wingham, in the middle of the electorate, the Salvation Army has received an allocation of 80 new places, which will deliver a massive new facility for the Manning Valley. In Wauchope, Bundaleer Gardens, which has been in existence for decades, has received another 40 places for high care residential care. In the aged-care approvals round in the 2016-17 budget, there is an $8.5 million grant to allow this expansion.

We've recently fought for and received an $8 million capital grant towards Anglicare's new modern, up-to-date nursing home and aged-care facility at Gloucester. They were struggling to get an up-to-date and appropriate aged-care facility, having the legacy of what used to be a nurses' home, adjacent to the hospital. It is currently straining under the physical limitations of the building because it wasn't really built with aged care in mind. Basically, it was a dormitory for nurses in the old days when nurses trained at Gloucester Hospital. Across the Hunter River, at Raymond Terrace, we have a similar facility that has been announced in these funding rounds. All together, we have made a huge advance across the Lyne electorate.

Across Australia, however, long before the recent attention in the media with the royal commission, the minister and the coalition government looked at the required growth in the workforce. They made a fiscal allocation to a workforce development fund. We've also increased funding for multipurpose centres. We have increased flexible multipurpose services, transition care, short-term restorative care and flexible care for the national Aboriginal and Torres Strait Islander care system.

The other large increase has been the home care support packages, and that is really a very significant increase. We know that up until recently there were about 79,000 people receiving home care packages, but in the most recent budget there was $1.6 billion extra, including 6,000 new high care home care support packages and, over the forward estimates, another 14,000 in total, which will address some of the unmet need, because people want to live longer and with better quality of care in their own homes. It's a 20 per cent increase in one year. As I mentioned, we had about 71,000 people receiving home care by March 2017, but now that's up to 85,000 people at the end of March 2018. In rural and remote Australia, we have addressed the reality that the economies of scale are not there, so there is a $40 million pool for capital grants. Across the whole of the nation, the spend in rural and remote Australia is really significant.

When we realise how many people in Australia will require residential care or support packages in their own homes at some stage of their life, we can understand why this is such an important issue. We have people living longer because of improvements in modern health care, we've got better nutrition throughout their lives and we've reduced smoking. We have done so much in this space because we realised that we have a huge demand coming forward.

The other thing I'd like to make a few comments about is the royal commission. We realised, and Minister Wyatt realised, that there were instances where care was not appropriate. That's why he initiated these inquiries and why he was at the forefront of asking for a royal commission. It has a very large remit. Overall, it's looking at and trying to ensure the quality of aged-care services for Australians. Across the Lyne electorate and even before I was the member of the House of Representatives representing the Lyne electorate, I spent a lot of time visiting aged-care facilities because of my medical practice background. We are looking at the holistic extent of aged care, trying to identify the extent and instance of any substandard care, including, I hasten to say, mistreatment and any other form of abuse, and what the causes are behind any of these systemic failures—if and when they're identified. What actions should be taken? We need to know how to deliver the best aged-care service for Australia's seniors.

We're also looking into the care delivered to people with disabilities, including that cohort of people who end up in nursing homes at a very young age. That focus on people with disabilities and younger people in nursing homes is really important. The scourge of dementia will get particular attention. We will look at what future dementia-care models can be used, what is being used and the future challenges in keeping care accessible, affordable and of a high quality all at the same time.

There is the context of more people wanting to spend their senior years at home rather than the historical pattern of entering into residential aged care at a younger age and spending four or five years there. Now the average in some areas drops down even to six months, or to three months in some instances in my electorate. In looking at home care support packages and how home care can be delivered, the focus on rural and remote Australia is very important because, as I mentioned, some of the economies of scale don't exist in rural and remote Australia. I think that the need for support from the federal government will be critical to maintain those standards.

What Australian communities and families can do to improve aged-care services, and what they're looking for, is ensuring that all services should be patient- or person-centred and that there should be choice for people going into them. The control and the interdependence of those requirements should keep services accessible, affordable, person-centred and high quality. And it has to be sustainable. As you know, Mr Deputy Speaker Mitchell, with the increasing numbers of senior Australians and with the amount of money available for all services, with the growth of the NDIS, the growth in the health budget and the growth in the aged-care budget, sustainability and quality are paramount. We can do this by using more technology and by growing our workforce, and also by looking at innovative models of care.

I thoroughly support this cluster of bills which will develop a one-stop shop so that both people working in the industry and people consuming the care in the industry will have a clear and transparent process for maintaining standards and for complaining when they aren't met. Aged care should be high quality. It should be accessible, particularly in rural and regional Australia and in electorates like Lyne. But please be reassured that I have fought long and hard over the five years I've been representing and caring for the Lyne electorate that we have delivered the goods in Lyne. There has been a massive growth and it is really well deserved because we have so many good institutions, but we need more physical places.

Patrick Gorman (Perth, Australian Labor Party) Share this | Link to this | Hansard source

Aged care is about people—people who we love and people who are vulnerable. Providing high-quality aged-care services to residents—elderly Australians—and assurance to their families and to those who love them is an essential task of any Australian government. Australia, a rich developed advanced country, should have one of the best aged-care systems in the world, and those who consume the services of the aged-care sector should have absolute confidence that the services they are being provided are of an international standard. Unfortunately, in Australia today, there are three debilitating problems with our current aged-care sector.

The Leader of the Opposition highlighted these problems plainly and simply in an interview recently on the national public broadcaster, the ABC. He highlighted these problems that are well known to anyone who works in the sector. Firstly, the staff do not get paid properly. We've got to be honest about that if we are going to grow and build this sector for the future. Secondly, we need adequate ratios of qualified staff, qualified carers, qualified nurses and all of the other health and professional workers who engage with the sector. Thirdly, years of budget cuts have reduced the quality of care and the time available to those who work in the sector to look after their residents.

The electorate of Perth is home to some 1,700 residential aged-care places from the Carramar Hostel in Morely down to Leighton Nursing Home in West Perth. The federal government spent more than $110 million in Perth alone on residential care in 2016-17. But to give us some idea of the scale of the problems facing the sector and facing us as a community, while there are 1,700 residential care places, in the electorate of Perth there are some 14,000 people over the age of 70 in the electorate. This is a big challenge and it's one that we're going to continue to confront in this parliament for many years.

Aged care has provided two women in my life with dignity in their final years. My great grandmother, Rooke, helped raise my father, Ron. Later in life, Rooke lived in the adjoining house to my home and she was my regular carer when my mother returned to work. I know all too well that older Australians are key to raising and educating the next generation of Australians. Rooke was sharp. She worked in the Australian tax office for decades and was proud of her efforts in being seconded to assist with the administration of Australia's war efforts. In her retirement, while her mind was sharp, she eventually began to have injuries from falls and minor incidents. There comes a point for many families where the burden becomes too much. My dad speaks of the pain that he and his mother went through in having to make the decision to place someone that they loved, who had been such an important part of their lives, into care. Dad describes his first engagement with the aged-care sector as navigating 'a mix of stigma and ignorance' and, at the same time, handling all of the personal guilt that comes when you take a loved one out of the family home into a world where the care is what is available or what you can afford, not always what you need.

We were lucky in our family that Rooke found a place that was close to home in a centre that is now known as Aegis St Francis. It was a centre that respected her interests. They even allowed her to form and run prayer groups while she was in what became her final home. She ran the prayer groups as her health continued to deteriorate and she developed dementia, something that affects more families than any of us in this place probably know. For myself—at the time a high school student in year 10 who visited regularly—and for my parents and my grandmother, it was the staff in the centre that made that adjustment manageable, emotionally and practically. I want to thank all of the staff who worked with Rooke at that time. The staff in aged care do heroic work.

Rooke had lived with her daughter, my grandmother Pat, since my dad was six months old. Grandma Pat herself worked in the healthcare space, in the administration at Sir Charles Gairdner Hospital or, for any Western Australians, 'Charlies'. After her retirement, she lived as an active pensioner, looking after my brother and me, learning tai chi and doing all those things that many people look forward to in retirement. Unfortunately, just a few years into her retirement, she developed pancreatic cancer, but she continued to live at home. For older Australians, living at home takes bravery and determination, but it is for many the best way to live and, wherever possible, it's a right that we should do everything we can to ensure. Grandma Pat required occasional care and was well supported in the home before starting to go in and out of palliative care. Again, to work in palliative care is heroic. Grandma Pat died when I was in year 12. I'm glad I can again say thank you to the people who worked at Silver Chain, in the palliative care and aged-care space, who cared for her when we no longer could.

It's because of these experiences and those of hundreds of thousands of Australians that I want to dedicate my contribution on the debate about this bill to the people who work in aged care—people like Simone Walsh, who works in the laundry of an aged-care home in Western Australia. Simone was leaving work one day when she heard the nurses talking about how incredibly sad it was that one of the residents who was passing on had no local family. Instead of just going home, Simone went to the resident's room. Simone sat and held her hand for the next two hours. She was there as the resident passed on, just so that she would not die alone. I think that tells you a little bit about the commitment that people who work in aged care have, not just to their professional job but also to the residents they work with and care for every single day.

Another Western Australian, Melinda Vaz, is a worker in aged care pleading for staff-to-resident ratios. Melinda has said that her facility is struggling due to the cuts:

We have a ratio of four staff to 31 residents. There is so little time that can be given to each resident. There are no mandatory staff-to-resident ratios for our industry, unlike in hospitals or childcare centres, so some facilities just cut right back on staff.

She says that she's aware of one facility where there are 60 residents being looked after or monitored by just one staff member during the night shift. This alone demonstrates the need to expand the conversation we're having today and for the royal commission to look at the need for staff-to-resident ratios if we are to have a sector that meets world-class standards. Again, to those who work in aged care: thank you for working in aged care; thank you for the work you do and for the sacrifices you make.

I'm also realistic that the operators in the aged-care sector are under extreme pressure. I've had the privilege to get to know, over a number of years, Graeme Prior, the CEO of Hall & Prior Residential Aged Care, a proud Western Australian company. I've learned from operators like Graeme, people who are passionate about ensuring that every Australian gets the quality of life they deserve. Graeme, in his leadership of Hall & Prior, has shown the true circle of life that aged care represents. I was pleasantly surprised to read, in researching for this speech, about the future of Woodside Maternity Hospital. Woodside Maternity Hospital is where I was born in 1984. It closed and concluded its work as a maternity hospital some years ago. A beautiful building in East Fremantle, it was built in 1897, initially as a residence. It became a maternity hospital in 1951 and is now under a major renovation to become an aged-care facility run by Hall & Prior. This redevelopment will create hundreds of jobs in the construction process and hundreds of jobs when it's in operation, add new aged-care places to the sector and ensure that this beautiful building continues to provide care for vulnerable Australians at the other end of the age spectrum. Graeme Prior explained his business philosophy: 'To me, it is part of what we do—preserving wonderful iconic parts of the community.' I think that comment is as true for the building as it is for the residents and consumers of aged care.

I make the point in this debate that aged-care residents are consumers. They are consumers of a service and they deserve all of the rights that are afforded to them as consumers in the Australian marketplace. I note we've got the shadow minister for consumer affairs in the chamber at the moment, and I thank her for being here for this speech. Becoming an aged-care consumer—

Mr Falinski interjecting—

I also thank her for the important work she does as part of her chamber duty for the operation of the parliament.

Becoming an aged-care consumer is currently not an easy process. There are many complex forms, weeks or years of investigation and waiting lists that feel like they can span forever just to get access to essential services that an individual needs. It is at this time that people also begin the discussion about plans for the final years of one's life, juggling the immediate needs of care services and the important decisions about what happens at the end of one's life and how that life may be celebrated by family and friends when someone is no longer with us.

In this regard, I want to commend the work of the chair of the Western Australian parliament's Joint Select Committee on End of Life Choices, Amber-Jade Sanderson. The committee's report, released in August, is a carefully considered analysis of the laws needed to ensure people can manage their health care throughout the dying process. I raise this work because aged care is not just one commission, one council, one service provider or one government department. For people to have dignity in their final years it is essential for both state and federal governments to work cooperatively to deliver quality and choice for all Australians. I note that local government should also ensure timely approval of aged-care facilities to make sure that there are enough beds available in local municipalities.

The aged-care sector, valued at some $17.4 billion by the Productivity Commission, has more than one million Australians accessing some form of its services with federal funding in this current financial year. That's more than 200,000 people in permanent care and 700,000 people accessing the Commonwealth Home Support Program. The Productivity Commission has issued a very stark and firm call about the need to think about the future of the sector, which is, I note, what the government is doing with the introduction of this bill today. The Productivity Commission said:

The Australian population is ageing rapidly, with the proportion of people aged 65 years or over in the total population projected to increase from 15.1 per cent in 2016 … to 21.8 per cent in 2056 …

The more alarming news is that by 2056 we will need to triple the aged-care workforce in this country. In other words, our nation will need around one million aged-care workers. That's one million workers delivering services to more than 3.5 million Australians in 2056.

In making further comments on this bill, I want to commend the work that Labor's shadow minister for ageing and mental health, Julie Collins, has done. Her advocacy for older Australians and the people who care for them is one of the reasons we are having this debate today. The Aged Care Quality and Safety Commission Bill 2018 will establish the new Aged Care Quality and Safety Commission from next year. The commission will have a significant mission—restoring confidence for aged-care consumers, restoring confidence for their families, restoring confidence for millions of Australians. It will also have an important role in dealing with some of the recommendations that come out of the royal commission.

The Aged Care Quality and Safety Commission will, fortunately, provide a single point of contact for aged-care consumers and a single point of contact for the providers as well. I think that's something that will be welcomed by many people who are operating in the very difficult business environment that is aged care. The agency will have responsibility for accreditation, assessment, monitoring, and complaints handling. In other words, it will have its hands full! This will cover residential aged care, home care, flexible care, the Commonwealth Home Support Program and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. For this reason I would say that, when the government considers who they will appoint as the first commissioner, it will be a very important decision for the government.

There are problems that this commission won't fix: quality standards in the sector are dropping; the reporting system is not working; there aren't enough aged-care workers and they aren't given enough pay; and we have had cuts in the sector. With the sector in crisis, I welcome this piece of legislation, but I will finish my remarks by saying there is much, much, much more to do.

Jason Falinski (Mackellar, Liberal Party) Share this | Link to this | Hansard source

I would like to join the member for Perth in thanking the shadow minister for consumer affairs for being here to listen to this very important speech. Before I arrived in this place I had a business that supplied a lot of furniture and equipment to nursing homes and to the aged-care sector and the healthcare sector generally. It was a very interesting perspective on life and quite a confronting one for a 30-year-old to start a business and see so many people at the end of their lives. In the years between coming to this place and looking after people in so many nursing homes across Australia, I think I saw the best and the worst of humanity. But the one thing I can say for sure is that the aged-care system in Australia has never been better. In thinking back to when I first started out, 15 or so years ago, my first experience with a nursing home was to walk into the UnitingCare facility in Croydon. Before even getting to the door you were overwhelmed with the stench of urine emanating from the facility. To this day, it is something I cannot forget.

