Julie Owens (Parramatta, Australian Labor Party) Share this | Link to this | Hansard source

I move:

That this House:

(1) notes that:

(a) the latest Government report indicates around 120,000 older Australians are waiting for their approved home care package; and

(b) more than 72,000 older Australians on the waiting list have no home care package at all;

(2) recognises:

(a) the majority of older Australians waiting for level three and level four packages have high care needs;

(b) some older Australians have been waiting more than two years for their approved package, many of whom are in their 90s and others who have terminal illnesses; and

(c) older Australians are entering residential aged care or even emergency departments instead of receiving their approved home care package;

(3) condemns the Government for failing to stop the wait list growing; and

(4) calls on the Government to listen to the growing chorus of voices for urgent action to fix the home care packages wait list now and properly address this national crisis.

It's with some frustration I rise to speak yet again about the failure of the government to adequately support the incredibly important Home Care Packages Program. Home care packages play a really important role in ageing. They allow people to stay home as they age, whether they need a small amount of support on level 1 or a great deal of support on level 4.

Unfortunately, with the release of the latest data on home care packages, it appears that the fate of many older Australians is sealed when it comes to receiving the support they need to age with dignity in their homes. Not long ago I spoke about a woman in my electorate of Parramatta, Mary Seeward, who died before she received before her approval for a level 4 home care package after waiting for many, many months. After speaking about Mary, a number of my constituents called to relay their own family stories about their issues with My Aged Care. One person's mother had been assessed in March and, in August, had still not heard anything back. He waited 5½ hours on the phone to speak to My Aged Care before he gave up. Another man had been waiting for the assessment of his needs for My Aged Care. After prompting from our office, the assessment was finalised, but he still has to wait for three to six months for a level 1 package and nine to 12 months for the package that he requires, which is a level 2.

We know the population is ageing. There are more than 18,000 people aged over 65 in my electorate alone, but under this government's watch the home care package waiting list has increased from 88,000 people to 120,000 people. This just isn't good enough. There are 72,000 older Australians on the waiting list who have absolutely no home care package at all. These are real people waiting, sometimes for years, worried and distraught about their future and the condition of their health. Forty-two per cent of people are waiting for a level 2 funding, but one-in-six people are waiting for level 4. These are real people with chronic conditions and in many cases their needs are time-sensitive, such as for my constituent Mary, who has now passed.

We know that the home care model is the best approach for aged care, both economically and socially. What is best for the older person is often the most affordable option for the taxpayer. It just kind of works. Home care allows a person to stay connected to their neighbourhood and their family home with all its memories, retain connection to their much-loved pets and to keep their independence. For the family, it eases carer responsibility, and for people who are already struggling to balance their work and home life it's essential. And conveniently, it is the most economically sustainable model for government as it keeps people out of nursing homes prematurely and helps prevent the visit to the emergency department. With that in mind, it is incomprehensible that almost 120,000 people are still waiting for their home care packages to be approved.

This is a no-brainer. If you manage the program well, everybody wins. Yet the government is idle, standing by while this incredibly important program fails so many of our older neighbours. The unbelievably long waiting list for home care packages is symptomatic of a deeper crisis of under-resourcing. It is a system collapsing before our eyes. This month, TheSydney Morning Herald reported the findings of a study of almost 5,000 aged care staff and what they had to say should be of great concern to everybody in this House: 81 per cent of workers said they did not have the time to do the tasks they are required to do, and they admitted that they are so stretched they're cutting corners and not giving the elderly people the help they deserve, leading to more residents being left unshowered, rushed during meals or placed at the risk of serious injury. And 67 per cent of home care workers reported an increase in complex needs, including more people with dementia. This is a growing need, and this government is failing to address it. The Prime Minister, Mr Morrison, is responsible for billions of dollars of cuts to the aged-care sector in the past five years—$1.2 billion cut from aged care in his first budget as Treasurer, backing in the $500 million cut in the 2015 Mid-Year Economic and Fiscal Outlook.

