Amanda Rishworth (Kingston, Australian Labor Party, Shadow Minister for Early Childhood Education) Share this | Link to this | Hansard source

[by video link] Labor supports action to fix the mess that our aged-care system is in, but is concerned that this bill, the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021, falls short, like so many of the government's responses. They were dragged kicking and screaming to have a royal commission into the crisis in aged care, but then, having received the report from the royal commission, their response has fallen short. The government have fobbed off, delayed or outright rejected the key recommendations that were made in the aged-care royal commission.

We must remember how we got to a position where we had to have a royal commission into aged care. We had a government that was failing to listen to the experts, failing to listen to the unions and those who worked in aged care and failing to listen to the families using aged care. After telling us for some time that there was no problem in the system they then, at the 11th hour when they could no longer deny the problems in aged care, they announced a royal commission. I think the government thought that this would allow them to kick the can down the road. But, unfortunately, we now have a situation where that royal commission has brought down a report and has made 148 recommendations, of which over half are not being implemented or are not being implemented properly. Of course, this bill is no different, with alterations and a number of items missing from the royal commission's recommendations, which this bill is claiming to address.

Of course, the government have not thoroughly consulted with those who are actually caring for older Australians or older Australians themselves. Older Australians, aged-care peak bodies, providers, workers and unions were not consulted in the drafting of this bill, despite the fact that this bill would have an impact on them, including in the areas of residential aged-care funding, workforce screening, provider governance, banning orders and also a code of conduct. These are changes that need to be properly consulted on, and it is disappointing that the government have not consulted on this bill. But this is not surprising, because the government haven't been doing their job when it comes to aged care in this country.

Older Australians helped to build this country. They worked hard, they paid their taxes, they raised families and they contributed to our society and our economy, and, as every Australian expects, they expect that in their time of need, as they age, they will be properly cared for and that the government will support them later in life. That is what they deserve and that is what they have earned after contributing for so long to their communities. But unfortunately, the Morrison government have not fulfilled their end of the deal when it comes to this conduct. After 21 expert reports, they knew that older people were not getting the care they needed but they did not act. Indeed, it was this current Prime Minister, as treasurer, who actually cut funding from aged care.

The Prime Minister 's record has proven that he cannot fix aged care, and his lack of leadership has meant that for eight years this government has neglected the system. It is a national disgrace. The royal commission highlighted the tragic outcome of this government's neglect, including maggots in wounds of residents and two-thirds of residents being malnourished or at the risk of malnutrition. The Morrison government's failure to listen to Australians in aged care and their families and, indeed, workers in the system, has been so disappointing. I have also been regularly hearing about this in my local electorate.

I have met with many aged-care workers who have almost been brought to tears, telling me the difficult decisions that they had to face, not how do they provide the best level of care, how do they make sure that they are able to spend time with each resident, talking about contributions, paying attention and connecting with these older residents, far from it. Local workers have been telling me that they have to choose which local resident they shower on any one day, which local resident gets their sheets changed on any one day. That is just appalling. These workers have been in tears because they went into aged care thinking that they could support and make the lives of our older citizens better. They thought they could spend the time to really provide that level of support, comfort and connection, a level of dignity, but they are just not being given the time to do that in a system that is under pressure.

Many people are finding themselves in aged care because they are no longer able to support themselves at home. I had three forums on aged care and seniors' issues recently in my electorate. When I hear people say that they are utterly scared, petrified, about a time when they might have to go into aged care, that tells us that we are just not getting it right.

In addition to potentially ending up in aged care because they can no longer care for yourself at home and do not have enough support, many people are finding that they are not even getting support at home through the home-care packages. Of course, the government, in the last budget, tried to say that they had fixed the problem by giving a booster of 80,000 new packages but with a waitlist of 100,000 people and growing, they have not addressed this problem in a substantial way. The maths does not add up. When you have a boost of home-care packages that does not meet demand then you still have thousands of people waiting. I am regularly contacted in my electorate by people who have been waiting years and for whom this measure in the budget has not fixed the issue. Whether that is getting a home-care package or, indeed, getting a higher level of care, there are people desperately waiting.

While I welcome the government's increase in packages, there are just still not enough to meet the demand out there. With this lack of packages being delivered, more and more people are feeling they have no other choice but to go into aged care and they are worried about that.

Also, in addition to home-care packages and the aged-care system, the other level of support really struggling under this government is the Commonwealth Home Support Program. I have many people who have qualified for the Commonwealth Home Support Program—that might mean extra help with the garden or the cleaning—who think, 'Excellent; I've now got this extra support,' but cannot find a provider in our local area. The books are closed because there just isn't enough funding. Delise, from Reynella, is one of those who had been approved for the Commonwealth support scheme. She contacted my office. She and her husband had been living in their family home for over 20 years and they were looking for supports to help them age at home. After Delise was approved, she said she received a list of local service providers that she could contact to get support services. She was looking for some help around the house and to look after her garden. Her husband had recently fallen while she was trying to help in the garden, and he ended up in bed for three weeks to recover. The need for some help around the house and garden was crucial. She contacted my office out of desperation. She had been trying to find a local provider to help but she was constantly told by local aged-care providers that they could not help because of the lack of government funding. Eventually, after calling and calling all the service providers on the list she was given, she was left helpless with no support.