There were other instances, such as when I pulled into a nursing home in Bathurst one day and saw all the staff in the parking lot smoking. When I went into the facility—it was in the middle of winter—I found all the residents sitting in chairs in the common room of the nursing home watching a fish tank, literally. I remember another incident in which a not-for-profit provider was looking at one of our beds. As I walked down the hall, there were three women—they happened to be women—in three separate rooms screaming for someone to come and help them. I don't know how long they had been there. I still remember their cries of agony as they sought to be helped. That was 15 years ago. I haven't seen anything like that in the last 10 years or so. It wasn't because the facilities didn't have enough money and it wasn't because the facilities were understaffed—in fact, in many instances, quite the opposite. It was because we were coming out of a period in which aged care was seen as the annexe at the back of the local hospital. It was because we didn't treat our tribal elders as human beings, but rather as problems, in many instances to be forgotten.

A huge change occurred in 1987 when the then Hawke-Keating government started to allow new nursing homes to be built. There were also the reforms of the member for Pearce and the member for Menzies in the Howard government, which allowed private sector investors to come into the market. As the member for Perth mentioned, providers such as Graeme Prior, who was a good customer of mine, brought a level of service and care to nursing homes and to nursing home residents because he actually cared about the people who were in his home. The member for Perth mentioned that they are not just residents but are actually consumers of these goods. That's why it's so important that we have the shadow minister for consumer affairs here. The importance of that is that when we started treating these residents as human beings who had a choice, the quality and level of care went through the roof. It was an important and critical factor in improving the level of care that older Australians, our tribal elders, got. It wasn't by dint of government regulation. It was by dint of government reform that allowed people to come into this market and to provide a better service.

To that end I also have to congratulate the member for Port Adelaide. If the truth be told, the Howard government probably did hold off on a lot of other reforms that the member for Pearce would have liked to have implemented. But the member for Port Adelaide, and then Senator Fifield when he was the aged-care minister, did a lot of important work in terms of providing even further flexibility in this market, which allowed more people to come into this market and allowed more people to have choice. The greatest problem that we have in Australia today is the fact that people, when they need to move into their last home, don't have a choice anymore. They have to pick either from staying at home, which has no longer become an option, or moving into a nursing home that was built in the 1950s, for the 1950s, with attitudes of how people should be treated in the 1950s, because there is nowhere else for them to go. That's not good enough. It's not good enough in the 21st century and it's not good enough in a country like Australia.

So when the Labor Party talks about cuts to aged care, know this: what they're saying is that when Minister Ken Wyatt introduced this bill and said, 'We are going to stand up for the rights of those residents. We will no longer allow private sector companies, and for that matter not-for-profit companies, to use our ratings system to rort taxpayer dollars while not delivering the care that they say they are delivering to Australians,' he stood up for the integrity of this parliament, for the integrity of the aged-care system and for the integrity of those people who are in those homes today.

Let's be clear that when Labor talks about restoring the so-called cuts, what they are talking about is restoring the rorts that were out of control in the aged-care marketplace, where people were rating people as having a level of care and requiring a level of care that everyone knew they didn't know. We had providers in the Australian market whose business case was that they could better manipulate the ACAR system to ensure they got the highest level of funding that they could possibly hope for. It was a rort. It was taking money from the care of others and putting it in the pockets of the unscrupulous. That's what Labor wants to return to in this entire argument. It's absolutely appalling and they should know better. They should know better primarily for this reason: both sides of this parliament have done a tremendous amount since 1987 to restore the level of care, hope and generosity that our country has always been known for to older Australians regardless of where they are in Australian society. What they're seeking to do is undo some of that bipartisanship for base political purposes. It is absolutely appalling.

When they start talking about staff ratios, know this: they're not talking about staff ratios; they're talking about nurse ratios. There are a lot of people in every nursing home and very few of them are nurses, because the care that is provided by those people is unqualifiedly great. It is quantitatively and qualitatively out of this world. Nurses are good at providing clinical care. The carers that we have in so many of our nursing homes right around this country provide a level of care that you could not hope to get anywhere else in Australia. You ask any older Australian today whether they would prefer to be in a ward bed in a hospital or in one of these new aged-care facilities, and out of 10,000 Australians I doubt that you could find one who would say that they would prefer to be in a hospital. The reason for that is primarily the love and care that these staff bring to those nursing homes. The Labor Party wants to rip that asunder. For what reason? For the purposes of appealing to their union mates in the nurses federation. It is absolutely appalling that they would indulge themselves in this level of politicisation of this sector.

When you think about it, an older Australian who spends their time in a ward bed in New South Wales in your average public hospital will cost the Australian taxpayer $1,600 or $1,700 for that night, but in a nursing home it's $160 a night, and they will get a better level of care. And that's what they require—not clinical care, but care. That's what this parliament should want. That's what both sides of this House should want for Australians.

When you also think about home care versus residential care, in so many parts of Australia, the key is this: that we are spending billions of dollars in providing services to people in their homes. Some of those services are not care-related services. They are gardening, cooking and other levels of care that our home care packages provide, and no-one thinks or would suggest that that's a bad thing. But compare that to the level of care that someone can get in a residential aged-care facility. That includes ensuring that people get their medicine in the right dosages at the right times, that they are properly eating and that they are getting socialisation—because the biggest issue that older Australians are facing, in my electorate and, I suspect, right across Australia, is a sense of social isolation, because they feel that they are stuck in their homes, whereas, in nursing homes and aged-care facilities across this country, a large part of the mission and the purpose that those aged-care facilities have is ensuring that their residents have the capacity to go out and enjoy their lives. And that's why residential aged care is so important.

I cannot speak too highly of Thompson Health Care, which has a number of nursing homes in my electorate. They, for example, have undertaken a major project, with the University of Technology and a number of pharmaceutical companies, to ensure that older Australians—who so often find it more difficult to communicate with their carers—are being looked after when it comes to pain, because so many issues that were seen as behavioural issues were actually our fellow Australians, simply put, in pain. These are not studies that are undertaken in public hospitals. These are not studies that are undertaken in every nursing home. Indeed, this is the sort of level of care and innovation that is going on in the aged-care sector in Australia because that's what you get when you have a competitive and innovative marketplace like we have in Australia. That is what you get when you treat people as more than just residents stuck in your nursing home—rather, as consumers who have a choice as to where they can go.

This bill, the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018, will make it even better for nursing homes and those people who spend the last few years of their lives in nursing homes, because it will ensure that every person who goes into a nursing home can know that they are getting a minimum level of care that is reliably performed, day in and day out.

I heard the other day that three-quarters of residents who live in these nursing homes have not been visited by a family member or someone in the last six months. That is just the way that our society is, unfortunately. It's the way that our community has evolved. So, for so many—for three-quarters of those people who are in nursing homes—their families have become the other residents and the staff of these nursing homes. We owe it to them to ensure that they have as much choice as possible.

When people have dementia, one of the side effects of the dementia is that people often end up reverting to the language that they first grew up with. We have so many Australians who were born overseas, who end up like my grandmother, who, in the last few months of her life, started speaking in Russian again. If she had not been in a nursing home where the staff were fluent in Russian, it would have been very difficult for her to communicate and for her to be understood and heard and cared for. But because we have a marketplace, because we agree with innovation, because we encourage it and encourage competition, there is a place for every person in the Australian aged-care market to get the type of care that they not only need but want. This bill is about ensuring that older Australians get the care that they need. But the marketplace that we on both sides of this parliament have created, over many years, has ensured that every Australian can get the care that they want.

In the minute that I have left, I would also like to mention that we have enormous challenges coming up. Those in the cohort of baby boomers are about to find themselves in that age category where they may consider putting themselves into their last home, being a residential aged-care home. We have challenges around workforce planning and we have challenges around the number of beds that are available. Ask any nursing home provider and they will tell you that the biggest challenge they face is planning and development. But we have created a system in this country that has ensured Australians get a superior level of care in their last few years. It is the job of this House and of this bill to make sure that we give them an even better experience than those who came before them.

Justine Keay (Braddon, Australian Labor Party) Share this | Link to this | Hansard source

I welcome the opportunity to speak on the member for Franklin's second reading amendment to the Aged Care Quality and Safety Commission Bill 2018.

As we know, we have a royal commission into aged care at the moment. And there are reasons for that—very valid reasons for that. But I want to take some of my time to put into context why the issue of aged care is so important to my home state of Tasmania and, of course, to my electorate of Braddon. The recent ABS census has revealed that Tasmania has the oldest population in Australia, with almost 20 per cent of our population aged over 65 years. The census also found that Tasmania's population is ageing faster than the Australian average, so we can get a bit of a picture of why aged care is so important in my state.

In my electorate, the ABS has found that the community of Latrobe, which is not far from where I live, saw the greatest increase in the proportion of the population aged over 65 years between the years 2011 and 2016, so those aged over 65 are very concentrated in my electorate. But Tasmanians need—right now and into the future—quality aged care.

Rather than support aged care, this government, like all coalition governments before it, has reverted to type. The Prime Minister, as Treasurer, cut $1.2 billion from aged care in his very first budget. That $1.2 billion cut came on top of the almost $500 million cut from aged-care funding in the 2015 MYEFO. This savage cut hit older Australians in residential aged-care facilities the hardest, with a 50 per cent cut to the indexation of complex healthcare subsidies. The previous member seemed very deluded as to what these cuts actually meant to the people in residential aged care. I remember going to Emmerton Park, which is in Smithton, in the far north-west of Tasmania, just prior to the 2016 election. The residents there wanted to hear from the candidates as to their positions on aged care. Sadly, at the time, the then current Liberal member for Braddon didn't bother to turn up. What he would have heard at that point was that there were residents in that facility who were very, very concerned about what those cuts meant to their daily lives. I had one lady who said to me: 'Does this mean I won't get my physiotherapy? That's what's actually keeping me mobile. I don't want to end up with some mobility aid; I want to keep walking, and that physio means I can continue to do that for as long as possible.' She was concerned that it would mean she would not have access to that physio. In fact, that's what happened because of those cuts.

And these cuts have continued. In May this year, in the budget, the government announced it would fund an additional 14,000 home care packages. But this money was not new money. This money was taken out of residential aged care. It wasn't actually growing the pool of funding to provide more care for our older Australians but was just shifting the money around.

The most recent data shows that there are now 121,000 people on the home care package waiting list. Over a three-month period, that list has blown out by an extra 13,000 people waiting. We hear these stories just about every day in this place and, particularly, the ones who are telling the stories are the ones sitting on the opposition benches, because we're the ones out there listening to people and who actually care about what home care packages mean for them.

I was speaking to a lady whose relative, whose mother, sadly, passed away in March. She spent her last days in residential aged care, but she was waiting for a category 4 in-home care package, which was granted to her six months after her death. How ridiculous is that? She could have passed away in her own home with that home care package but, sadly, she was forced to spend her last days in residential aged care.

The average waiting time, according this government's own data, for level 3 or 4 packages is still more than 12 months, and the example I just gave pretty much demonstrates that is the case. While the government continues to hide the state-by-state breakdown of this data, a local provider in my electorate has told me that there are more than 3,000 people in Tasmania waiting for a package.

Waiting for these packages has a terrible impact on families. I received an email from Karen, who is the daughter of Terrence. Terrence lives in my electorate and Karen lives in Queensland. She wrote to me in absolute despair. Her father had been diagnosed with Parkinson's disease eight years ago and was given a terminal diagnosis of Lewy body dementia. He had been assessed for a level 4 home care package and had been sitting on the system for over 12 months.

Karen's mother was Terrence's sole carer, 24/7. He was receiving an emergency level 2 home care package last year, but things got so bad that Karen was ringing My Aged Care, trying to find out what was going on. She was told that he was on a priority list but that it would be another 12-month wait. It got to a crisis point where Karen's mother just fell into a heap; a neighbour found her on the floor of the home, sobbing. Karen had to ship her parents to Queensland to provide them both with the care that they needed because Terrence could not get the level 4 care package that he had been assessed for. The toll on the carers in this scenario under this government was absolutely tremendous and all the hearts of the opposition members here know all too well what this means, because we hear it all the time. Now, Karen is not sure what's going to happen with her dad. She knows that they can't live with her permanently. They're trying very desperately to work out what is going on with his care package, and she came to me in absolute despair. But this is one story of far, far too many.

We know the list has blown out by 13,000 people over a quarter and that over 121,000 people are still waiting for the package that they deserve. The crisis in aged care of this government's making is not just confined to these aged-care packages. We've heard and we've seen some shocking stories. I want to share stories of two people from my electorate who have contacted me about the quality of residential care being delivered. I've removed the identity of the facilities to protect the management and staff, because I know they're doing the absolute best they can under the funding arrangement that's in place.

Elle from my electorate wrote to me, and her letter is quite long. I'll try to paraphrase it. She wrote:

After the recent Liberal leadership fiasco, I've lost any faith in the prospect of the federal coalition government taking action in the interests of elderly people in regional areas, who involuntarily are destined to end their lives in a residential aged-care facility. Which is why I'm writing to you now, in your capacity as my local MHR, asking you to make representations in the Australian parliament on behalf of such individuals.

And I'm very privileged to do that on her behalf. She continued:

Just under 12 months ago, my then wholly bed-ridden husband was admitted as a permanent resident of an aged-care facility with an ACAT 'high care, complex needs' assessment. Progressively, over the ensuing six months, commendable standards of care and support enabled him to get out and about in a wheelchair for up to 5 hours a day; leaving him nevertheless dependent on carer support for all bed based needs over the remaining 19 hours or so each day.

Come January this year, it became apparent that fewer staff across care and related categories were 'on the floor' on weekends and public holidays. At a residents' meeting, the facility manager announced the then pending cuts to staff shift hours and other resources. He advised shifts for personal care staff would be cut by 14 hours per day, inclusive of already understaffed weekend and holiday periods. The facilities manager explained that those cuts were unavoidable given the range and extent of reductions in levels of previously accessible federal government financial assistance to residential aged care.

Elle went on to provide me with some of the consequences of these additional cuts imposed by this government. Residents are waiting up to 90 minutes when they need to go to the toilet. There are not enough staff around and no-one can find a staff member when they need one. They're woken at 7 am and left on the toilet for ages while the shower water keeps running. There are lots of stories about residents being left in bed until 1 pm and reports of residents falling because they try to get up and do things for themselves. There are instances of carers in tears when they find their loved ones at risk of getting out of bed themselves and carers clearly under great stress. New arrivals have said that they cry when they get home at night because they can't provide the level of service they've been taught they should. Elle said to me:

Please, please do whatever you can to make representations in appropriate quarters and to relevant decision makers.

She signs off her letter to me 'Almost despairingly'

This is what members of the opposition are hearing day in, day out. I am very privileged to stand here in this place and talk to the government members, although there are only two opposite me now. I'm hoping the minister is hearing this. This is just one sad example, not just of the carers, the families or the person in residential aged care but of those who are taking care of them, the staff in these facilities and what they are facing day in, day out because this government does not care about these people or about our aged-care system. That is due primarily, in my opinion, to the savage cuts that they've made in this sector.