In spite of the growing needs of an ageing population, there is both a challenge and an opportunity for our nation. Aged care is not even a cabinet portfolio. There is no holistic, whole-of-government approach to aged care. In addition to underresourcing, blowouts in waiting times and funding cuts, there is a labour crisis, which has only been made worse by the government's cuts to TAFE.

Where is the plan? Waiting times now are ridiculous, and a third of aged-care workers plan to leave the industry in the next five years. It's going to get worse. There will be more people in care and fewer people to serve them. Scott Morrison has no plan now and he has no plan for the future. If he doesn't think there's a problem then he's seriously out of touch. He needs to act and he needs to act now.

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

I thank the member. I just remind members to refer to people by their titles rather than their names. Is the motion seconded?

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

I second the motion and reserve my right to speak.

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

In moving this motion, the previous speaker, the member for Parramatta, referred to her frustration. I can understand and respect that, because an elected member of parliament who stands at the podium here or in the chamber does so because they seek to pursue the best interests of the community that they represent and, as part of that, to make sure that we are providing the support services to people when they are at the most vulnerable stages of life. That's what this government has been doing.

The frustration that I and others feel is that, after committing billions of dollars towards extra home care packages, as we have, including in the last budget, to make sure that all senior Australians at that vulnerable stage of life get the support and care they need, we come into this chamber and have an opposition member move a motion such as this, when at the last election she ran on a platform of providing exactly 0.0 dollars for extra home care packages in Australia. Let's think about that. This goes to an issue of trust. When it comes down to who Australians trust to provide the support and assistance they need, we know it isn't the opposition that Australians trust. This is not a partisan attack, but it is a criticism of the honesty that sits behind this debate.

We have done so much to reform aged care and provide the support and assistance that people need at different gradations of the health and wellbeing associated with their ageing. We've made sure that people are in a situation where there is sufficient funding to make sure that people can get aged-care places. That is particularly challenging because the number of people who are staying in their homes is growing, and they are staying there for longer periods. Those who are going into residential aged care need support at a more acute level, particularly around issues such as the rising rates of dementia.

One of the reasons that people are able to stay in their homes longer—it is not just out of wish or ambition—is that the taxpayer, through the Commonwealth, funds support services for them to be able do so. This government has invested $2.2 billion to address the waiting list for home care packages. No-one is trying to pretend that there isn't more work to be done. There is, because of the enormous and increasing number of people who are staying in their homes longer and who are in need of support. But the reality is that there is only one way that we can make sure that we meet that expectation and that challenge, and that is to have a strong economy so that we have the tax revenue to make sure that we can fund the ongoing services. That's the basis on which this government was elected and is meeting the aspirations of the Australian people.

If you compare that to the alternative approach, that of the opposition, of going to the election with 0.0 dollars of extra commitments, you start to see very clearly why some of us find motions such as this frustrating. We're investing an extra $150 million over three years from 2019-20 to expand Commonwealth Home Support Program packages in priority across Australia, and around 18,000 people are expected to benefit. And, of course, since the 2018-19 budget, the government has provided $2.2 billion, as I already mentioned, to release an additional 34,000 home care packages—34,000 more home care packages than those put forward by the mover of this motion.

It's about time we had an honest conversation about the challenges confronting Australia in aged care. It's part of the rich challenge that we face as part of an ageing population. The basis from which we start that conversation is actually being honest. That's the problem I have with this motion. For this mover to stand at the lectern and move this motion—when they offered nothing to the Australian people when they went to the election; perhaps that's one of the reasons why they now sit on the opposition benches—and to make political use of some of Australia's most vulnerable people without full acknowledgment of their lack of support and care for them, is something that, frankly, I find despicable. But that is their choice and they'll be judged accordingly for their conduct. I think what we should focus on as a parliament is continuing to bring people together to support the government's program and to support the home care packages that Australians so desperately need.

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

I will pick up from where the previous member was speaking. He is frustrated that he's got to defend this government's appalling record. He wants an honest conversation about what's happening in aged care in this nation. Well, I'm going to give him one, and I'm going to give him some honesty, because, whilst the government is 'annoyed' about motions in this parliament, I wish they'd be annoyed about the 120,000 Australians who are waiting for home care packages on their watch. That is practically an entire electorate of people who are not receiving the care that they desperately need. Perhaps most shocking of all is that 72,000 elderly Australians have no home care package at all. There are 72,000 people in this country with their names on a list—parents, loved ones, people with children and grandchildren—and the government comes to this chamber and says, 'We're frustrated that we have to get up and talk about these issues.'

