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

I rise to speak in support of the Aged Care Legislation Amendment (Emergency Leave) Bill 2020. Mother's Day, last Sunday, must have been particularly hard for thousands of mums in aged-care facilities. For many, it would have meant, for the first time, seeing their children and grandchildren through a pane of glass or a cold flat screen on this special day—horrible, but necessary. It's likely that these restrictions have prevented widespread outbreaks in our aged-care facilities to date. But it is indeed the cruellest irony of this pandemic that the best way to love someone is to stay away from them. The heartbreak for families has been profound.

The coronavirus pandemic is testing the aged-care sector in ways that it could never have imagined. Facilities have plans in place for infectious disease, such as influenza or gastro outbreaks. Coronavirus makes these pale in comparison. These times, however, call for exceptional courage on all fronts. Older Australians living in aged-care facilities, having seen a lifetime of ups and downs, are now the ones most vulnerable to the pandemic. The aged-care workforce, working part-time or casually, and many from overseas, are doing hard work with dedication and with care, and I thank them. And the aged-care facility management are making tough calls, balancing the respect and dignity of their residents with the care and protection of them and their staff. I've been on such a board. I was formerly on the board of St Catherine's aged care in Wangaratta and I know very well the difficult decisions that these boards have had to make in order to keep our aged and most vulnerable people safe—doing that while knowing that they were breaking the hearts of the people who so very much want to visit them.

I've received many calls from constituents about visiting their loved ones in aged-care facilities. At the end of March, the crisis seemed like it was on a trajectory to match the worst of what we'd witnessed overseas. Responding to the urgency of the crisis, providers set their own rules—in some cases, stopping visits completely. For many, this sudden change felt like a door being slammed shut. Families of residents were in tears on the phone, distressed and confused about why they were being denied entry. It seemed too much. This was likewise upsetting for residents, who look forward to seeing their families on a regular basis to share stories, show photos and, in better times, hold hands and have such a dearly beloved hug.

Older Australians in aged care disproportionately experience loneliness. Loneliness in aged-care facilities is devastating, and this, of course, has been made so much worse by the necessary interventions of this pandemic. Social distancing has made that unbearable for many. In addition, with group gatherings and external excursions cancelled, visits in these circumstances would have been more important than ever. For our loved ones with cognitive challenges, the confusion must be absolutely terrible.

I'm glad to see that the industry led aged-care visitor access code, released yesterday, establishes a nationally consistent approach to continuing visits while managing the risks of COVID-19. This 13-point code will be reviewed in three weeks, which is important, as the consultation time frame was, understandably, very short. This code includes, as it should, a human rights approach to care which both protects and respects residents and their families. Importantly, the principles maintain that visits can take place in a number of ways, including using technology; through windows, courtyards and balconies; and in person upon arrangement. The digital divide, however, is very real for older people. FaceTime and Zoom are not intuitive if you're not a regular user or indeed if you don't have access to an iPad, an iPhone or any other device. Of course, nothing can replace seeing your loved ones face to face. My hope is that this code will clear up the confusion which has caused so much angst and distress.

As this virus is likely to last many more months we need to move beyond a kneejerk response, appropriate at the time, towards measures that are sustainable and compassionate over the long term. My truest hope, though, is that the Royal Commission into Aged Care Quality and Safety will bring about true reform across the sector that reduces variation across our aged-care facilities. There should not be an A team and a B team on this. It should be consistent, high-quality care.

I am pleased to support this bill. This bill introduces a new type of leave that will enable providers to remain eligible for the residential aged-care subsidy in declared emergency situations. This means that approved providers cannot decide to charge aged-care residents a fee during declared emergencies to reserve their place in an aged-care service. This change increases flexibility in aged-care services, which is so important in uncertain times. We all want our family to be safe, to be well cared for, to be healthy and to live in an environment where they feel comfortable, relaxed, loved and free. As we've seen, coronavirus outbreaks can be highly disruptive to the routines of our aged-care residents. These changes can be stressful and can cause concern about the residents' physical and mental health and wellbeing. This change makes it easier for residents to decide to leave the aged-care service and temporarily relocate to another place if they're concerned about their safety when there is a declared emergency. This also allows them to use their remaining allocation of social leave to maintain normal visiting and special events with families.