Brian, another member of my electorate, is a resident in a facility and he's written to me:

I am a constituent in your electorate and a permanent resident of a not-for-profit aged care facility which receives financial assistance from the Federal Government.

I am 83 years—wheelchair bound but otherwise intact and very observant about issues and problems surrounding that facility.

Early last month—

this was back in August—

… residents were informed by the facility manager to the following effect:

(1) Because of reductions in funding previously available via government assistance, care staff cuts will be necessary on a scale leading to significant reductions in shift hours.

We are getting a bit of a pattern here.

(2) In the circumstances, management was unable to predict either the impact of such cuts or the extent to which the most vulnerable residents would be adversely affected.

(3) Further cuts in staff and resources could well be necessary from financial year 2018/19 onwards.

Brian continues:

Subsequent experience has shown adverse effects of cuts in staff and shift hours to be significant.

I would hope no elected government would intentionally treat its elderly citizens, most of whom have raised families, worked hard, paid their taxes, and/or otherwise contributed to their respective families over many decades, by making budget decisions with such foreseeably adverse consequences.

I ask you to make direct, strong and urgent representations to government to act with the compassion and understanding that we expect from our elected representatives.

Yours hopefully

Brian

Hear how he signed that off? Please take note, those opposite, of the way those two constituents of mine have finished their letters to me: 'Almost despairingly' and 'Yours hopefully'. You can just imagine what these people facing. One has her husband in residential aged care and the other is a resident who is clearly observing what is going on. These personal stories time and time again clearly show our system is in crisis. They cannot give up on their members in these facilities and this is why the royal commission is so important and Labor welcomes, finally, this commission going ahead.

Why did it take the Prime Minister to get all wound up over a Four Corners report to be galvanised into action? One can easily conclude it was all about getting the politics right and not about the issue. If it was about the issue, the coalition government should have and could have acted sooner, because we've been telling these stories for a very long time. Instead, they've repeatedly ignored the calls from Labor, from families and from stakeholders. Now we have to have a royal commission into aged care and it has to look at every aspect of aged care. But let's not wait until the royal commission finishes; we know what needs to be done. The government is sitting on so many reports. It could actually start fixing the system today, but it's not.

Regarding the workforce issues, I had a tremendous opportunity to go to one of the facilities in my electorate, Meercroft Aged Care, and walk a day in the shoes of an extended care assistant. It was very confronting, I have to say. I think we know what takes places when a loved one is in residential aged care, but I saw it firsthand. There was an elderly man getting showered and cleaned up. There was a 40-year-old with Huntington's disease who has a sister in the dementia care ward with Huntington's disease as well. I saw the work that these people do. It's backbreaking work and there are the long hours. The bells are ringing all the time. We know there are not enough people on the floors of these facilities. It was an absolute privilege to go with Elaine at Meercroft—to walk with her and see what she does.

I say to every member of this place: do it. Ring up the residential aged care in your electorate, put on your soft shoes and walk around with them, get your hands dirty and meet some of these wonderful residents and wonderful carers who this government has completely neglected. See exactly what it's like to provide that level of care to those residents, but also see what those people receiving that care are going through. I think it would open your eyes and I think it would make members opposite actually stand up and tell the stories of the people in their electorates who are suffering under a system that is severely underfunded.

Rowan Ramsey (Grey, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on the Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018. Aged care is not always perfect, but it is our job here to make it as near to perfect as possible: for our grandparents, for our parents and even, might I say, eventually, hopefully, for ourselves. They, that being our parents and our grandparents—and hopefully us, by the time we get there—deserve our respect. They've earned it. They've built the world in which we live.

Aged care, though, will be an ongoing challenge for governments for virtually as long as governments exist. The intergenerational reviews have clearly mapped out the ageing of the Australian population and the demands that will be placed on the taxpayers' dollars going forward. Regardless of that demand and just how difficult it is for us to meet as a nation, we do have to meet it; we are obligated to do so. It is one of the reasons, of course—and I won't get onto this, but the Prime Minister has been saying it quite clearly—why we need to have a strong economy: we need to ensure that we can care for our aged sector, for those who have built this nation, in an appropriate manner. Regardless of how we do that, we need to make sure that good quality infrastructure exists where it is needed and, more importantly, that within that good quality infrastructure there is good quality care: the love, the consideration, the respect and the first-class medical and hotel services that our aged sector deserve.

Events in the recent past have turbocharged change in the aged-care sector, most notably in my home state of South Australia with the tragedy, the debacle and the disgrace that surrounded the Oakden nursing home, which was a state government owned and operated facility. It was engulfed in scandal when it was found that the facility was guilty of institutionalised abuse. In fact, residents were, at times, not fed for what was deemed to be poor behaviour. That is beyond belief. It is appalling. Mercifully, that place is now shut. Unfortunately, I think we can be fairly sure that the behaviour that was so bad at the Oakden facility is not confined to just that one facility in Australia. There will be echoes of Oakden found elsewhere.

Before I go on I want to put in a plug for aged-care workers, particularly those in my electorate of Grey. I have visited many nursing homes and facilities over the years, and I can't remember a facility where I was not impressed by the strong dedication of the staff and by their care for the residents. When I spoke to the residents, they seemed to almost unanimously speak about what a wonderful place they lived in. The infrastructure is generally good. Often it is excellent, and I'm very pleased to have been to a number of facilities to mark the fact that the Commonwealth has made considerable contributions to enhancing and expanding those facilities. So often it's excellent. Sometimes, though, it is tired and in need of rejuvenation, undoubtedly. But I've found that even in these facilities, pretty much without exception, the staff have had that same loving, caring, respectful dedication to their job. But can I guarantee that every staff member and every facility is doing exactly that? Of course I can't. In fact, if there is one bad apple in the barrel, that's one too many. So I'm hopefully going to find in this royal commission that the facilities in my electorate largely live up to the plug that I've given them. I'll be somewhat surprised if they don't.

When I do receive complaints to my office from families that are not happy with facilities, I obviously go to every degree to try and find out exactly what has happened, where fault might lie and what is being done to make sure that those issues are assessed. Sometimes there are two sides to the story, as all of us that come to this place would know. We have to be careful when we're making allegations, particularly any public allegations, that we know what we're talking about. But I work through those situations when they are brought to my attention. I have one that I'm working on at the moment.

To come to this bill, the government's aim is to ensure the system is the best that it can be. The bill repeals the Australian Aged Care Quality Agency Act 2013 and the transitional provisions related to that act. The bill amends the Aged Care Act 1997 in order to establish the Aged Care Quality and Safety Commission and the commissioner to have a one-stop shop, as it were, to ramp up and give more power to this organisation so we can root out any transgressions that are in the system. Hopefully they will not be many. I'm pretty confident there won't be many. But I'm fully aware there were 5,000 submissions to the scoping study.

The aim, simply, is to do better than we have ever done before to make the system the best it has ever been. I'm very hopeful that this commission and commissioner will help bring about whatever change is needed to bring about that outcome. I congratulate the minister. He is a very fine gentleman and I think he's doing a very good job. One of the fundamental changes that he's made to the system is to alter the reporting and registration system for home care packages so that for the first time a national government actually knows what the real demand is for home care packages.

It is interesting that when I hear the criticisms from across the chamber, the member for Braddon most recently, they know full well that when they were in government they didn't know either what the real demand was for home care packages. It's taken courage for the minister to bring that forward and put it on the table, because now he's getting criticism for not immediately filling that backlog. He's had the strength. He knew what was coming. Our mate Ken's been around the system for a while. He knew very well that this was an understated and unrecognised demand in the system. He's had the gumption to get up and put it on the table and then to go to cabinet and get some extra finance to do something about it—$1.6 billion in the last budget. That's $1.6 billion for 14,000 new home care packages, which will take us to 74,000 by 2022. That's an outstanding result. Well done to him.

As he knows, I know and you know, Mr Deputy Speaker Howarth, there is more to be done, because there is still this backlog that this new system has established. He's done other things as well. Very recently he announced the $40 billion funding available for infrastructure grants for nursing homes, and certainly across my electorate there's been quite a bit of interest in that. In fact, as has been stated in this place, we have, at this stage, record funding for aged care in Australia—record funding.

I know there is a criticism from the other side that keeps coming up: 'You've cut; you've cut; you've cut.' I don't know what it is about mathematics which suggests a record is not more than we've ever had before. A record, by its very definition, means this is the most money that has ever gone into the system. It's not less; it's more. It's because we are running a strong economy. As I said earlier, I'm not going to give you a long lecture on the economy, but the turnaround has been quite stark, I think, over the last three years or so. It's really picking up a head of steam. It's taking a while to get to my home state—we had a few other issues we had to deal with—but I think it's even starting to filter through there. We're looking forward to MYEFO when it comes around. Certainly the result that came out of last year's budget, the $8 billion improvement, was very good. It gives the government the flexibility to do things about some of these long-term problems, and that's what we've been doing.

Now we're having the aged-care royal commission, which the Prime Minister announced last week, to shine the light in. Once again, this is a brave move and not unlike the minister's move, because when a royal commission reports there is some kind of obligation, or at least a public expectation, that the government will act on that royal commission and not just ignore the incredible amount of work that a royal commission does in a certain area. I will be looking forward to that report. I'm hopeful that the task will not be as great as some might imagine, but it may well be. It may well be a huge impost on future governments. But, as I said at the beginning of this contribution, whatever it will be it will be, and we're going to have to meet it. So, with this bill, the minister is putting the blowtorch, if you like, to aged care and making sure that the sector is actually delivering what it is being paid to do. It is being paid by the taxpayer and subsidised by the taxpayer to deliver first-class aged care. We have to make sure that it is doing that, and that's what the new commissioner will do.

In closing, before I run out of time, I'll return to a subject that I've touched on in this place before. Peterborough is a town of around about 2,000 people in my electorate. In it's day, like a number of other communities, it had an aged-care hostel that had its own management. Like many other towns, including the one that I come from, we in our wisdom, in the eighties, amalgamated the hospital boards and the aged-care facility boards. It made sense because there are a lot of genuine cross-benefits and a lot of things that you can share. It worked very well until the previous state government in South Australia, which had 16 years at the helm and was thrown out last March, decided that we didn't need hospital boards anymore, and all of us who were on those boards were made redundant. The previous state government inherited a whole swag of aged-care facilities and, as state governments don't see them as their prime responsibility, over the years it didn't reinvest in those facilities. In fact, their ownership arrangements now make it quite difficult for those particular facilities to access Commonwealth funds when it comes to infrastructure grants.

This is an ongoing issue in Peterborough, in Cummins and in a number of other communities that I could name. We are at the stage where we need serious reinvestment. I've asked the minister to look at this closely. We've got a new minister in South Australia. I've asked him to look at it as well to see if we can come up with a way—an ownership model or a way of making sure that the bid is adapted to fit the rules—to find some Commonwealth support for these small communities. I can tell you: a town of 1,000 or 1,200 people doesn't need a 65-bed nursing home unit. In fact it would be empty most of the time and go broke very quickly. What we need is the right-sized unit that is attached to the local hospital to give mutual benefits and to make sure you make best use of your staff, with all the things that go with it.

But it is unfair not to make an effort to provide that aged care where you have the bones of the potential to do so. People who have lived in a community all their life, given their option, if they have to move out of their own home—and we'll do everything to try to keep them in their own home—would prefer, of course, to stay in the community in which they have lived for all their life and where, hopefully, their family still lives, where they can be visited by their friends and visited by their family. It comes as a great shock to some when they have to move maybe hundreds of kilometres to access the kind of care they need.

I understand that there will always be tight spots. There will always be times when we're short of places at the right place for those particular consumers. But, where we can, we need to reinvest in these smaller units, and we need to find a way for them to survive. That's something else that I regularly bend the ear of the minister on: the extra costs of operating these smaller units within country regions. We need once again, as we do with the overall challenge of aged care, to rise to that challenge and find a way for them to survive, to replenish, to renew and to provide a first-class service to those residents of the smaller communities as well. With those words, I will conclude, but I recommend the bill to this House.

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

I thank the member for Grey. I just remind him too: you have to call the minister by his correct title here. You can't call him 'Kenny'. It has to be the Minister for Senior Australians and Aged Care. That's just a reminder. Thank you.

Cathy McGowan (Indi, Independent) Share this | Link to this | Hansard source

I support the comments from the member for Grey and the attention he gave to the extra costs of providing services in rural areas. I too would like to address that as part of my speech. I welcome the government's establishment of the Royal Commission into Aged Care Quality and Safety. It's timely and an important inquiry. In my electorate of Indi, every year I undertake a community survey. In the 2018 Indi budget survey, 79.4 per cent of respondents said that the issue of aged care and health was very important to them.

The screening of the ABC Four Corners program highlighted totally unacceptable treatment of some people living in residential aged-care facilities and created great conversation in my electorate of Indi. This ABC program showed that there's a difference between our expectation—our want—that people in our community be cared for and what is actually happening in some areas.

I'm looking forward to the terms of reference of the royal commission. The commissioners have now been announced, so I'll be really looking forward to encouraging my community to make submissions to that royal commission.

However, I don't think we need to wait until it's all done before we start active work on this. There's real, important work that needs to be done around aged-care workforce planning. Approximately 11.3 per cent of Australians aged 70 and over live in outer regional, remote and very remote areas, and residential aged-care facilities in our remote and outer regional areas are generally exactly as the member for Grey has said: small in size. These facilities lack the economies of scale and the scope that are often the case in urban areas, and aged-care costs per person in these settings are much more expensive. So it's this whole sense of: how do we design innovative, creative and effective solutions for our people who live in small country towns and more remote areas?

Today, I want to talk about some of the issues that we know exist. We know that cost is a factor. It's not only the cost of providing services; it's the cost of getting people and staff to and from services. For example, in Corryong, if you're going to bring up a specialist from Albury-Wodonga, it's the time and the cost of the travel, the two-hour trip both ways, to get there. That's expensive. But it's also that in Corryong, a small country town, we don't have access to the specialist services that we need, and they have to travel, which it is important that they do. But I'd also like to say that one of the wonderful things about the Corryong community is that it has got such creativity and such innovation in addressing its own problems. It, together with Alpine Health, has done stand-out work under a model called multipurpose provision of services, and I'll talk about that a little bit later.

The answers in many instances do lie within the communities, and we need the government then to be an active partner in putting in the resources and the money needed to provide these services. What's been happening in communities like Corryong, which has tried so hard as a community to address its own needs, is government has given it a slap in the face by cutting the services, cutting the extra funding needed to bring specialist allied health people into the community to do the work. For a lot of things, we know what needs to be done now. The knowledge is held and we don't really need to wait until the end of the royal commission to support all this.