I bet you they're frustrated! How about the people who are frustrated and worried about their parents, their mothers-in-law and grandparents who are frail and invalid in their homes? I tell you what: that's frustrating—not sitting in this chamber and lecturing everyone about, 'Just wait until you get a stronger economy.' Where is it? Where is the stronger economy? When's that happening? The last time I checked, our economy is starting to tank.

Let's not have any more weasel words from this government. Get on your feet and start apologising to Australians. That's the first step you need to take. The number is growing. In their time, in almost seven years in government, the waiting list for home care has grown from 88,000 to 120,000 older Australians. We have been calling for action on reducing the waiting list since the first release of data, and we are not alone. Doctors and nurses are banding together to call for immediate action to fix the nation's aged-care system. Fine: ignore what Labor has to say, but listen to what the health professionals are saying. Listen to what doctors are saying about what we need to do with regards to fixing the aged-care crisis in this country. The AMA President, Dr Tony Bartone, said that the peak medical body 'can no longer wait and watch the aged-care system in Australia deteriorate.'

That is part of their detailed submission to the Royal Commission into Aged Care Quality and Safety, which has been extended for six months and has so far received more than 6,000 submissions and heard hundreds of hours of evidence, including of alleged neglect and mistreatment. People are sitting in aged-care facilities being malnourished. People in aged-care facilities are dehydrated. And we hear from this government that they're frustrated that they've got to come and debate a motion today. I'll tell you what's frustrating: when you're in an aged-care facility and you're being dehydrated and malnourished, or you're a son or grandchild worried about the care of your parents or your grandparents in their own home. There is no more serious statistic in the AMA submission than, when they called for a big investment in home care packages and we heard that there are 119,524 older people waiting for the level of package they had been assessed for in June and 16,000 people had died waiting for one. And the previous member says, 'You shouldn't politicise this issue.' Well, it is political. You're in charge; do something about it!

So not only would we be saving people's lives this would also help the budget as well, because at the moment many older Australians are waiting for more than 12 months for the package they have been approved for and some are waiting for more than two years. This is unacceptable. We know that 14,000 elderly Australians have had to enter residential aged care because they could no longer stay at home waiting for the care that wasn't there. Others enter the hospital system and emergency departments. A week does not go by without another disturbing account emerging about the mistreatment or neglect of older Australians in residential care. Review after review has been ignored. Recommendations after recommendations have been ignored. What's worse is not only the government not putting extra money in aged care, the government are cutting funds meant to find ways to improve the system.

We see time and time again that the health and wellbeing of our eldest Australians should not be a political football. I will agree on that. But this should hardly come as a shock when we have a Prime Minister with an awful track record when it comes to funding for aged care in this nation. We know that the government has ripped billions of dollars out of the aged-care sector for the past five years. Funding for residents has indeed gone backwards. The Prime Minister cut $1.2 billion from aged care in his first budget, as Treasurer, backing in a $500 million cut in the 2015 Mid-Year Economic and Fiscal Outlook. Not with a mediocre handout but with a decisive response that this crisis deserves, this government should be hearing these messages. I commend the member for Parramatta for sticking up for older Australians—I'll continue to do so, as every single Labor member will.

Pat Conaghan (Cowper, National Party) Share this | Link to this | Hansard source

I rise to speak against the motion on this government's actions to assist older Australians to stay in their homes longer. As I said in my maiden speech, we do need to do more for our older Australians who need assistance. I commend the minister and this government on making it a priority to invest more in aged care. In my electorate of Cowper 27 per cent are over the age of 65 and that is rising at 1.3 per cent per year. This government promised to increase the number of home care packages, Commonwealth Home Support and residential home care places and that is what it has done. And it can only be done with a strong budget underpinning investment. We have increased our aged-care funding from $13.3 billion, when this government came in, to over $23.5 billion in 2021.