I am so pleased to see that the bill ensures that providers are no worse off but ensures they continue to receive the residential subsidy while residents are taking this emergency leave. This is crucial, especially to rural health services, such as those in my electorate, that run residential aged-care facilities and run on very slim margins.

While the coronavirus pandemic is the emergency at the forefront of our mind, this bill also notes that an emergency may include a natural disaster. This is an important inclusion for communities in my electorate that experienced the devastating 'black summer' bushfires. For residents who wish to evacuate from a service with their families during an impending fire front, they should not have to draw down their social leave just to be safe, and this bill guarantees that is no longer the case. During these recent bushfires, Corryong Health, with its aged-care facility, came under direct attack, with flames only 300 metres away. What followed was immense fortitude shown by the service and its residents as the service experienced days-long blackouts, no phone reception, restricted access to water and significant workforce shortages as staff evacuated their families or left to defend their own homes and farms. Once the fire front passed, the 37 residents were convoyed out through the blackened landscape and temporarily rehomed in Yarrawonga and Numurkah aged-care facilities, returning to Corryong three weeks later. This extraordinary feat was undertaken by Corryong Health staff, with Ambulance Victoria and the SES. Credit is due to Yarrawonga Health and the Numurkah district health service for making the residents feel welcome, loved, safe and secure during their stay.

When bushfires are approaching an aged-care centre and a town is being evacuated, this is exactly the circumstance in which the minister should exercise his powers under this new bill. Like all of us, aged-care residents should have the freedom to choose to leave their homes when they're in danger so they can have certainty over what happens next. This bill would remove any financial burden that would dissuade them from doing so, and I congratulate the minister on this amendment. The residential aged-care service of which I speak is run by Corryong Health, which serves the stunning and isolated town of Corryong and its surrounds. I was pleased to host Minister Hunt on his visit to Corryong in January when he heard firsthand what this service will need to keeps its residents and patients safe and secure in the next disaster. This includes an emergency fail-safe telecommunications system, an emergency water supply for firefighting—extraordinary, really—in their hospital, potable water and funding for capital works. Unfortunately, though, there's been little substantial progress on these proposals since that visit, and I will continue to work with the minister to ensure that funding for these crucial supports, including the residential aged-care service, can be secured.

So what to do next? Despite the sense of optimism we might be feeling today with the easing of social-distancing restrictions, we know that the coronavirus will have a long tail, possibly stretching out for years. While the aged-care sector provides high levels of care and protection for its residents, those residents are also the most vulnerable to the disease. Now is the time for the government to look ahead, plan for the future, and address other aspects of the aged-care system that the coronavirus will exacerbate.

A particular concern to me is the integrity of the aged care package assessment and service delivery. In response to coronavirus, many aged-care assessment providers have replaced in-person assessments with telehealth or phone based assessments to protect the health of both the assessors and the clients. But in-home visits are actually what's needed and are, ultimately, critical to ensuring that vulnerable people receive the care that they need. Assessment teams are highly trained to identify the physical, emotional and social needs of clients, as well as identifying instances of elder or financial abuse. It's impossible to fully deliver this over a phone. So we need a plan, and we need it soon, to ensure that people are assessed to get the support they need.

Concerningly, I have heard that some in-home aged-care residents are refusing visits from nurses and allied health professionals due to fear of infection. If continuity of care is disrupted for a long period, we risk deterioration in the health of older Australians, possibly causing an increased risk of hospitalisation. Older people should not be making do. They need to be confident that they can get the medical care that they need without jeopardising their health. And, likewise, the nurses and allied health professionals who treat them need adequate protection to do their jobs effectively and safely.

I've written to the Prime Minister sharing these concerns and he's assured me that his government will continue to review its response to the situation as it evolves, in order to ensure that older Australians are receiving the right support. I welcome the government's investments to date and encourage the government to continue for looking for opportunities to improve the system of aged care.