In my own community of Indi there's a fantastic organisation which looks at the scoping and training needs in rural and aged care. They've set up a network, including Wodonga, Beechworth, Corryong, Tallangatta and Alpine, which is Mansfield, Mount Beauty and Bright. The network is supported by La Trobe University to do a lot of this work together and has so much knowledge. At another time, the minister responsible, the member for Hasluck, came and visited north-east Victoria, conducted a roundtable meeting with the primary partnerships group and talked about the really good models that were already in existence. So we know a lot. But what we don't do is say, 'How do we get the knowledge that's on the ground and link it upwards to the decision-makers at that level?' It's such a big gap, and I think we put the bureaucracy in the middle and make it so difficult. I'm hoping that, as part of the royal commission, definitely, and as part of the commissioner, the job will be to work out how we can bring these two things together. Because there is so much local knowledge, and I hear it when I go around and see some of the wonderful, innovative, creative things that are happening. It's just not reflected up the chain.

I want to spend a few minutes of my time talking about some of the wonderful models and organisations that work in my electorate and to say: thank you for your creativity, your innovation, your problem-solving and the wonderful care you give to my constituents. I'm going to name some of them. In Myrtleford there's Barwidgee Lodge. In Mansfield there's Beolite Village and, associated with the hospital, Bindaree Retirement Centre. In Tallangatta, Bolga Court does a terrific job, with a beautiful view overlooking the lake; it's almost like a men's shed where people can build things and do things. They've done a fantastic job in providing, in the most glorious part of north-east Victoria, a really lovely service-provision model.

In Wodonga proper we've got Bupa, which operates a more traditional nursing-home arrangement. In Benalla there's Cooinda Village. At Lake Eildon we've got Darlingford Upper Goulburn Nursing Home, and what a fantastic job it does. We've got Estia Health in Wodonga. In Rutherglen, a small country town near where I live, we've got Glenview Community Care Nursing Home—and a special call-out for Glenview. Not only do they provide aged care, which they do really well; they also connect up with the childcare centre just across the road, and they're linked with Indigo North Health and provide fantastic community care for residents.

In Bright we've got the Hawthorn Village Aged Care Hostel, which is run by Alpine Health. Down at Alexander, we've got Kellock Lodge, and what a fantastic job the board of Kellock Lodge has done recently in its negotiations with the Anglican diocese—a special call-out to your board and the community there. In Mount Beauty there's Kiewa Valley House. At Tallangatta we've also got the Lakeview Nursing Home, which is associated with Alpine Health. In Benalla we've got the Morrie Evans Wing attached to the nursing hospital. In Myrtleford we've got Myrtleford Lodge Aged Care. In Wangaratta we've got Rangeview Private Nursing Home and we've got St Catherine's Hostel, which does a fantastic job. I was really pleased to take the minister there earlier this year. We've also got St John's Village in Wangaratta. In Yea we've got Rosebank Nursing Home. In Corryong we've got the Upper Murray nursing home. Out at Baranduda, near Wodonga, we've got Westmont Aged Care Services, and what a fantastic model they now provide—all types of care; they're picking up the home and community care and they're now a centre of excellence for the provision of aged care right across north-east Victoria.

In Yackandandah, which is where I want to finish this brief outline, is the Yamaroo hospital. The Yamaroo hospital is run by the Yackandandah Health service. If ever you want to see a community that has the most amazing approach to community health, it's Yackandandah. We used to have the old Bush Nursing Hospital, but for a whole lot of reasons that didn't work, so now it's called Yackandandah Health. The nursing home and hostel go with it. They're doing amazing development now. They've found a paddock behind the hospital and they're building specialist accommodation there, integrating it into the community. One of the things I particularly love about Yackandandah Health—they visited parliament recently with their plans for integration of housing and health and care—is the work they're doing with the Totally Renewable Yackandandah project. Totally Renewable Yackandandah is a model of energy generation at the community level. The old hospital, as it's still fondly known, has got this enormous array of solar panels on the roof. I wasn't able to find the figures in time for today's speech, but they now generate so much of their electricity themselves.

What I was really hoping to do in my speech is to say that it's really timely to have the Aged Care Quality and Safety Commission Bill before the House and it's really good that we've got the royal commission happening, but let's not forget the fantastic work happening in our communities as we speak. I give a call-out to the people providing the care. They give the opportunity of the solutions done at the local level and the regional level to be bubbling up through the system so that we can learn and value-add.

I want to finish my talk on the role of the multipurpose service, and the MPSs that operate in Corryong and in Alpine, which are Bright, Mount Beauty and Myrtleford. MPSs were an effort by communities to bring health together into one bundle. There are seven funded MPSs in Victoria. They're funded by the Commonwealth, with support from the Victorian government, to provide the needs that our communities have identified. I think it's a fantastic model, but it sadly doesn't have the support that it needs, so I've been lobbying the various ministers, saying we need to review the funding and review the operation. We really need to bring the MPSs into the 21st century and give them the resources that they need to actually meet the needs of local communities. Corryong is doing that, but it could do with so much more love, care and support. Alpine, in its way, is doing some fantastic work. I would just love to see a lot more attention given to those really good models.

My final call-out that I would really like to bring to the parliament is the role that some of those smaller, more isolated community groups have with telehealth. I'm so impressed by an amazing network of telehealth operating right across north-east Victoria. To Albury Wodonga Health, and particularly to the old Wangaratta hospital, now Northeast Health Wangaratta, what a fabulous job you're doing in getting telehealth out into the small hospitals, enabling specialist services and diagnostic services and really using modern technology to make our system work so much better. I call out to the University of Melbourne Northeast Health Wangaratta model and all the partnership institutions that are now working together. Every time I go out to the communities and visit the hospitals or aged-care facilities and see the work they're doing, I'm just so full of pride at the innovation and the technical expertise that our communities can bring to bear in solving problems.

Tonight, as I bring my comments to a close, I think we've got an enormous amount to offer in the future as we design healthcare services that particularly meet our needs in rural and regional Australia. We must know that rural and regional Australia are different. It often costs more to deliver services there. Our particular communities have often got a lot to be involved with, and we can do so much if we make better use of them. I would like to encourage all my existing networks to link into the scoping, skills and training needs in rural aged care. To the members of the network providers in north-east Victoria, great work. La Trobe has a centre for rural health, and they're doing some fantastic research work around aged care. So good work, north-east Victoria. I'm really looking forward to being your advocate as we move forward. I hope we can get some action before the end of the royal commission. I hope we can find a way of getting change on the ground now and not wait until 2020 before we actually get the results out of that. I look forward to working with the minister and the opposition as we progress this and come up with some really strong plans for aged care in rural and regional Australia.

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

It's an old-age lesson that we're all taught as kids: respect your elders. As I was growing up, often my parents would introduce me to someone, and it would always be, 'This is Mr —' or, 'This is Mrs —' and I try to do the same with my own three sons when I'm talking to them; it might be, 'This is Mr Smith,' or, 'This is Mr Vasta,' or whoever it is. It is important to get across to our kids that elders should be respected. That's exactly what this bill is here to do, and I'm happy to speak on it.

Australia—as we know, as Australians—is the best place in the world to live. Often, I believe, people don't always recognise it, but it is because of our older Australians, our senior Australians, that we have been left the great country that we have today. It's their leadership that has seen our country battle wars and financial crises and everything else that we've gone through, and come out stronger. Our democracy and individual freedoms are steadfast today because they made sacrifices for our generations; whether they fought in world wars or so forth, we certainly have been left the great country that we have today because of senior Australians.

We owe a great deal to older Australians. That's why I, as an individual and as the member for Petrie, and we, as a government and as a parliament and as a nation, need to ensure that they are supported and cared for as they age. So I very much welcome Prime Minister Scott Morrison's call for a royal commission, and I support this bill, the Aged Care Quality and Safety Commission Bill 2018.

This bill is one of the most important things that this parliament will talk about this month. The reforms to aged care and the royal commission have started the conversation in the community, and the overwhelming response has been to ensure that we, as a government, do everything that we can to ensure our elderly receive first-class care. At this point, I'll add that it's not just government—the Australian community must do all that they can to ensure that elder Australians receive first-class care.

The footage that we saw recently on Four Corners did show horrendous abuse by some individuals in aged-care facilities. It was not only hard to watch; it was heartbreaking. I don't think there's a single person in the country who would watch those videos and not be distressed.

This parliament aims to make decisions for all Australians, and, by establishing the Aged Care Quality and Safety Commission, we are putting in place a framework that will better protect older Australians who rely on aged care. The commission is part of a significant reform in the regulation of aged-care providers. The commission will be responsible for a number of things, including the approval of providers of aged care, compliance and compulsory reporting of assaults from 1 January 2020.

Before I speak further on the specifics, I would like to say thank you: thank you to the aged-care facilities in my electorate of Petrie. It's easy to focus on the negative side of aged care, on the problems and the people, and—as we saw a member do earlier—just on the letters from people who have had issues. But there are many Australians who receive great care in aged care. That would be the majority of people in aged care, from my experience in getting around my electorate and seeing the providers and the staff at places like BallyCara in Scarborough, Seasons Aged Care in Mango Hill, Azure Blue in Redcliffe, the Holy Spirit Home at Carseldine or Bridgeman Downs Aveo.

In fact, I recently opened Opal aged care in North Lakes. What a wonderful facility that place is. It is cutting edge in dealing with the fact that as our cities grow we have less land—they have gone high-rise in their aged-care facility. It is more like the foyer of a five-star hotel. When you walk into it, that's the feeling you get. It is beautifully decorated, with a wonderful little coffee shop and cafe and a hairdresser as well, and you are greeted by wonderful staff. At the end of the day life is about relationships—the fact that when people walk in the door and are greeted well is important. It is a high-rise facility with wonderful rooms that are spacious and have ensuites. There are very good facilities, such as lounges where senior Australians staying there in aged care can just sit and chat to one another.

At Opal North Lakes they also have a dementia unit. I've just finished reading a book on dementia by one of my constituents, Debbie Flack. It talks about her experience with her mother—who has now passed away—and the heartbreak she went through in dealing with her mum, and a little bit about what the member for Grey spoke about before, which is that aged-care facilities have changed over the years in how they deal with people with dementia. The new one, Opal, has certainly done a great job there.

I've also visited Beaumont Care, Compton Gardens and St James Terrace—a whole lot of them—to name just a few. During my visits, I have been humbled to hear and see firsthand the work that staff do every day to make residents comfortable and cared for. Since the royal commission was announced by Prime Minister Scott Morrison, I've also started to communicate a little bit further. Whilst I've been to many aged-care facilities in my electorate, I've also started to communicate a little bit more and ask what's actually happening in their aged-care facility. I am talking to the residents there to hear their stories firsthand. I'm not there all the time, but I can visit these places. I would like to hear directly from them, too, and I would like to recognise the staff and the facilities that are doing a great job and doing it extremely well, for which I thank them. But, if there are issues, I would like to hear about them as well.

I spoke earlier about the fact that as a government we are trying to do what we can and as the member for my electorate I'm trying to do what I can to respect senior Australians, including when I get out to local schools to talk to primary school kids. I encourage them to spend time with their grandparents, listening to the stories and the wisdom and the knowledge they have gained over 70 or 80 years of life, and beyond. My four grandparents have all passed away, but I remember that in my 20s I would often sit down with them, particularly my nanna Mary, my mum's mum, who was in Zillmere, and talk about World War II, when, during her time in the Army, she operated the spotlights on the Brisbane River looking for Japanese submarines. They never found any. We know they sneaked into Sydney Harbour, but they never found any in the Brisbane River. The stories you get from your grandparents are really important. It was the same when I spoke to my grandfather. Life lessons were passed on. It is very important that grandparents pass that on to younger Australians, which is why I encourage students to do that when I visit their schools.

Often people say to me, 'Oh, you're a politician, Luke. Gee you must live a busy life.' You must get that as well, Deputy Speaker Vasta, as you live a busy life. But the fact is that all Australians now live busy lives. Every Australian lives a busy life. My wife, Louise, and I have three sons, a Doberman to walk and a business to run, and Louise is on different committees.

Ms Henderson interjecting—

She's busier than I am, Member for Corangamite. Often, people in my electorate live fast-paced, busy lives. The other thing we do is put up six-foot fences, don't we? We get our 400 square-metre block or 600 square-metre block, or we may have a unit. Often, we put up six-foot fences around our homes and we don't always talk to the neighbours. The reason I mention is this is because, as Australians, we live fast-paced, busy lives and we don't talk to our neighbours.

I was talking to a lady in aged care the other day and she was saying that she just wished she could spend a bit more time with people. I understand that. They're busy with their work in caring for people. They could chat to them for half an hour, but if you chat to them for half an hour you're probably pushing up the costs for those same people when they are paid staff doing that. That's why I say that as a community and as a nation, we do need to be doing more for older Australians. I would say to people in my own electorate: 'Go and visit your parents. Go and visit your grandparents.' To those schools in my electorate or those community groups—Lions Clubs or Rotary Club; and I met with some ladies the other day from the Older Women's Network in my electorate—I say, 'If you're looking for something to do, go and visit some of those aged-care facilities. Talk to the older Australians in those facilities that I've just visited.' I know that some schools will visit aged-care facilities or visit the local hospital at Christmas and so forth. It is a great opportunity, maybe for kids who don't have grandparents, where they can go and visit some aged-care facilities with the school and talk to those people who just want to chat. Often, many people in aged care just want to be able to chat. They might not be very mobile and they might not be able to get outside—and, obviously, the staff, like all of us now, are fast paced. I just want to make the point that as a government and as a parliament we can do these things, but that the Australian community can do them as well. I think that ministers, shadow ministers and members of parliament should encourage Australians to do that as well.

Obviously, I am proud to be part of a government which has introduced this bill. We are ensuring that older Australians are respected, listened to and cared for, no matter what their age or where they live. Whether they're self-funded retirees or on the pension, whether they are in the biggest or smallest aged-care homes, in the cities or in the regions, this bill protects and enhances the safety, health, wellbeing and quality of life for all older Australians in aged care, which is exactly how it should be.

The independent commission will make things easier for both residents and providers, becoming a single point of contact in relation to quality of care and regulations. By simplifying the process, any questions, complaints or reports of mistreatment will be, and should be, answered and dealt with quickly and appropriately. By making the commission responsible for regulating residential aged-care services, flexible-care services, home care services and Commonwealth-funded aged-care services, we are ensuring that all sectors of the aged-care sector are governed by the same body.

The message is clear: Any person or organisation doing the wrong thing will be found. We won't stand for substandard care, and we have included the option to shut down an operator who is doing the wrong thing as part of the broader reforms. This bill is part of the government's broader aged-care reform agenda, which we announced in the May budget. We have taken steps to improve aged-care regulation and to provide greater transparency of quality in aged care. We have also funded some $22 million to trial specialist elder abuse support services and have begun working with the states and territories to develop a national online register for enduring powers of attorney.