In the last 12 months we have increased the numbers of home care packages from 99,000 up to over 125,000. This is now projected to increase to 157,000 by 2022-23. This increase has seen a significant reduction in the waiting times and a decrease in the number of people waiting for their approved packages—down by 9,000 in the previous quarter.

The opposition claims that this government cuts spending on aged care when it has actually increased year on year. They need to stick to facts, look at the real story and offer meaningful debate over the best way to address the challenges ahead in aged care.

The national prioritisation system, or queue, provides a framework for the assessment and allocation of home care packages consistently and equitably across the nation based on the person's needs and circumstances. A person's position in the national queue is determined by their priority for home care services and the time they have waited for care. People receiving approval for packages can receive an interim package whilst remaining on the queue. Over 97 per cent of people are provided with the opportunity to access services under the Commonwealth Home Support Program to ensure that they have options to address their care needs whilst awaiting their approved home care package. The system ensures that most people who are approved for care, and particularly high needs of care, have access to some level of subsidised care in their home whilst waiting for their packages for their approved level.

As at 30 June 2019 there were 47,000 people waiting for home care packages at their approved level and had been offered a lower level package. This figure is down by over 5,800. In the June 2019 quarter 74 per cent of people have accepted their offer for an interim package while still considering their offer. Just over 12,000 of these people did not take up the offer for various reasons—perhaps deciding to go into residential care, they do not need the level of care approved for that time or they are happy with the services they have been receiving. I accept, if we're going to have an honest conversation, that there are still 72,000 people who are waiting for a home care package at the approved level who have not been offered a package. However, that figure is down from the last quarter. Whilst this figure represents a considerable challenge, 95.6 per cent had been provided with access to Commonwealth Home Support Program. Importantly, the number of people approved for level 4 packages who have not yet been offered a package fell by 34 per cent or 11,000 people. Those waiting for a level 3 package also fell.

I, like many of my colleagues, would rather engage in policy discussion on how to ensure older people in our regions and rural and remote communities can have a choice in providers, can access services and can stay in communities and close to their families. I recently met with a constituent in my electorate. Her husband has approval for a level 4 package but cannot find a provider to travel the 53 kilometres from Kempsey to provide services that will enable him to come home from his residential care facility. I'm pleased that the number of home care providers has continued to grow, including in my region of the mid-north coast. I will continue to work with my constituents, our regional providers and my colleagues on how we can improve access to services.

There is more work to do. There are challenges now and into the future. This government has a plan and we have been doing that in a calm and considered way.

Fiona Phillips (Gilmore, Australian Labor Party) Share this | Link to this | Hansard source

I'd like to thank the member for Parramatta for the opportunity to talk on this motion today. In my electorate on the New South Wales south coast we have one of the highest numbers of aged pensioners in Australia and I'm regularly hearing from people who are suffering because of this government's failure to provide them with adequate home care packages. One hundred and twenty thousand people in Australia are waiting for home care packages. This sounds like a high number; it is. But I want to talk about a smaller number: the individuals.

In January, Margaret was approved for a level 2 home care package. Margaret has mobility and neurological issues that cause her back and neck pain. She was discharged from the hospital in February and began receiving help through the Commonwealth Home Support Program. She was paying $140 out of her pension every fortnight for support services to help her shower, dry and dress as well as cleaning and transport for shopping. It took Margaret eight months even to be offered an interim level 1 package, but this was less support than she was already receiving. In September she was reassessed and approved for a level 3 package, but all she has been told is that she will have to wait another three to six months before she can even get a level 2 package. Margaret, like many people in my electorate, lives on her own and is frail. She needs more support, but she has been abandoned by this government.

Then there is Laurel. When she contacted my office, Laurel was in desperate need of a wheelchair. She needed help with weekly shopping, transport and social services. She needed to be on a level 3 home care package. She had been approved for the level 3 package, but she was only on an interim level 2. When she first applied for the level 3, Laurel was told that the wait time was 12 months, but this soon blew out to 18 months. But, in fact, she waited 20 months—close to two years—long enough for her needs to have increased, and she is now approved for a level 4 package. I understand she is still waiting.