Earlier this year, Delise and her husband made the difficult decision to sell their family home in Reynella and move into a retirement village. She had been reassessed for a Commonwealth home support package and again approved. Again, she was given a list of local providers to call to see if they could offer her services. She was incredibly frustrated to find that, again, all the local service providers said they could not assist her. Delise said that many of the providers again told her they couldn't offer any assistance due to the lack of government funding. Delise is not the only person I hear this from; I hear this over and over again from those who think they will get that extra support, only to find, when they call their local service providers, they cannot get any help.

There was also Pauline, who contacted my office about her mother's experience with the aged-care system. Like so many other stories, hers is heartbreaking and it is not difficult to be moved. She shared her experience with the constant lack of carers, which compounds an already underfunded system. She spoke of the times when her mother had to wait 40 minutes before she was able to be lifted to go to the toilet and was then forced to wear a diaper due to the lack of staff available to move residents. This was in residential aged care in my electorate, and it's just not good enough.

Josephine, from Trott Park, also shared with me her mother's experience with aged care—another heartbreaking but, tragically, all-too-common experience. Josephine's mother would only get three hours of care per day, meaning she was often left in her room for the rest of the time. Josephine believes the mental health impact on residents is significant and has contributed to her mother's deteriorating health.

We need to fix our aged-care system. Whether it is in residential aged care, whether it is in home care or whether it is a Commonwealth supported package, it is just not good enough. I am really pleased that Labor has committed to a number of things that would support people in the system: a minimum staffing level in residential aged care to reduce the home-care waiting lists so that more people can stay in their homes for longer; importantly, recommended by the royal commission, transparency and accountability; and making sure that staff have training and that there is a better surge workforce strategy. The government has implemented some of these things, but they, as I said, are not done in a way that is properly consulted on and not done in a thorough way, as demanded by the royal commission. It is important that we see the government respond to this. I would really urge the government to address this. Older Australians can't wait much longer. I have also heard of numerous occasions when residents in my electorate have actually passed away while they were waiting for an upgrade in their home-care package. This just isn't good enough. It isn't good enough, in a country like Australia, that we treat our older Australians like this.

I know that, as we move forward, Labor will have more to announce when it comes to aged care. This is critically important, but we shouldn't have to wait for a change of government to address this issue. This government should put its attention to this. It failed when it came to the vaccine rollout in aged care. It failed when it came to vaccinating aged-care workers. This was meant to be a priority, and it was like drawing blood out of a stone. This government just could not get its act together.

So, while I say that older Australians shouldn't have to wait, I think that we really need a change of government. Only a Labor government can be trusted to reform our aged-care system to ensure that older Australians get the care and support they deserve.

Brian Mitchell (Lyons, Australian Labor Party) Share this | Link to this | Hansard source

[by video link] Many times I have stood in this place to speak about aged care in this country. Once again, the message is the same: the government cannot be trusted to fix aged care. Labor supports action to fix the aged-care system but is concerned that the bill we have before us, the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021, falls short. The government has fobbed off, delayed or outright rejected key recommendations from the Royal Commission into Aged Care Quality and Safety, and this is extraordinary. Of the 148 recommendations, more than half are not being implemented or are not being implemented properly, and this bill is no different, with alterations and with a number of items missing from the original royal commission recommendations that it claims to be addressing.

It's concerning that older Australians, aged-care peak bodies, providers, workers and unions were not consulted in the drafting of this bill, despite the impacts that this bill will have on them and the sector, with changes to residential aged-care funding, workforce screening, provider governance and banning orders, along with a code of conduct. These are not small changes, and there needed to be proper consultation. For this reason, Labor will move a motion to refer this bill to the Senate Community Affairs Legislation Committee for further inquiry.

Older Australians helped build this country. They worked hard, paid their taxes and raised their families. They rightfully expect that the federal government will support them in their later years. It's what they deserve. It's what they've earned after a life contributing to the community. The Morrison government has consistently let them down and failed these Australians and their families, and this is an issue that impacts all of us. We will all grow old, and we all have loved ones who are getting older and frailer. Labor believes that those who built this country and earned our respect deserve so much better from the system.

It is, frankly, nothing short of a disgrace that this government has neglected older Australians and the aged-care system for eight long years. The royal commission graphically highlighted the tragic outcomes of this neglect, including maggots in the wounds of residents and two-thirds of residents being malnourished or at risk of malnourishment. The Prime Minister failed to listen to Australians in aged care, he failed to listen to their families and he failed to listen to workers in the system.