We want to provide more choice for older Australians so that they can live healthier, more independent and safer lives. The establishment of the Aged Care Quality and Safety Commission is an essential step towards streamlining regulations and ensuring that the quality of aged care is upheld across the country. The bill will, hopefully—and I use that word, 'hopefully'—restore some peace of mind for the families of those in aged care. The commission will be a single point of contact for questions, concerns and complaints. All Australians can be assured that this independent commission will not just shuffle paperwork but will work tirelessly to improve and uphold quality care standards across the country. This reform has been shaped solely around those who rely on aged-care services and their families. This bill is for them, to ensure that the health, safety and wellbeing of the consumer is the No. 1 priority in the residences they choose to call home. Our older Australians have made a remarkable contribution to our country. Without their sacrifice, bravery and leadership our country could have been a very different place. It is imperative we support them as we age. That's why I'm proud to support this bill. When I say 'we' I mean all Australians.

Ross Hart (Bass, Australian Labor Party) Share this | Link to this | Hansard source

Around 1.3 million Australians are currently receiving some form of aged care provided by around 400,000 nurses and carers. The statistics show that it's projected that by 2056 the aged-care workforce will need to triple. That is, there will be nearly one million workers required to deliver services for more than 3.5 million older Australians, and older people will represent as much as one in four Australians.

Any of us can trot out those statistics in this place, but what we need to consider is the personal aspect of this area of policy. It is absolutely true that each of us will, at some stage, require some measure of assistance if we live to an age that requires aged care. Every Australian who requires aged care should receive an appropriate level of service that is safe and clinically appropriate. We shouldn't have the circumstances which have been recently identified on Four Corners and other public controversies with respect to the quality of aged care. This is something that needs to be addressed as a matter of urgency, and it's something that really does move beyond us as the people's representatives standing here in parliament. There needs to be concrete action to ensure that safety, quality and dignity in aged care is maintained.

Public expenditure on aged care as a share of the economy is expected to double by the 2050s. It is obvious to me that the aged-care system is in crisis. The fact that the aged-care system is in crisis should be obvious to any reasonable observer. But, when Labor first raised this issue, when we pressed the issue, as I might say we must when calling any government to account, we were heavily criticised by the minister. Now, as I said earlier today, this crisis is recognised implicitly with the calling of a royal commission. Billions of dollars have been cut from aged care in the last five years by this government. The present Prime Minister, Mr Morrison, cut almost $2 billion in his first year as Treasurer. There are now 121,000 people on the home-care package waiting list. It is telling that when I first wrote this speech I included the figure of 108,000 people. Between when I drafted this speech and now there are a further nearly 15,000 people that are now added to waiting list. The list include 88,000 people with high needs, many of them living with dementia and other high-care requirements.

More than a dozen reviews and reports, including hundreds of recommendations, still sit on the minister's desk without being actioned. Three different aged-care ministers across the governments of Prime Minister Abbott, Prime Minister Turnbull and now Prime Minister Morrison have had the responsibility for this for the last five years, but in my submission they have failed to undertake any real reform across this vitally important ageing portfolio. As I indicated earlier today, I've spoken on a number of occasions on motions moved by my good friend and colleague, the shadow minister for ageing and mental health, Julie Collins, the member for Franklin. Those motions criticised the government for its delay in releasing important information on the government's progress in addressing the home care waiting list. As I said earlier, in my opening, each of us should have a real interest in this policy area. This has a direct impact upon the dignity of vulnerable older Australians.

The purpose of the Aged Care Quality and Safety Commission Bill 2018 is to establish a new Aged Care Quality and Safety Commission from 1 January 2019. The commission will be responsible for the accreditation, assessment and monitoring of aged-care services and Commonwealth funded aged-care services, and for complaints handling. The role of the commission is to protect and enhance the safety, health, wellbeing and, importantly, quality of life of aged-care consumers and also to promote confidence and trust in the provision of aged care and to promote engagement with aged-care consumers about the quality of care and services.

This is all particularly timely, given the appalling vision that we saw on the Four Corners reports over two weeks. It's appropriate for us to ask: what is the government's record with respect to this important area of public policy? And, more broadly, what is the government's record in supporting and funding regulators? I say that this government's record in supporting and funding regulators is bleak.

This is a government that called the Australian Securities and Investments Commission the 'tough cop on the beat'. We now have a royal commission highlighting every day failures not just in regulation but in general law enforcement. This government's unfortunate record of incompetence extends across multiple portfolio areas. What use is a philosophy that drives to cut what is described as 'red tape' when that regulation is properly required to maintain public trust and confidence, public trust in safety and consumer protection in multiple areas, whether it's finance or it's aged care? The undeniable fact is that the Aged Care Quality and Safety Commission will have a significant task in restoring confidence and trust in the provision of aged care—and this is before any evidence is taken with respect to the proposed royal commission and indeed before any terms of reference are agreed or published.

Aged care has been a policy area which, in the past, has attracted a significant level of bipartisanship. Labor introduced welcome reform with its Living Longer Living Better reforms. Those reforms were designed to deliver important benefits to older Australians, reforms that included more support and care at home; better access to residential care; increased recognition of carers, particularly those from culturally diverse backgrounds; more support for those who suffer from dementia; and, of course, better access to information to assist in the planning and delivery of care. It's important for all of us to understand that the central philosophy driving policy was that of consumer-directed care not just providing greater choice for older Australians as to the care they wanted but also delivering independence and support to live at home for as long as possible.

There was a growing wave of outcry from the public about the quality of care that older Australians have received, particularly with respect to residential aged-care facilities, even before the revelations from the Four Corners story. This was first highlighted by the investigations around elder abuse and neglect at the South Australian Oakden facility. In response to Oakden, there was a Senate inquiry. This in turn triggered the government to commission a review which is better known as the Carnell-Paterson review. The review was then handed to the then Turnbull government in October 2017.

Labor supports the Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018. They should be considered non-controversial, but there are a number of concerns. Firstly, it's taken nearly a year for the government to introduce legislation into parliament in response to the Carnell-Paterson review. The bills are, in my view, a missed opportunity for the government to give the new commission stronger arbitrary powers, particularly given the level of public concern in relation to service providers. Although the advisory council is set to continue, the government has yet to fill vacancies on the advisory council. Labor will put the government on notice that there must be no change to the cost-recovery process and/or fees to ensure the ongoing support which is necessary for smaller providers, in particular in regional Australia, which is where I represent. The government has also not addressed the policy area with any success, which is evident from the significant level of public concern about the aged-care sector.

As I said earlier, more than a dozen reviews and reports, including hundreds of recommendations, still sit within government and on the minister's desk without being actioned. It might be said that the government has proceeded to cherry-pick rather than deal with the reports and the reviews in an holistic manner. The lack of response in relation to the reviews and reports in relation to any reform fits a disturbing pattern of inaction, incompetence and cover-ups by successive governments.

The Abbott-Turnbull-Morrison governments have shown a complete lack of commitment to the Australian aged-care system by cutting billions of dollars from the aged-care system. The aged-care system has been used as an ATM to try and prop up the budget, with significant cuts in support to the industry, and there have been denials that there was a cut in the first place. That is what this government does: it consistently argues that it is delivering additional funding year after year—that is, in raw dollar terms—and it says it can't be accused of cutting health, education or the funding available to aged care. In this particular case, they've been caught out with their hands in the till. The aged-care funding instrument was cut by $1.2 billion. This means a cut to services to vulnerable, older Australians. It's absolutely obvious to me that standards in the care of older Australians have slipped under the weight of these cuts, in particular with the lack of supervision and attention to standard.

I, like every other representative in this place, I'm sure, receive many complaints and requests for assistance from constituents who are attempting to navigate the aged-care system. My constituent Estelle came into the electorate office to express her frustration at the system. She lives with her elderly mother and provides care to her. Her mother cannot get into a nursing home because she owns a small farm. To make matters worse, Estelle has been told that there is no palliative care available to her mother 'because of funding constraints'. Estelle told my office that she's looking forward to a change of government and a better approach to aged care.

I've also been speaking to Malcolm, who regularly visits a friend, Neil, in an aged-care facility in Launceston. Neil is recovering from a broken hip and requires physiotherapy as part of his recovery. Malcolm was horrified to learn that the only way Neil could get access to this treatment was to pay $75 per hour to a private physiotherapist. That is because the facility where Neil is a resident no longer has the funding to offer physiotherapy and other allied health services to its residents—a direct result of this government's $2 billion worth of cuts to aged care funding.

I've previously brought to the attention of the House concerns raised by Diana, who lives in a small town, Bridport, within my electorate. She despairs at the state of the My Aged Care website, saying that it should be a 'research tool for older Australians, not an advertising platform for providers'. She pointed out that, despite the fact that she lives in a remote seaside village and the fact that she finally received an aged-care package after an extended wait, according to the My Aged Care website, she has in excess of 80 providers who might provide services to her in Bridport. This is more than are available to a potential consumer in Hobart or Canberra. The reality, of course, is that there are few providers available to her, despite what that website reports. I also spoke to Michael from Launceston after the facility where his mother is a resident tried to increase her accommodation fees by 60 per cent following a refurbishment.

Clearly, there are real concerns with respect to safety and quality within the aged-care sector. There are many services that are doing very, very well, but we need to ensure that there's not just the rhetoric of being a tough cop on the beat and that the government actually follows through.

Rebekha Sharkie (Mayo, Centre Alliance) Share this | Link to this | Hansard source

When the Prime Minister announced the royal commission into aged care, he said that instances of older people being hurt by failures of care simply cannot be explained or excused. I agree with the Prime Minister. I've spent months listening to stories about aged care from my community and the nation, both the good and the bad, but the footage captured in the Four Corners program that aired a couple of weeks ago was indeed heartbreaking. This system is not working. Just for the Four Corners story, more than 4,000 Australians were willing to share their stories in relation to their care experiences.

The Aged Care Quality and Safety Commission Bill 2018 purports to protect the safety, health and wellbeing and quality of life of aged-care residents. It is a noble aim, but I think it will take a lot more than this bill to achieve that purpose. I am pleased that the government has announced a royal commission into aged care. It is my hope that this commission will give families the opportunity to share their experiences. Healthcare workers can share their concerns and providers can outline their plans for change. There is a wealth of experience that the royal commission can draw upon from academics, industry experts and staff with many years of experience. My hope is that we will listen to what they have to say about the sector and how they hope to change the system for the better. I know I have benefited from the knowledge of people like Peter Vincent of Aged Care Matters and Ian Henschke of National Seniors, whose insights and genuine passion for reform are something that I value and values that I share. Similarly, Victoria Traynor and her team from the University of Wollongong have worked tirelessly to establish a framework for aged-care nursing competence. While the framework is still in its early days, the results so far demonstrate the benefits to residents and providers of investing in professional development for those working in aged care.

As I've said before, we must ensure that we are listening and acting on the stories of families and residents. For too long families and residents have been too afraid to share their stories. I also recognise the efforts of the minister and his active role in aged-care reforms, not only with the bill before the House today but also with those that have already passed, such as the Aged Care (Single Quality Framework) Reform Bill, and of course the forthcoming royal commission.

The issues facing the royal commission are wide-ranging and intertwined. It will need to review an uncertain workforce, complex funding arrangements, training and education shortfalls, accreditation and compliance issues and consumer expectations. This cannot be done overnight. We need to allow the royal commission sufficient time to complete this comprehensive investigation, but it is equally important that we do not allow the royal commission to delay or derail existing plans for improving the quality of care for our older Australians and things that we can do right now in this parliament.

The Prime Minister said:

The royal commission will be in addition to, not instead of, the actions we are taking.

I intend to hold the Prime Minister to that statement and I will continue to push for consumer-centric reforms to the aged-care sector to ensure we have transparency in staffing. Residential care experiences differ widely and the share of expenditure spent on staffing differs from place to place. I'm led to believe that anywhere from 45 to75 per cent of income that a home receives is spent on staff. That is an extraordinary difference, and it must be looked at. We must have transparency about how our residential care homes are run, how much is spent on food, how much is spent on hands-on care and activities and wellbeing.

With that in mind, I turn back to the bill before the House today, the Aged Care Quality and Safety Commission Bill 2018. The department said this bill is the product of the recommendations of the Carnell-Paterson review, consultations with the Aged Care Quality Advisory Council and extensive roundtable discussions with the sector.

Broadly speaking, the commission is in effect the end product of a merger between the Australian Aged Care Quality Agency, known as the quality agency, and the Aged Care Complaints Commissioner, known as the complaints commissioner. The new commissioner will bear primary responsibility for ensuring that our aged-care sector is one that puts the wellbeing of our older Australians first and that the quality of services provided is in line with community expectations. The new commissioner will in turn be supported by an advisory council, the Aged Care Quality and Safety Advisory Council, which will include members with 'significant expertise in relevant fields'. The commissioner will also be supported by a chief clinical adviser and an expert clinical panel to seek out and receive clinical advice where relevant to the role of the commission. The commission's powers will extend to all Commonwealth funded aged-care services from residential care to in-home care. As of 1 January 2020, the commission will be responsible for the accreditation, assessment and monitoring, and handling of complaints processes.

I want to pause here and draw attention to the fact that, currently, it is the government that is responsible for providing or revoking accreditation of aged-care providers. The minister is the one who ultimately makes the determination as to whether a provider should be granted a licence to operate and, in turn, receive ACFI funding. And yet now, in the midst of this turmoil, that responsibility is suddenly being transferred from the minister's office to an outside agency. That, I find concerning. The government says that this bill is a necessary structural change to improve how the aged-care sector is regulated. But what has actually changed? How can passing overall responsibility from the minister to the commissioner be an improvement? I always felt that the buck stopped with the minister. If the buck stops with the commissioner, I feel that is a retro step.

I acknowledge the government's efforts in recent months, including the recent consolidation of quality standards and the efforts to uphold those standards through stronger enforcement provisions. But this new commission reads more like a change of stationery rather than a structural change of the aged-care regulations. For example, let's look at the proposed regulatory functions of the new commission, and the obligations it can impose on providers. There is no real change. It still requires providers to have a written plan for continuous improvement in the quality of care they provide and it still enables audits to be carried out in specified circumstances. Now these are all clearly good things. But my point here is this: these provisions were already in place when the maltreatment and abuse were taking place. These provisions were already in place when families, like those featured in the Four Corners story, were left with no other option but to covertly record the distress and the suffering of their family members. These provisions were not enough to protect our vulnerable older Australians then and they are not enough now.

What is needed now is greater transparency and accountability. As I stated previously, this is the aim of my private member's bill. And I believe now, more than ever, this parliament should put aside the finger pointing, put aside playing politics with this and work together to deliver the outcomes that Australian families expect and deserve. I cannot see how transparency in nursing homes and in our aged-care facilities is anything but a good thing.

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

Although the bills before us today are considered noncontroversial, it is important to stand up and make a few statements, particularly on behalf of constituents in my electorate, in relation to aged-care quality and safety. I do have to express my disappointment that, again, the government is creating another commissioner. Whilst we on this side support that, what this government hasn't done is create the framework that is required, invest in the staff that are required, invest in the skill development that is required to ensure that we have quality and safe delivery of aged-care services. It's another bill to create another commissioner, but a commissioner is at the tip of the iceberg and we're yet to see the real body of reform work that needs to happen. This government has failed so many times to get on with the really tough work and the tough reform that's required. We do need to really look at aged care and act quickly.