This brings me to home care package wait times. Our focus now is on the coronavirus, but we cannot wait for the crisis to pass to fix the waiting times for home care packages. The smartest way to keep ageing Australians safe from coronavirus is to let them stay in their homes, where they're comfortable and secure. If supports are in place, they don't need to enter residential aged care and become exposed to coronavirus or encounter the enormous stress of an outbreak or the necessary change in routine this might bring. Why isn't reducing the shamefully long wait for home care packages part of the government's coronavirus response? The wait time is still over 12 months for the highest level packages. In the quarter to December 2019, over 104,000 people were still waiting for their approved home care package. While they wait for the government to deliver what has been agreed to give them, their health may deteriorate. They may be hospitalised as there's simply no other way to get their care. We can't afford a bigger sickness burden on our hospitals at this time. Their families are doing the best they can to care for them, while maybe struggling themselves. While COVID-19 specific aged-care measures have been significant, the government needs to do more. It controls the levers. It can clear the waitlist. There cannot be any more excuses. It can and must do this to close the loop on the protection of our older people.

Zali Steggall (Warringah, Independent) Share this | Link to this | Hansard source

I rise to speak on the Aged Care Legislation Amendment (Emergency Leave) Bill 2020. I am supportive of the intent of this amendment, which allows residents to take leave from their aged-care facility during an emergency, such as the one we are in currently, and for the provider to retain eligibility for the residential care subsidy. The bill will compensate residential care providers by maintaining eligibility for relevant subsidies and will reduce financial pressure on those providers in emergency situations. The bill will also provide relief for the residents so that if they depart their facility during an emergency, they will not be liable for additional fees to reserve their place. This is a fair policy. But I do fear for some facilities who may have higher costs due to their location or services offered. They may suffer greater financial impact than others. As we discovered with the impact of the recently-introduced childcare legislation, well-intentioned policy can create dire circumstances for those in the industry.

Regarding the current funding provided to aged-care providers, many are saying that the costs that they are incurring as a result of the COVID-19 pandemic far outweigh the additional support that has been provided by the government, and many of them report not yet having received any additional funding. The increased costs include the need for personal protective equipment, the additional cleaning services, the technology to maintain family connections, and the need to pay staff on sick leave as well as those who are backfilling. I've spoken to a number of aged-care providers in Warringah and some have claimed that they are yet to receive any additional funds. Nor have they been contacted by the Department of Health via the usual channels with any advice on how to access the funding. It's a timely reminder to the government that when press conferences are held and public announcements are made, certain expectations follow and are created. I urge the government to remember that well-intentioned promises are commendable, but they must be followed up with speedy and accurate action.

I understand that some $52.9 million of the funding is to be provided via a grant under the COVID-19 Aged Care Support Program. However, as the minister has stated publicly, the government has announced nearly $850 million in funding for the sector. I would appreciate the minister's advice on this matter and will be writing to him accordingly to raise the issue.

There's no doubt this period has created unprecedented strain on our aged-care facilities in Warringah and on the individuals who call them home. Like many of my parliamentary colleagues, I'm sure, my electorate office has received phone calls and emails from those with loved ones who are housed in aged-care facilities. There was, of course, no one consistent line. Some are asking for stricter restrictions, some are asking for a relaxation. All are concerned.

In speaking with those who manage these facilities in Warringah, it's clear that their absolute No. 1 priority is keeping their residents safe, and I commend them and their workforces for the amazing work they're doing to make that happen. To the credit of the facilities in Warringah, with the steps they have put in place, including the provision of PPE and extra staffing, there have not been any cases of COVID-19 locally, and that's how we want it to stay. For those who manage those spaces, those who work there, those who live there and those who have loved ones there, that is a consistent theme: to keep COVID-19 out and to keep the residents safe.