These are not isolated cases in my electorate. I was recently contacted by the daughter of a 92-year-old woman from Berry. She has a severe hearing disability and is very frail, but she wants to stay in her home. In July 2018, she was approved for a level 2 home care package. She is asking for someone to help with the housework and general maintenance. She wants a personal alarm in case she falls because she won't be able to get help. These are just basic things to help this lady in her 90s stay at home. At the moment, all the help she gets is two hours of housework a fortnight and someone once a month to take her grocery shopping. After waiting 12 months for a home care package, her family tried to find out how much longer it would be and they were told she would have to wait another three to seven months—some quiet quite distressing news for her family that wants to grant their mother's wish to remain independent. Perhaps the most heartbreaking case of all was the poor gentleman who tried to get some help for his wife. She had been approved for a level 4 package but was only receiving an interim level 2 package. She was terminally ill, but she waited six months for her home care package. Devastatingly, she passed away before that assistance arrived.

This isn't about statistics. It isn't about numbers. It is about people—real people who are struggling, real people who deserve better than to wait years for the small level of help that can give them the dignity, support and independence they deserve. Without the support of these packages, many of these people could end up in our already overrun hospital emergency departments. They could be forced into aged-care homes before they are ready or before they should have to go into them. They could injure themselves, deteriorate their conditions further, or worse.

The people of my electorate deserve better. Their families deserve better. We need urgent action from this government to fix the mess that it has created. The government has to act now to stop the wait list from continuing to blow out. It needs to show some real compassion and care to older Australians. These aren't numbers; these are real people—someone's mother or father, someone's wife or husband. They are someone to somebody. They are someone to me, and I will keep fighting to make sure they get the help they deserve.

Helen Haines (Indi, Independent) Share this | Link to this | Hansard source

I thank the member for Parramatta for highlighting this pressing issue. Assistance to age in place has become the most in-demand form of aged care. It's about showing respect for the wishes of older people to remain in their homes and part of their communities. Of the 72,000 people waiting without having been offered any package, 11,000 are assessed as requiring a level 4 package to stay in their homes—worth $50,000 per year. That most of those waiting have been approved for Commonwealth Home Support Program, CHSP, services is not an adequate remedy. It is a confusingly similar name but a very different program. The CHSP is designed to provide entry-level care to an amount below the lowest home care package. This is far less care than someone waiting for a level 4 package needs and deserves.

I see this lack of adequate care in the thousands of people on the waiting list being forced to enter residential care even though they can and want to stay at home. One man with motor neurone disease wrote to me to say he was told that his wait time would exceed his prognosis, and still they put him in the queue. Another man wrote to me about how his wife was waiting so long for a home care package that he was no longer able to take care of her and had to place her in a residential care home. This makes little sense for government, as the annual spend on residential care per resident is higher than for a level 4 home care package. The lack of packages being made available is preventing the use of a lower cost option that the person concerned would actually prefer.

The current waiting time for packages is over 12 months. I have heard from constituents who have been waiting for over two years. We heard about them here this afternoon. But, in many cases, their care needs arise suddenly and they need immediate help. Earlier this year, I heard from a constituent who was the full-time carer for her husband. She was involved in an accident and needed to go to Melbourne for surgery. She was unsure how long she would be away. Not wanting her husband to go into care, she could not get the surgery without first getting funding for a full-time carer to replace her while she was away. When care at home is needed, older people are rarely in situations where waiting is easy. It puts strain on their families and on their communities as well. When a person is approved for a package, they are assessed for what their needs are now, not in 12 months time.

Concern about waiting for home care is of special importance in regional and rural areas. We have older populations who are increasingly needing care. In my electorate of Indi, 21 per cent of people are over 65, compared with 15 per cent nationally. People in regional areas use residential care less than those in cities and face higher costs in travelling to services. In the Hume region, where my electorate is, there are 948 people on the waiting list.