I too want to acknowledge the workers who spoke up bravely to Four Corners about what they were seeing, experiencing and witnessing on a daily basis in the facilities in which they work. Thanks again to the families and to the people in those facilities for speaking publicly. It's not easy, when you're somebody that works in a centre, to speak publicly to the media about what is occurring in your workplace. Not only are you putting your job on the line by speaking publicly and raising an issue but you're also exposing the real vulnerability and weakness within your own workplace. I've met many aged-care workers—not just people who work in my electorate but also those in the unions that represent aged-care workers, like the HACSU members, the United Voice members and the ANMF members—and what they all have is pride about where they work. For them, it's a calling, a vocation. They truly, deeply love working with older Australians and working in aged care.

When they have been to parliament to speak to members—it is disappointing that members of the government did not meet with these workers on the many occasions on which they came—they spoke to us about how it's our turn to care. They spoke to us about how they are low paid and they are undervalued in their work, which they are. They spoke to us about how some of the agencies and organisations that they work for only spend $6 a day on food for residents. They spoke to us about the problem with not having correct staffing ratios at work. They spoke to us about what happens when somebody calls in sick or if somebody's on leave and they're not backfilled. They spoke about how that compromises their ability to deliver quality care.

In a recent media release put out by United Voice, they said how devastated they were by the revelations about the aged-care sector, but, unfortunately, that they're not new. Like many members of United Voice, they are placed in situations that lead to poor care on a daily basis. If that exposure weren't enough—if it weren't enough for workers who've come forward to this place to raise their issues—then surely the constituents who have called electorate offices would shock this government into more urgent action. We need to do more than just create a commission in relation to tackling the crisis in aged care.

We are facing yet another inquiry as the unions, workers and family members have said. Whilst we support the royal commission and the work it will do, we also believe that there is enough out there now that the government can be doing more. We've held lots of inquiries into aged care and we've known that there will be more and more older Australians entering aged care for quite some time, yet we are still failing to do the body of work that is required to ensure that we have quality care.

Critical to quality care is making sure that we manage high workloads, unpredictable hours and the lack of support for carers when they're performing their roles. Funding cuts have had a huge impact on aged care and aged-care delivery services. Inevitably, when you cut funding to aged care, it is borne by the workforce. The workforce shoulders the cost when you cut. It's common, it's really unfortunate and it shouldn't happen. In community services and in the health and community sector, when governments cut funding like this government has done in almost all of their budgets, organisations are told that they have to deliver the same amount of care with less money. They shave off corners. They cut from budgets. They cut day programming. They cut back hours. If somebody's sick, they're not replaced, putting more and more pressure on workers in these facilities.

One of the comments made by a WA aged-care worker is:

I want things to change for old people.

I have been in aged care for 15 years and working with dementia patients for the past 13 years. We're all heartbroken at times because we can't give the people what they want.

We have dementia residents coming up to us and saying: 'You don't have time to talk to us.' We get trained to take them through their day—now you rush them.

I think that that comment really hits to part of the problem. There's no quality that's allowed to be included when people are now staffing in aged care. There was, once upon a time, when the aged-care worker was the best friend, the person that they could have a laugh with, when they were able to chat—when they were able to be human and engage with the people that they cared for. These days, their rosters have been so cut back and they're forced to look after so many extra residents that there's not even time for a simple hello and goodbye. Another worker said:

I have worked out that from 7am, if we gave 15 minutes for residents' showers and 20 to 25 minutes for residents who use hoists and allowed an hour for breakfast, we would finish our last resident at 2.15pm.

Again, this is speaking to the pressures of trying to get things done quickly.

I've had people in my electorate come and speak to me about when staffing levels are low. If they're at one end of the facility and the buzzer goes, if they don't have enough staff on, if somebody takes a fall, they could be there stuck on the ground for anywhere from 40 minutes to an hour whilst they try to help the other resident. Literally, the way in which some of these facilities are being staffed is in case nothing goes wrong. That is a terrible way to run aged-care services because, as we all know, as we become older, something does go wrong all the time, so having the extra staff there is critical to help.

It's also about quality of life. Like many, I go to aged-care facilities. I enjoy the 'walk a day in my shoes' when I walk around and I talk to the residents and meet with them. The days that they enjoy are the days where they've got activities and they've got theme days. We have the Melbourne Cup coming up, so many residential facilities in my area would have a theme day. There are sporting colours theme days, their singalongs, their craft days, the days where they have schools—and particularly a lot of the VCAL students—come in to do work in their organisation. Our Catholic college partners with St John of God in their aged-care facilities to facilitate a real work placement experience. But these programs can only occur if they have enough staff on the ground on the day.

Workloads are high, as I said. About one in 10 workers in aged care has two jobs. That's double the national average. I'll just state that again: one in 10 aged-care workers has two jobs. Partly it's because they're only on part-time rosters or casual rosters, but the other main reason why—and this is what the workers tell me—is that their wages are so low. Their wages are so low that their full-time work or the work that they do in aged care doesn't actually pay the bills, so they take up other caring jobs outside aged care to try to subsidise their income.

The other problem we have in this sector is that, unlike, say, the early childhood education sector, there is no national quality framework that exists. Only about half the staff working in the aged-care sector hold a certificate III or a certificate IV qualification. They are barely paid the minimum legal wage, and often salaries are just above the minimum wage. We know through working through industry and through talking to the workforce that we need to work collaboratively, together, to see a similar national quality framework introduced. The staff themselves want to upskill. The staff themselves want to be more engaged. They want to have the skills to be able to deliver the care that they know that their residents require.

The statistics speak for themselves: 1.3 million Australians are currently receiving some form of aged care provided by about 400,000 nurses and carers. I know that there has been a lot of talk about looking at ratios. I do support ratios; however, I believe they need to be in a broader context. We can't just talk about nursing. We need to look at making sure that we've got ratios where we are reaching the complex care that's required. Every facility might be slightly different. There needs to be a discussion about what a safe ratio for dementia care is. What is a safe ratio for high care and low care?

When I get out and speak to some of the facilities in my electorate, there's a really stark difference between the not-for-profit community aged-care facilities and public aged-care facilities through Bendigo Health and then the for-profit facilities.

In the Macedon Ranges, there is a Bupa facility and there is RM Begg, which is a locally based not-for-profit facility. That not-for-profit facility is the place of choice for many people; however, they have a very long waiting list. They have extra staffing time and staffing hours. I'm told that it's a wonderful work environment to work in, but they acknowledge openly that they're slowly going broke under the current funding model. They're simply not adequately remunerated by the current system to continue the quality of care, and they don't want to compromise care. Meanwhile, up the road, Bupa—which is making profit and delivering a return for its shareholders—gets constant complaints from the GPs in the area, from the residents in the area and from the staff that work in the facility. There are regular reports of there not being qualified nurses on, that people who are sick aren't replaced and that programming has been cut, and there are questions about the quality of the food.

We are at a crisis point within our aged-care system: which model of care do we wish to deliver? We are a society that will be judged, and in this place here we are judged, on how we treat our older Australians. They deserve dignity and respect in their elder days. They deserve to be in places where they do feel at home, where they do feel included and where they are respected. They also deserve a workforce that is well paid and respected, and which has the resources that it requires in order to do its job. So I'm hoping that the new Aged Care Quality and Safety Commission will actually make strong recommendations to this government on how we can fix our aged-care sector.

We need to make sure that we do get policy back on track in this area. After the funding cuts from this government in many of their budgets and the impacts that those have had on this sector, the very least that this government could do is not just to create the commission but to restore the billions of dollars that they've cut. This would help the workforce to skill up and deliver quality care, and it would help facilities to deliver better programming for the residents that live in their facilities. It would also give more peace of mind to family members.

It's one of the hardest things at a listening post: to meet a family member when they've just had the heartbreak of losing one of their older relatives. There are some of the horror stories that they share with you, about how there was not the dignity and respect for their loved one in their final days, or that they passed away in pain because there was nobody on shift to administer the medicine that was required or that they feel their loved one died of neglect or starvation—as one person put to me—because the food was so inadequate and not something you would serve to anyone, let alone to our older Australians in aged-care facilities.

People have a right to be concerned about what's happening in our aged-care institutions, and whilst this commission, which has been a long time coming, has been established, it's a little bit of work in a lot of work that needs to be done.

Joanne Ryan (Lalor, Australian Labor Party) Share this | Link to this | Hansard source

I rise today to speak on the Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018.

Like my Labor colleagues, I agree to support the bills but want to note the strong concern that we all share about this government's slow response to introduce this legislation to the parliament. Today has been a day of listening to speaker after speaker on that side of the chamber, the government members: a cacophony of pathos to camouflage a complete lack of action in this space. As a nation, we should judge ourselves by how we treat our elderly. For all that older Australians have given our country throughout their working lives, they deserve respect and dignity. Recent revelations in the media confirm what Labor has been saying for a long time: that the aged-care sector is in a state of crisis. Like many local residents who have contacted me, I was appalled when I watched the shocking stories on the ABC Four Corners program. The investigations at the Oakden facility were equally disturbing yet occurred some years ago now. Like many, I was particularly shocked by the standard of care being delivered in some residential aged-care facilities.

There has been a public outcry for action on the quality of care older Australians are receiving in residential aged-care facilities, and rightly so. Our older Australians in residential aged-care facilities deserve so much better than what we've seen on our television screens. They deserve dignity and they deserve to be cared for as if they were being cared for by a loved one. It is clear that the current regulatory framework that should be protecting older Australians is not working. Current reporting mechanisms are overly complex and accessing information about complaints is equally difficult.

These bills are an opportunity to restore faith in the aged-care sector. However, the government has unfortunately missed the mark yet again. There are around 1.3 million Australians currently receiving some form of aged care, provided by around 400,000 nurses and carers. It is predicted that by 2056 the aged-care sector will increase to around one million workers, with 3½ million older people requiring care. The legislation before us today is in response to the Oakden investigation and a Senate inquiry which triggered the government to commission the Review of National Aged Care Quality Regulatory Processes, known as the Carnell-Paterson review. The report of the review was given to the Turnbull government on 23 October 2017. We stand here today, in October 2018, with a piece of legislation in front of us that will respond to some of the elements and the recommendations from that review. These bills go some way to responding to the 10 recommendations of the review, to establish an independent Aged Care Quality and Safety Commission from 1 January 2019. I stand here today when I was to speak on this some three weeks ago. But of course this legislation was pushed off the agenda, pushed back a further three weeks, and we're going to try and establish a commission by 1 January 2019. It is October and the legislation is still in the House and is yet to go to the Senate.

In the context of recent public concern, the commission will be tasked with restoring confidence in the aged-care sector. It will create a single point of contact for all aged-care consumers and providers of aged care in relation to quality of care and regulation. But it will take an extraordinary effort by those opposite to see it formed by the projected date of 1 January 2019. The problem is that this government is too busy fighting within itself to focus on looking after older Australians. We have had five long years of watching inaction on that side. Their lack of action in relation to any reform in this space is disturbing. As the member for Bendigo outlined, we do not have a framework on which to measure the care that is being given. We have not done the hard work to reform aged care to ensure that we're getting quality, especially given that there are dozens of reviews and reports sitting on the minister's desk that have been blatantly ignored. Saying that the government has not acted in any regard would in fact be somewhat misleading. They have acted: they've slashed funding from the aged-care sector. There has been nothing but funding cuts over the past five years. It began in the 2014 budget with the dementia supplement cuts, which signalled the slide that we've now witnessed for five years. The current Prime Minister, Scott Morrison, has tried to deny it multiple times over the past couple of months, but in his first year alone as Treasurer he was responsible for cutting almost $2 billion from the aged-care sector.

The system is in crisis and those opposite need to take responsibility for it. I remember after the 2014 budget visiting one of the local not-for-profit aged-care facilities to hear how they were going to struggle without the dementia supplement, how they were concerned about the increasing number of dementia suffers with high needs, and how they were going to struggle to meet those residents' needs and they were going to struggle to explain to their families why that was the case. That was some time ago now, and they are still struggling.

The government values older Australians so little, it seems, that the minister for aged care is not included in cabinet. I would suggest that's a direct result of why this particular area has seen such savage cuts. It is deeply concerning that, in response to the aged-care crisis, the Liberal government have shown no compassion, just funding cuts. Inevitably, the result of these cuts is that the standard of care for older Australians has declined. We now have before us an agreement around a royal commission that is set to wind up in 2020. It is important that the royal commission shines a strong light on the quality, or lack thereof, in the system. It needs to look at the reasons for the appalling treatment occurring under current guidelines, legislation and the funding model. The commission should be given scope to look at the impacts of cuts and the changes to the ACFI on the current aged-care facility system. It should explore the impact of the lack of home-care packages and the subsequent impact in early entry into the aged-care system. It should look at the workforce, training and quality that has led to the outrageous practices that we have seen.

The other side of the aged-care system is the home care packages. Again, in this space we are seeing an absolute mess from this government. Time and time again, the lack of packages has been raised by the member for Franklin and many of us on this side in private members' business. Time and time again, we've complained about reports and data being held back as the numbers on the waiting lists rose. The home care package mess is another failure to add to the Liberals' record when it comes to the aged-care sector. It says a lot that the member for Cook, Scott Morrison, approved a multimillion-dollar taxpayer funded advertising campaign encouraging older Australians to access home care packages, whilst the waiting list for home care blew out to 121,000 people. The $8.2 million advertising campaign was the single biggest advertising spend in the 2018 budget. This campaign not only wasted millions of taxpayer dollars which could have been used to fund the home care packages but also gave older Australians false hope of their chance to accessing them.

What we know is that there are now 121,000 people waiting for home care packages. Of those people, 95,000 are waiting on the list with high-care needs, many with dementia. The blowout in the list means that older Australians are waiting, in some instances, more than two years before they can access a home care package that they have been approved for. The result means that people are going into aged-care facilities earlier than they would otherwise have needed to. This is irresponsible, not just in terms of quality; it's also financially irresponsible. We know about the cost blowouts as people enter aged care earlier than would have been necessary. This year's budget provided funding for a mere 14,000 packages over a four-year period. Three thousand five hundred packages per year is woefully inadequate when you consider that, in the past three months alone, the waiting list has grown by 13,000 people. While any money for the aged-care sector is welcomed, the provision of 14,000 packages over four years, when the waitlist is sitting at over 121,000, is disgraceful and says everything that is wrong with the policies of those opposite.