That includes nurturing their mental health, of course, as this age group are particularly vulnerable to the virus. For weeks, and sometimes months, many of our elderly have been isolated from their loved ones. This has led to severe mental deterioration for some individuals. For aged-care facilities within Warringah, this has been difficult. They regard the mental health of their patrons and residents as of the utmost importance, and I've been very pleased to see the innovations and programs they have implemented, and the approaches put in place to address the mental health needs of their residents. I encourage the industry and the government to retain that focus on mental health for this vulnerable section of our community. It's one of the reasons I was pleased to see the industry come to an agreement collectively on the access code of conduct. In doing so, they recognised that, yes, the healthcare needs of residents and staff are important—most important. But we must also find a way to cater for the emotional and compassionate needs of the residents—maintaining good physical health does not necessarily mean we have to sacrifice emotional health.

When this access code was still a draft and placed on public exhibition, I immediately let my community know and I encouraged them to submit their feedback. There was a very tight time frame for comment from providers and users alike, and, while the comments and assessments of the code were diverse, it was clear that all were driven by the need to keep these facilities as safe as possible—even if it meant that contact with friends and family had to be compromised or rethought. Now that the code has been released, I've provided a copy to the aged-care facilities in my electorate and I'll consult with them to provide feedback. The code's 13 principles are a good foundation and will be reviewed later this month. It's now even more imperative that the government funding promised to these facilities and this sector arrives in a timely manner to help facilitate the implementation of the code.

I join with many of my parliamentary colleagues who have taken this opportunity to thank the nurses, the orderlies and other staff of aged-care facilities who are at the frontline of care, who are working long shifts and putting their own health on the line to attend to our elderly and vulnerable. We can't imagine the thoughts they must have each morning as they get ready for work, or the thoughts they have each night as they return home to their families or loved ones, uncertain if it was the day their luck changed and that maybe they had been exposed to the virus. These nurses and other staff are daily walking that line between life and death, and it is here that I would like to raise the issue of nursing ratios.

During the 2019 election campaign, I supported a call for better nursing ratios within our healthcare facilities, including aged-care centres, and I remain true to that commitment. We need to make sure that these vital workers—essential workers—do not become exhausted workers, hollow workers, broken workers. They need to be able to focus on providing the highest standard of attention and medical assistance to those in their care, and when the ratios are unworkable they simply become stretched beyond their capabilities.

I commend the work of my crossbench colleague, who unfortunately cannot be here due to the crisis, the member for Mayo, who has previously tabled legislation regarding staffing ratios, specifically in aged-care facilities. Her bill, introduced in 2018, aimed to provide greater transparency for families moving loved ones into residential care. The intent of that bill was to require aged-care facilities to disclose staffing ratios on the My Aged Care website, and there were mandatory time frames for reporting any changes. That bill was warmly welcomed by numerous organisations, including National Seniors Australia, the Council on the Ageing Australia and the nurses and midwives association. Sadly, her noble attempts were ultimately unsuccessful in creating that much needed change, but I think it's timely for this government to be reminded of that important measure. I call on the government now to revisit this issue of staffing ratios.

This pandemic has shone a light on systemic problems within the age-care system. As we emerge from the crisis, we must put aged-care reform at the heart of our recovery. In my electorate of Warringah aged care is a key issue, with 15.7 per cent of the total population aged over 65—and this proportion is growing. I've spoken with the CEOs of several aged-care facilities in Warringah, and they've told me that families are emotional and frustrated because they have taken the right steps but they're not getting the help they need. They feel guilt because they can't supply the care their loved ones require, and the wait for home-care packages is far too long and needs to be addressed as a matter of urgency. Families wait for up to two years for their home-care package following an initial assessment. By this time their parent's condition has deteriorated and the family can no longer cope in caring for them, so the difficult decision is made to placed their loved one into an aged-care facility.

At a time when we are focusing on encouraging Australians to stay home, this must be a priority for the government. The elderly deserve respectful, affordable, accessible and safe aged-care options that are offered in a timely manner. We want aged care that promotes independence and wellbeing, with choices so that people can stay at home longer while being healthy and connected, and more options for a suitable mix of home health and medical support being available.