I commend the government for increasing the number of packages available and reducing the length of the waiting list in the last quarter; however, for older people and their families who need help now these changes are not moving fast enough. If we want to offer a consumer driven and market based homecare system, we cannot have the number of packages capped so far below demand. I encourage the government to increase their rate of releasing new packages to clear the backlog. And if the government cannot solve the problem, then we need to legislate maximum wait times so that in the future older people can be certain of getting the right amount of care at the time that they need it.

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

I, too, want to thank the member for Parramatta for bringing this important issue to the parliament. She's been very passionate, as have many on this side, about this homecare waitlist for some time. We do acknowledge that the government has done a little bit of work here, but when you've got 120,000 people on the homecare waitlist, when you have seen the waitlist blow out from 88,000 people 2½ years ago to 120,000 now, when it's only due to political pressure from the community, from this side of the House, from unions, from workers in the sector that the government has finally actually done something—it wasn't a priority prior to that pressure—then I think it shows just what sort of government this is. This government isn't doing anywhere near enough when it comes to aged care generally, as we've seen from the royal commission, but particular in homecare packages.

This is something the government could fix today if it wanted to. The government could easily bring forward packages that are in the forward estimates and deal with this issue today. The government also knows that there's about half a billion dollars currently sitting in unspent funds that could be utilised for people who have been approved a homecare package. The government could also prioritise people with terminal illnesses who have less than six months to live or people in their 90s. The government could do so much more today if it chose to do so, but the fact that we've had six years of this government, four ministers, and the waitlist blowout over the last 2½ years, from 88,000 to the 120,000 that it is today, shows that whatever the government's doing it is nowhere near enough and it's not good enough for all of those people and their loved ones who are advocating so hard to try to get them the care they need.

As we've heard from so many speakers, these people want to stay in their own homes. They're able to stay in their own homes with a little bit of support. When you're in your 80s and your 90s and you've contributed to this country and you want a bit of support to stay in your home, you would have thought that the government of the day would actually be able to provide that support. Well, that's not what's happening in Australia today. We're a wealthy nation; the government should be able to fix this.

As we've heard, tragically 16,000 Australians died whilst they were waiting for home care in the 2017-18 financial year. They died without receiving the home care they had been approved to receive. We also have heard that around 14,000 people on that waitlist went into residential care or hospital before they wanted to, or before they needed to, because the care that they needed to stay at home was also not available under this government. The government needs to listen to these stories; it needs to do more. You had the Prime Minister on 7.30 saying that aged care, and home care particularly, was a priority. Well, it's not something you sit on for years if it's a priority; it's something you act on if it's a priority, and the government has been very slow to act. As I've said, they only acted in response to pressure.

We're going to wind up that pressure. Indeed, the parliament last week in the Senate approved a motion that was moved by my Tasmanian colleagues Senator Carol Brown and Catryna Bilyk that actually condemned the government for the shameful number of homecare packages and the number of people waiting on the waitlist today. So that's one chamber of this place that has actually moved a motion, which has been supported, to say the government needs to do more as well as condemning the lack of action to date.

Interestingly, we have the Mid-Year Economic and Fiscal Outlook coming later this year—it's just a few weeks away—and this would be an opportunity for the government to do something about the homecare package waitlist. You've got the Prime Minister saying, you know, 'Well, it's a priority for me,' on 7.30 and then a couple of weeks later we have him in the parliament saying, 'No, no, no; I'm going to wait till the end of the royal commission.' This is something that doesn't have to wait. My call to the Prime Minister is: you can fix this today. You can do things today to help people waiting on this waitlist today. You have the Mid-Year Economic and Fiscal Outlook in late November, early December. This is a great opportunity for the government to show that it is prioritising older Australians, to show that it will actually fund some home care packages. The government needs to deal with the home care package waitlist. It is simply not good enough that we still have today 120,000 older Australians waiting on that waitlist. It is terrible to get those calls—as many members in here do, as we've heard today—from loved ones trying to advocate for their loved person, to get them care so that they can stay at home, because they prefer to stay at home. In this country today, this should be able to happen. Australians who want to stay at home should be able to stay at home.

Rick Wilson (O'Connor, Liberal Party) Share this | Link to this | Hansard source

There being no further speakers, the debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.