The issue raised by the member for Bendigo, thankfully, is around the workforce. The government is yet to commit to any funding to the Aged Care Workforce Strategy Taskforce. In the next 30 years, the aged-care workforce is expected to increase by 300 per cent, so we need to get this right now. The government's hands-off approach is failing not only the sector but older Australians who are reliant upon it. After they came into office in 2013, the Liberal government dumped Labor's $1.5 billion workforce compact and supplement. Labor will continue to advocate for a comprehensive workforce development strategy to address issues of training, staffing levels and an ageing workforce. The government is failing to ensure that the aged-care sector has staff that are adequately skilled and equipped to care for our rapidly ageing population.

That is not to diminish the work of the many carers and nurses I have met who work in this sector. To a large degree, those I have met are caring people. They are committed workers, tarred with an uncaring brush because of the images that we have seen on our television screens. I have met with aged-care workers and they have shared their stories about the real impact of funding cuts on the work they do. Their stories horrify the broader public—they do not meet the community's expectations. They speak of having little time to spend with residents, no time for conversation. There were tears when I met with workers in the western district. There were tears for how their role has changed and has impacted on the quality of life of the residents they care for. They talked of how heartbreaking it was not to be able to sit with someone while they drank their cup of tea. They spoke of the time pressures of having to get so many people out of bed and showered and dressed for the day. Aged care should not look like it is being institutionalised. Aged care should look like care.

The bills that are in front of us today will establish a commission that was called for 12 months ago. The royal commission will shine a light on things, but we know now what many of the issues are. We know that there are issues in terms of staff ratios. We know that there are issues in terms of the quality of care. These things need to be addressed immediately.

In contrast to the crisis caused by the Liberal government, Labor has a strong track record when it comes to ageing reform. In 2012, Labor introduced the Living Longer Living Better ageing reforms. In May this year, in fact in the budget reply, Bill Shorten said that an elected Labor government will make dementia and ageing national priorities, because it is the right thing to do—to make sure that older Australians have the dignity and respect that they deserve in aged care.

I know how often members on this side, and those opposite, are being contacted by people concerned about either the level of the home care package that they are likely to receive or the treatment of loved ones in aged-care facilities. I have heard many of those opposite raise these issues in this place, and I've also heard them come back and tell us how they had gotten ministerial intervention around a home care package for a level 3 or 4 resident in their community. Ministerial intervention is not good enough in this space. We need to act and we need to act now. Beyond the Aged Care Quality and Safety Commission, there needs to be action taken before we see the end of the royal commission. We cannot wait until it is concluded before we start implementing changes to fix this sector, which is in a state of crisis nationally. The government cannot ignore the situation any longer, as they have with previous inquiries.

Elderly Australians deserve to spend their twilight years in a dignified way. They deserve to have care in the institutions in which they are living. They deserve to have people working with them who care for them, who have time in their day, who are receiving a decent rate of pay and who have high-quality training. We need to increase the expectations for every—every!—facility to ensure that the quality of care that we would want for our own parents is being provided for every elderly Australian.

Peter Khalil (Wills, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Aged Care Quality and Safety Commission Bill 2018. Deputy Speaker Hastie, you know that we support the royal commission into aged care, as, of course, do the vast majority of the public—there was a 240,000-strong petition to that effect. But it should not be an excuse for inaction on the issues that are facing the aged-care sector today. I've received emails, phone calls and letters—hundreds of them—and I've visited constituents of mine who have shared with me their struggles with the quality of their own aged care and that of their family members. As the need for high-quality and transparent aged-care services expands, we must act now. We must address these issues and support the quality of care that older Australians should be receiving. This bill goes some way to doing that.

The impacts of understaffing and underfunding are real—we've heard about that. The ones who get the short straw as a by-product of those shortcomings are our parents, our grandparents and our loved ones. That is not to mention, as the previous speaker has, the nurses and aged-care workers who look after them. There are around 1.3 million Australians who are currently receiving some form of aged care. This care is being provided by around 400,000 nurses and carers. There clearly are not enough carers and nurses to do the job, and the ones who are doing the hard work on the ground aren't given enough pay, respect and support. Their role is critical in the care of our older Australians and will become increasingly important as the numbers increase, so we have to act now.

We have to implement long-term solutions to this growing and demanding issue. It is projected that by 2056 the aged-care workforce will need to triple to around one million workers to adequately deliver the services for more than 3½ million older Australians, who will represent one in four aged Australians who will need that care.

The recommendations from a Senate inquiry and the subsequent Carnell-Paterson review following the investigations into elder abuse at the Oakden facility in South Australia have led us to this point, but it has been slow, halting and fumbling. We are extremely concerned about the government's dithering response in introducing legislation into this parliament. We are concerned that the government have yet to respond to many of the other recommendations of the Carnell-Paterson review. We are concerned that the government have known about this review and the recommendations since October 2017. That was a year ago. What is the hold-up?

The government only decided to act when they watched, or heard about before watching, the harrowing Four Corners series, the first part of which aired during the last parliamentary sitting week. The sharing of the personal experiences of families and residential aged-care facilities suddenly made them wake up to some of the problems that were right before their noses the entire time. But the Carnell-Paterson review is not the only review that has sat untouched by the government. There have been more than a dozen reviews and reports, and there are hundreds of unactioned recommendations.

There can only be one sad answer to this dithering, this slowness. Clearly, unfortunately, the coalition government are too busy fighting amongst themselves, day to day, to actually do their day job, to drive long-term reform and to make the necessary changes to address the issues in the aged-care sector. What they've managed to do, just barely, is fit in what is pretty much a piecemeal—piecemeal in nature—process.

I recently visited the Ethnic Communities Council in my electorate to speak and participate on a panel at its forum on the aged and those on the aged pension. A lot of the discussion included the challenges faced by culturally and linguistically diverse pensioners in particular—the rising cost of living, access to health care, maintaining active lifestyles, mental and physical health in retirement, but also the additional language and cultural challenges faced by those pensioners from very diverse backgrounds, some of whom migrated to this country in the fifties and worked all their lives helping build Australia. Really, these challenges are shared by all ageing Australians.

The forum took place on the Monday after Scott Morrison's ascension to the position of Prime Minister. The slowness in addressing these issues could be an indication, maybe, of another reason besides the infighting—that is, his philosophical view towards the elderly. As I was researching that speech, it was interesting to read what Scott Morrison had said about those elderly constituents—

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

Order! The member will refer to—

Peter Khalil (Wills, Australian Labor Party) Share this | Link to this | Hansard source

Sorry Mr Deputy Speaker—what the now Prime Minister—

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

Thank you.

Peter Khalil (Wills, Australian Labor Party) Share this | Link to this | Hansard source

at the time the member for Cook, had said in the past when he was a freshly minted Treasurer. In 2015, he had made comments stating that the aged pension should not be regarded as an entitlement for all. This is a fundamentally flawed view of the social contract that binds pensioners with the government. These are pensioners who have worked 40, 50, 60 years, paid their taxes and made their contributions. There is a contract that binds them with the government, and that is that the government has a responsibility to provide them with their pension.

I was quite shocked by the philosophical position that was put by the then Treasurer and now Prime Minister. In my mind the Prime Minister's philosophical position on this is a big part of the problem that we're facing right now. As Treasurer during the Turnbull government, he then outlined his vision for an overhaul of the country's retirement income system, by both reducing expenditure on welfare payments and limiting the amount of revenue foregone through tax concessions.

I have a fundamental difference of opinion with this philosophical position. As I said, there is a binding contract between the elderly Australians, pensioners in this country, who deserve, after all of their years, decades, of hard work and commitment to this nation, that they are looked after by the government. It is not an entitlement; it is not welfare; it's part of the social contract. I said to the pensioners and the aged in my electorate of Wills, 'The pension is not a privilege. It is a right which you have worked for and which you deserve.' And this principle applies to aged care as well. Its provision is of fundamental and existential importance to millions of ageing Australians.

The government may have abandoned the proposal to raise the pension age from 67 to 70, but I would say let's not be fooled by the new Prime Minister. He may be the new Prime Minister of Australia, but there is a track record there of wanting to make cuts to social welfare payments and of seeing the provision of these aged-care services and the pension as a form of welfare. Some of these policies are lifted out of the right-wing think tanks that we know of, like the Institute of Public Affairs.

Let's look at the contrast. Labor has a strong track record of support for aged care. The Living Longer Living Better reforms were delivered by Labor in government in 2012 and 2013. These reforms were designed to deliver important benefits to older Australians. They included more support and care at home, better access to residential care, increased recognition of carers and those from culturally diverse backgrounds, more support for those with dementia and better access to information. I think it is a truism. I mean, it is obvious, but I will say it again: Labor has always prioritised health care, especially for those working and living in aged-care facilities. It was Labor that was responsible for the historic reforms in 2012.

Opposition leader Bill Shorten committed in his budget reply speech that a Labor government, if elected, would make dementia and ageing a national priority. The fact is we are in a mess because, for years, the coalition government have been slashing funding to aged care repeatedly. It is only now that they claim to have some concern, but they continue to fail the public on aged care. In the Turnbull government, Sussan Ley was health minister and little if nothing was done to progress the LLLB reforms. The current Minister for Senior Australians and Aged Care—a portfolio clearly not valued enough to be included in the cabinet—has also struggled to progress any of those reforms. Three different aged-care ministers across the Abbott-Turnbull-Morrison governments have had carriage of these reforms for the past five years and have failed miserably to do any real reform across the ageing portfolio. How can we call ourselves a fair and generous country if we continue to treat elderly Australians without the respect that they deserve? The system is in crisis and it is no wonder. You can't fix aged-care support and support our ageing population and our healthcare workforce by slashing funding. It just doesn't work that way. When you cut funding, you make it harder; you make it more difficult for those in aged care.

The government's lame attempts in the 2018-19 budget were woefully inadequate and they've admitted this themselves. Data released from March 2018 sadly now reveals more than 108,000 older Australians are waiting for a home-care package. These numbers are shocking and the government made a much touted—by themselves—commitment to 14,000 home-care packages over four years. That's a drop in the ocean and nowhere near the number that is needed. It is not just inadequate; it is actually an insult to older Australians. This is only worsened by the fact that it's not even new funding. It was pulled out from another part of the budget. It was found in the same bucket and re-allocated.

The government puts older Australians and their families so low on their list of priorities that they did not even commit to increase funding to keep their promises to address the waitlist to access these packages. What a sad reflection on the government—self-centred, fighting themselves, unable to focus on the needs of older Australians. Whatever light this government held up to itself as a government that would be concerned for the ageing is now covered in darkened ashes. The government created the aged-care crisis. The government then ignored the aged-care crisis, and the government and its budget failed to fix the aged-care crisis.

Labor, when we were in government, recognised the national crisis in the aged-care system and offered practical policy and reform to make change. But things have actually got worse over the past five years under the coalition government. Inaction has been the catchword, and it's clear that a royal commission into the abuse and cover-ups of neglect in the aged-care sector is absolutely necessary. At least we can agree on that across the aisles—we can agree that we need the royal commission.

So we, on this side, wholeheartedly support the royal commission into aged care. It must examine the impact of the years of neglect, the years of funding slashed from those who need it most, and the Prime Minister's, Mr Morrison's, own attacks when he was Treasurer, when he cut almost $2 billion in his first year.

I've had many recent visits, and many visits over the two years that I've been an MP, to residential aged-care facilities in my electorate, and I've heard firsthand, from the workers and the residents, of the difficulties that they face. I support their campaign around funding, as to increasing the ratios in the system and the staffing issues generally. Fixing these issues will undoubtedly improve quality of care for some of the most vulnerable members of our society and concurrently improve the conditions of some of our least appreciated workers. But, as I said earlier, the royal commission can't be an excuse for inaction by this government.

The purpose of these bills that we speak on today is to restore confidence in the delivery of aged-care services to those in aged-care facilities—those with family who reside there and those who work there. Despite the minister for aged care receiving the 'A Matter of Care' strategy more than two months ago, the government has actually sat on it and has only just released that strategy. It is yet to make any concrete commitments to increase funding to support the aged-care workforce in the 2018-19 budget. How does the government expect to drive reform without providing that additional funding? How does that happen?

Labor has called on the government to heed the important advice of the chair of the report, John Pollaers, and implement the workforce strategy in full to meet the growing demand. We've seen that the public has lost confidence in the safety and quality of the delivery of these services. That is why this bill seeks to establish a new Aged Care Quality and Safety Commission, starting on 1 January 2019, that will take this restoration of confidence as its primary task.

The government, frankly, has a lot of work to do to get this right—to get the commission right; to make it available to support the public as soon as possible—and they're taking far too long to do the work to establish it. We, on this side of the House, hope that the Greens political party, as to referral of these bills to the community affairs committee, will not further hold up the passage of this extremely important legislation. The government is still yet to fill three important positions on the advisory council, and you would think that these would have been filled by now if the government were as concerned as the public are on this issue.

Under Labor, there was a clear plan within our reform package. That was achieved largely through a bipartisan approach, and we're proud of that. So we hope that we can work together again to ensure that these issues in the aged-care sector are addressed, because these older Australians are so important, given the commitment to and the sacrifices they have made in this country, to help build it and to give us the wonderful future that we have before us.

Sharon Bird (Cunningham, Australian Labor Party) Share this | Link to this | Hansard source

I would like to indicate, at the beginning, in speaking to these bills—recognising that we're dealing with two cognate bills—that I support the amendment that has been moved by the shadow minister, but I also indicate that I think, as many of my colleagues do, that, if that amendment is to not succeed, these bills need to be supported. That is because we are in a really critically important time for the aged-care sector. In my electorate, this is certainly one of the most pressing issues that I and my staff deal with on a regular basis.

These bills before us, the Aged Care Quality and Safety Commission Bill 2018 and the Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018, are enacting some of the recommendations of the Carnell-Paterson review of aged care. In particular, the first bill is establishing a new Aged Care Quality and Safety Commission, intended to be operational from 1 January 2019. That will bring together quality assurance and complaints procedures in the aged-care sector. That's obviously as a result of the review. It's a worthwhile thing to do.

But we do have some concerns about the aged-care sector, and I want to touch on those in general. First of all, I want to say that while this bill is definitely a move in the right direction and is a response to an important review it's now in the context of the agreement to establish a royal commission into aged care. There is no doubt in my mind that the royal commission will hear very significant and important evidence from across the nation and from all of our communities about some of the things that are a real challenge to us in looking after our elders as a nation. I commend the fact that that is to proceed.

Having said that, it is also critically important that the things we already know are not left to languish whilst the royal commission occurs. There are actions that government could take, such as the legislation before us today, that can be progressed in order to make sure that we provide better care, love and attention to the elders of our community. I don't think that anybody in our community would expect any less of us in this place. So, in that context, I want to talk about two particular areas where it's one thing to have a quality and complaints procedure but where we also need to get the other aspects of service delivery in place. One of them is around funding and delivery of services and the other is around workforce and providing for the future, given that we know this is a space where we'll need to not only improve quality and skills but increase staffing levels—the numbers of staff that will be required to do the job. Why this is so critically important, and why I think that so many of us on this side of the House wanted to speak on the bill, is that we've got elders in our communities, many of whom are living much longer and much healthier lives. They're active and participating in all sorts of activities, often now for decades after retirement. Certainly it's not something that our grandparents' or great-grandparents' generations would have anticipated post-retirement, but it's a reality. And that's a great thing.