It's important when we talk about this sector to also consider the needs of carers. Residential respite is a key issue for those who provide full-time care to their loved ones. Carers, of all people, need to be able to plan ahead for the huge logistics involved in preparing for an absence. I have received multiple letters requesting clarification of the government's policy on residential respite. I ask that the government consider the proposal that the subsidy for residential respite be allowed to be used towards having a resident carer in the patient's home. In the words of my constituent: 'Imagine not being able to plan or look forward to your next break from work, which is not just nine to five, five days a week, but is actually 24-hours a day, seven day a week, 365 days a year, with no weekends, and is both physically and emotionally draining to the point of desperation.' We should not forget that, like child care, the burden of this unpaid and unrecognised labour falls disproportionately on women. In this regard, I'll continue to advocate for greater gender equality and balance in caring arrangements.

I support this bill and its efforts to provide flexibility under emergency circumstances. But we also need to ensure that crisis funding that was promised is adequate and arrives for providers to ensure essential services are delivered and to facilitate the implementation of the code. We also need to look forward to our recovery and to ensure we address systematic problems in our aged-care system and the unnecessary burden on our carers.

In conclusion, I refer to the ongoing Royal Commission into Aged Care Quality and Safety. The intent of this bill reflects one of the key systematic problems identified by that commission in their interim report released last year—namely, that the current system is designed around transactions, not relationships or care. This bill seeks to introduce an element of compassion, reflecting the importance of relationships and the need for care at a time when our elderly are vulnerable and their families need it most. While the proceedings of the royal commission have been placed on hold due to the crisis, there's no denying that its work has taken on even greater importance. This pandemic has shone an even greater light on the sector, and I, like many in Warringah and indeed across Australia, will be eagerly anticipating the outcomes and recommendations the royal commission will hand down. I'm sure the government will take heed of those findings, and I encourage them to implement any eventual recommendations in full and with haste.

To the staff of Warringah's aged-care facilities, I say thank you so much for the work you are doing in such challenging times. I say to the residents of those facilities, some of whom I visited prior to the crisis, and your loved ones, that I can assure you this parliament is doing all it can to ensure you are protected, nurtured and empowered at this difficult time.

Jason Wood (La Trobe, Liberal Party, Assistant Minister for Customs, Community Safety and Multicultural Affairs) Share this | Link to this | Hansard source

I will make the summing-up speech on behalf of the Minister for Aged Care and Senior Australians. The Australian population is ageing, and senior Australians and their families deserve to be treated with respect and dignity whilst receiving high-quality aged-care services. Integral to this is the empowerment of aged-care residents to make their own decisions about their emotional wellbeing and physical health and safety.

During difficult and challenging times, such as the current COVID-19 pandemic, it is vital that senior Australians are supported in their right to exercise choice about their care. The COVID-19 emergency has highlighted a gap in existing residential aged-care leave provisions when faced with a large-scale emergency. Currently, permanent aged-care residents are entitled to up to 52 days of social leave each financial year. If a resident exceeds their 52 days of leave, they are required to then pay a significant fee to retain their place within their aged-care home.

During the current pandemic, many permanent residents have indicated they wish to temporarily relocate to stay with family in order to reduce their risk of exposure to COVID-19. These residents currently have no other option but to use their social leave allocation, which will likely run out before they are ready to return to their aged-care home. If they choose to remain on leave, the additional charges that will be incurred to secure their room will place a significant and unnecessary financial burden on them or their families. In many cases, residents may simply not be able to afford the additional charges and therefore will be forced to return to a home or possibly forfeit their place.

The isolation, lack of visitation and inability to stay with family for the duration of the COVID-19 pandemic have caused cognitive decline and anxiety for a significant number of aged-care residents. Many residents and their families are fearful of contracting or spreading the virus whilst in an aged-care home, yet due to the limited leave provisions available they are unable to exercise their right to manage their own health and wellbeing. The new leave type being introduced through this bill will ensure residents have access to appropriate leave during emergency situations and this will not see them financially disadvantaged or losing other leave entitlements for situations completely out of their control. This change is in the best interests of all older Australians and the broader community and supports the residents, and in turn their families and carers, to make their own decisions about their personal safety and care. I thank members for their contribution to this bill.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.