It also means that as a result of being more healthy, more active and more engaged, it's now becoming the case that most people are often going into what we used to consider a more common experience—residential aged care—when they're at the very critical end. So they go in with very complex challenges and problems and need much more professional and qualified care provided to them. Dementia is a major issue now, as are complex health problems. People living longer means that at the end of life we are more likely to have the culmination of many of those impacts of ageing happening. It also means, obviously, that for quite a lot longer in life people will be looking to stay in their own homes—and we know from health outcomes that that's a much better thing for people to do. I think there has been a very strong bipartisan view that being able to support people to stay in their homes longer is a really good thing; it's a good policy aim. It's certainly a big part of what drove Labor's reforms in government, in the Living Longer Living Better reforms, to make sure that people were supported to do that.

What frustrates me and my community at the moment—and I've spoken about this in the chamber before, so I'll just touch on it here in this debate—is the fact that post the change of government in 2013 we have seen successive cuts to funding in the aged-care sector. Certainly I was made well aware by many of the providers in my electorate—and I'm sure other colleagues found the same in their electorates—of the massive changes that were made to the funding instrument and the implications of that cut across the sector. And that continues to be the case. Before the last budget the government had put out a whole lot of stories in the media about how there was going to be a big aged-care boost in the budget. Like many in my community, I was anticipating that it would come through, because, in particular, home care packages have been a real issue for people in my electorate. We know that people are being assessed as needing the most high-level package—a level 4 package—which means that they need the highest support to stay in their own homes, which, consequently, means that if they don't get that support they are much more likely to have to move into the residential aged-care sector.

Just from a purely economic perspective for government, it's better—because it is more efficient and cheaper—to keep people in their own homes. Residential aged care per head is a much more expensive proposition. This is being frustrated by the fact that there are over 100,000 people waiting for care packages across the nation. In my own area, there are over 1,000 people who have been assessed as needing it but who are waiting. I will just remind the House that those published public figures about people who are waiting for a care package do not include people who have been assessed for higher-level care and then put on an interim lower-level care package. You might need a level 4, but there is a wait for it, so, in the meantime, the government puts you on a level 2, which is, obviously, a lower level of support.

The reality of that impacts another group of people for whom I think this legislation, and the whole issue, is so important: families, loved ones and carers. I cannot tell you the number of times that I've had family members in tears talking to me and my staff, waiting for a home care package to be delivered. The reality is that most families who have an elderly relative are in one of two situations. Some people are working themselves, so they have the stress and worry about being at work all day when they've got an elderly relative in their own home: not being able to pop over at lunchtime and check on them, or, if they ring and they've got a problem, not being able to duck over to see them. This puts enormous stress and pressure on people. And that, obviously, has productivity implications for people in the workplace. Getting this right would have a really important economic flow-on for those workers in our communities who have caring responsibilities in families.

Often, people are not only are working; the way our demographics are these days—people not having families until much later in life—they often have kids of their own that they're also juggling in terms of child care and school commitments and so forth, at the same time that they're dealing with older parents and family members. So this is a huge issue in our community, and it's an enormous stress on people, particularly when they've got a loved one who they know has been assessed and is entitled to support, but it's taking up to a year to get that for them. Imagine that you are a son or a daughter of an elderly person in that circumstance, where you're trying to work, you're trying to support your own family, you love this person and you're trying to do everything you can for them, and for month after month that pressure continues on you even though that person has been assessed as entitled to support. It is unacceptable, and the measly 14,000 places that were in the last budget barely make a dent on that long waiting list—and the funding for that came out of residential care funding anyway; it wasn't additional money. So this has real implications not only for our loved elders in our community but also for their families, their work colleagues and the businesses that they work for.

The third group of people who I want to talk about in terms of the aged-care sector are the providers. By that, I mean the aged-care providers who are caring, quality providers. In this environment, with what's happening, they really are going to have a hard time of it too. It's very unfair to those providers to be put under the pressure of funding cuts and also under the pressure of delivering quality services and trying to match those up. I'm very conscious in my own area of providers who were running particular programmes to really give some quality of life to residents and who, through changes to the funding instrument and so forth, were not able to do a whole lot of things that they really wanted to do. I want to acknowledge them in this situation.

Most significantly, I want to acknowledge the aged-care workers. These are just amazing people. I'm sure all of you in the chamber will have visited aged-care providers in your own area. You would know that, by and large, they are women, but increasingly more men are working in this sector. You would know how deeply they care for the people that they're working for—their residents or older people that they're visiting and providing services to in their homes. It's just an amazing aspect of this sector—how deeply dedicated the workforce are. But they're not supported well enough.

That means some challenges for us around a female-dominated sector's pay rates—certainly Labor's had something to say about how we get better in that space—but also around training and development. The job is becoming more complex; it requires higher levels of skill. Part of that is also about resilience and about helping people get the skills and knowledge they need to feel competent and, therefore, confident in their work and not stressed by it. It also goes to sheer numbers. We're all ageing. It's one of those industry sectors that's unlikely to take a downturn. We're all going to hit that point and we are going to need a huge increase in the number of people working in the aged-care sector. It has already been a challenge for many providers to recruit people. It's hard to get young people to see the sector as a viable long-term career option, although it is one and it provides great opportunities. They're seeing a sector under stress, under pressure and underfunded, without appropriate recognition of skills or support through upskilling and retraining, and when people look at that it's very hard to encourage them to come into the sector. We have to get much better at workforce planning. I do think it was a great error by the Abbott government, when they were first elected, to abolish the over $1 billion workforce strategy that Labor had put in place alongside the reforms. I think it was very short-sighted.

I want to acknowledge that I attended a forum with many of those workers in Wollongong in June. Our local Labor councillor, Arthur Rorris, spoke, and so did Gerard Hayes from the Health Services Union as well as locals Amanda Hampton, Karen Singh, Lisa Walker and Lyn Martin, who between them have decades of experience in the sector. The thing that they were there for wasn't about their own educational opportunities or their own pay rates; it was about their despair and about making sure the system delivered for the people they loved and cared about and the clients that they were working with. It was just inspiring to hear that dedication. I want to pay huge respects to those workers and say to the whole parliament that we need to do better.

Many of the people I have spoken about are carers, and in my final 20 seconds I want to acknowledge it is National Carers Week. The website's up and running, and I encourage people to support a carer. Go and have a look at the website and support National Carers Week.

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

I want to start by acknowledging my thoughts are with the families, friends and loved ones who have had their parents or loved ones affected by some of the stories that I've been hearing today and those we have seen in media over the last few weeks. Aged care is a policy area that needs urgent attention due to the fact that Australia has an ageing population. Around 1.3 million Australians are currently receiving aged-care services provided by approximately 400,000 nurses and carers. It is projected that the aged-care workforce will need to triple by 2056—that is, around one million workers will be required to deliver services for more than 3.5 million voters. Older people will represent one in four Australians. Public expenditure on aged care is expected to double as a share of the economy by the 2050s. Right now, there are over 100,000 people on the in-home-care-package waiting list, including 88,000 people with high needs, and many of those are living with dementia. This demonstrates the high demand and rapid growth of this sector.

When Labor were last in government, we understood the need to act quickly, and we are still aware of the need for urgent attention. Due to the fact that Australia has an ageing population, the ageing-policy area is a rapidly changing environment. Labor made massive reforms to the sector, delivering the Living Longer Living Better reforms in 2012 under the then minister, the Hon. Mark Butler. The Living Longer Living Better reforms were designed to deliver important benefits to older Australians. Those included more support and care at home; better access to residential care; increased recognition of carers—and I pay tribute to carers, as this week is Carers Week—and those from multicultural and diverse backgrounds and also for our First Nations people; more support for those with dementia; and better access to information. The main focus was about consumer-directed care that would give older Australians not only a greater choice about the care they wanted but the independence and support to live in their homes for as long as possible, preferably until they passed away.

There was a clear plan for the Living Longer Living Better reforms, and Labor delivered a massive aged-care reform package that provided $3.7 billion over five years. Labor legislated these reforms, and we funded them. And then something devastating happened for the aged-care sector three months later. The LNP Abbott government was elected, and then the attacks on aged care commenced.

The very worst thing about the current LNP government is that the Minister for Senior Australians and Aged Care is not included in cabinet. Three different aged-care ministers across the Abbott-Turnbull-Morrison governments have had carriage of the Living Longer Living Better reforms over the last five years, and all have failed have to do any real reform across the Ageing portfolio. The former Minister for Health and Aged Care, Sussan Ley, did little or nothing to progress the reforms. The current minister, Ken Wyatt, has also struggled to progress the Living Longer Living Better reforms. More than a dozen reviews and reports, including hundreds of recommendations, still sit on the minister's desk without being actioned. The reports have all been there, sitting on the minister's desk. Instead of responding to them with compassion, they have responded with cuts.

Arguably, the worst thing that this LNP government has done to the aged-care sector is the massive cuts. The LNP have cut billions of dollars from the Aged Care Funding Instrument and have dumped Labor's $1.5 billion workforce compact. Under Scott Morrison's watch as Treasurer, the aged-care budget was used as an ATM to try to prop up the budget. He cut approximately $1.2 billion from the aged-care sector. Now, as Prime Minister, Scott Morrison has tried to say that he hasn't made any cuts. Allow me to enlighten the Prime Minister, who seems to have forgotten that he was Treasurer and apparently cannot read his own budget papers. The budget papers are very clear. Under 'Aged care provider funding' on page 101 of Budget Paper No. 2 from the 2016 budget, it states:

The Government will achieve efficiencies of $1.2 billion over four years through changes to the scoring matrix of the Aged Care Funding Instrument (ACFI) that determines the level of funding paid to aged care providers.

It's there in black and white. How inept can one honestly be? You cannot rip $1.2 billion out of the aged-care system and not have an impact on the quality of services.

The aged-care industry bodies warned at the time of the 2016 budget that the cuts would result in reduced quality of standard of care. And—no surprise to anyone except the LNP—that is exactly what has happened. It was always going to be inevitable that these massive cuts would, sadly, lead to reducing the standard regarding the care of our older Australians.

Care for older Australians is fundamentally a human right. The LNP seem to be too busy fighting amongst themselves instead of focusing on what truly matters. The lack of response in relation to any reform fits a disturbing pattern of cover-ups and inaction on aged care from successive LNP governments. The aged-care workforce is expected to increase by 300 per cent in the next 30 years, underscoring the challenges and opportunities to get this right. But how does the LNP government react to this rapid growth rate? By cutting vital funds to the sector. The current situation in the aged-care sector can be no surprise to this government, and the responsibility for this demise rests solely on its shoulders. But, instead of responding with critical funding, it has responded with denial and a royal commission.

Personally, I back the royal commission, as does Labor. After all, it is Labor that has been saying for some time that the system is in crisis. It was only in May that the Leader of the Opposition, Bill Shorten, said this in the parliament, and the government likened it to committing elder abuse. So it is a positive step that the LNP have changed their minds and are finally listening to people who use aged-care services, and workers, because the issues are blatantly obviously.

In Townsville I have set up an aged-care reference group, and that group and members of the wider community have raised a number of issues. Firstly, the staff don't get paid properly. Secondly, the ratios of nurses and support workers to patients, and the skill mix of staff, need to be addressed. I think there needs to be a discussion about the ratio of qualified people to residents, and about the care that those residents need in the aged-care facilities. Are there enough nurses? Are there enough doctors? Do we have the local pharmacist involved? Can we get GPs to visit aged-care facilities? These are all questions that need answering.

Thirdly, regarding Prime Minister Scott Morrison's cuts to aged care, you can't cut billions of dollars in funding to residential aged-care facilities—supporting people with high needs and complex conditions, like high-care dementia—and expect a better result. Fourthly, is the cost of access. I am hearing lots of stories about people feeling ripped off in retirement villages.

Fifthly, is, importantly, My Aged Care. Accessing My Aged Care is simply a traumatising experience for many elderly people—apart from the fact that many elderly people are not computer literate or do not even own a computer. When my father was extremely unwell and living in a residential aged-care facility, he was being transferred to hospital and my mother had a fall and broke her pelvis whilst walking with him to the ambulance. If that was not traumatic enough, when she was eventually discharged from hospital, she also needed a visit from the aged-care assessment team, because she needed an assessment for support services. The nurse visited and spent five hours with my mother, doing the assessment on line. At the conclusion, she hit the 'submit' button, and the entire assessment disappeared from the screen.

The long and the short of this story is that she had to redo the assessment at a very traumatic time in her life. The only reason she had a nurse visit was because she had just been discharged from hospital and she needed immediate support. My mother had family to support her in this process. The question for me is: what happens to older Australians who do not have someone to support them? My mother-in-law got her appointment for her assessment after she died. The My Aged Care process needs immediate attention.

There have been several inquiries into the problems in the aged-care sector, which the LNP government has not acted upon. If we are going to be serious about a royal commission, then the entire system must be included—the cuts, the reports, the inaction, everything. The royal commission must look at all aspects of aged care. It must look at the long-term sustainability of the sector, the workforce and the quality of care. It all must be investigated.

The workers in the aged-care sector work really hard every day. They are on very low wages. Sometimes they are low-skilled workers, and sometimes they are highly skilled individuals who are not receiving the remuneration they should because they are working in the aged-care sector. They need to have their say as well. The workers I have spoken to want to feel proud they work in the aged-care sector. They want to go home feeling they have done a good job and have had the time to properly care for the older Australians in their care. As a nation we want to encourage people to work in the aged-care sector and we want to ensure that this royal commission takes a long-term view, and not just a rushed short-term look at some systemic issues.

Most importantly, the royal commission must allow for and encourage older Australians to have their say—as well as their loved ones and their families. They must feel safe to make complaints without fear of repercussions. If the government is ever to rebuild faith through the royal commission process, then it is vital that older Australians and their families have their say.

But it is also critical that we do not wait until the end of the royal commission before we take action, because we know what action needs to be taken. The LNP government cannot use the excuse of a royal commission before they commit to take the necessary action to fix the sector in its immediate crisis. Older Australians and families cannot wait. The LNP government must act now on the things we know are wrong with the system. The reports are available and the reports say that the cuts are having a detrimental impact on the quality of care offered in aged-care facilities. Now it is time for the government to step up, say they are sorry and restore the funding that has been cut. You don't fixed aged care by cutting funding. You don't fix aged care by not funding it. You certainly don't fix aged care by delaying action. That is really at the heart of what has happened to the aged-care system.

That brings me to the bill at hand. The Carnell-Paterson review recommended bringing together the functions of the Aged Care Quality Agency and the Aged Care Complaints Commissioner. There are 10 recommendations in the Carnell-Paterson review. The purpose of the Aged Care Quality and Safety Commission Bill 2018 is to establish a new Aged Care Quality and Safety Commission from January 2019.

Debate interrupted.