Aged-care workers are exhausted, they are overstretched and they are underresourced. As we saw during the pandemic, they lack the resources they need to take care of frail older Australians. It's quite simple. Labor believes these workers should be paid more and there should be more of them. Earlier this year, I was able to meet with Rachel, Chrissie, Karen and their colleagues—members of the Health Services Union, who travelled to Canberra. They work in the aged-care sector and they told me about the HSU's Change Aged Care campaign. Their compassion for the people they care for was evident, but so was the need for better pay, more support and job security for the incredibly important work they do. A similar campaign by the United Workers Union has identified several workforce issues within aged-care facilities in my electorate over the past few months, including unfilled shifts, understaffing and excessive unpaid overtime. A key theme of that campaign was more time to care: older residents in aged care simply need more time with the people who care for them. The women I sat down with are incredible, hardworking women—just ordinary women who you would see every day in the street: mums, even grandmothers, doing hard physical work. They would sit with residents during their lunch breaks because they had no time during their paid shifts. These are incredibly dedicated people doing this work, and they don't do it for the money; they do it because they care.

A properly and transparently funded aged-care sector will lead to better pay and conditions for all aged-care workers, and only this can ensure the high-quality care that all older Australians deserve. We all know that the aged-care sector will likely face a critical workforce shortage in the coming years—a shortage of more than 110,000 workers over the next decade. What we see with aged-care work is that it's so hard for young people who come through that a lot of them don't stick it out. They can go and get a job somewhere else that pays better and has less onerous conditions, so there's a lot of churn in this industry. What we need are long-term workers, people who stick it out for years, who residents get to know and who get to know the systems in place. We need a better place, better pay and a workforce with better conditions.

But it seems that creating and training the workforce that cares for some of our most vulnerable citizens is simply not a priority for the Morrison government. Just last month we heard reports of the government dragging its feet on funding for a new respite and training facility in northern Tasmania. Community Care TASMANIA has announced plans to develop a respite and training centre for excellence, with the proposed facility to include six rooms, each available for respite care, along with a communal lounge, consultation rooms, nurses' offices and a training facility. CCT approached the government to provide $2 million as part of a federal infrastructure grant program. Funding was supposed to be announced in July, but so far it has been crickets from the government. I would hate to think that this funding is available but that it has simply not been announced because the government is more interested in announcing funding close to an election than getting the funding out the door so that these residents can start getting the care they need and these families can get the respite they need. That would be terrible, if the funding has already been made available but simply not been announced because the government is more interested in its own political fortunes and an election announcement rather than getting the money out the door. I hope that's not the case. But Labor knows that nothing will change in the aged-care sector without real reform to the workforce. Unfortunately, we have seen nothing from those opposite to improve wages for overstretched, undervalued aged-care workers, and this has to be a major priority of any aged-care reform: better pay and better conditions for the people who provide the care.

When it comes to reforming the aged-care sector, there's a laundry list of what this government simply has not done. Of the 148 recommendations from the aged-care royal commission, more than half are not being implemented, or are not being implemented properly, and that beggars belief. The government has ignored the recommendation to require a nurse to be on duty 24/7 in residential care and the government has failed to clear the home-care package waitlist of 100,000. Only 80,000 packages were included in the budget over the next two years and thousands more Australians joined the waitlist every year. The maths do not add up.

I receive calls to my electorate daily from concerned families whose loved ones have been waiting months or even years for the support they need to continue living in their own homes. The assessments are done, the packages are not funded but they're assessed as having deserved the packages, and some people are dying before the funding they have been assessed for becomes available. It is an absolute outrage. Just a few weeks ago my office was contacted by Sandra about much-needed in-home support for her partner, Richard. Richard had been on the waiting list for a home-care package since November 2020—11 long months during which his health deteriorated to a point where Sandra was struggling to provide the level of care Richard needed. Sandra's own health and wellbeing was going downhill as the physical and emotional demands of being a full-time carer were beginning to have an impact on her. My office was able to assist with getting Richard's home-care package approved, but it should not take intervention by a federal member of parliament for people to simply get the support they desperately need.

We know what the Morrison government is not doing, but let's consider for a moment what it is doing. This government is gifting $3.2 billion to aged-care providers via a basic daily fee increase with no strings attached—billions of dollars with no mechanism to ensure that any of it goes to actual care or better food and not to management bonuses or a new office fit-out. We've seen the reports in the press of the aged-care providers on the mainland with their Maseratis and expensive mansions. There is nothing in this package to stop people like that from buying a new Maserati or a new mansion. It's an absolute disgrace that the government is handing this money over without the strings of better care or better staffing. It's simply not good enough.

The Prime Minister 's record proves he simply cannot be trusted to fix aged care. This is a government that threw $20 billion at profitable companies but refuses to do what is desperately needed to fix aged care. Older Australians deserve so much better. Older Australians deserve dignity and respect. After eight long years of Liberal-National government, another three years, clearly, will not fix the aged-care crisis. Only an Albanese Labor government will get this job done.

Pat Conroy (Shortland, Australian Labor Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

I welcome the opportunity to make a contribution on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill. The electorate of Shortland, which I have the privilege of representing in this place, is the sixth-oldest electorate in Australia. Aged care, both residential and home based, matters to my constituents, and they know that they have been let down by the Liberals and Nationals over the last eight years. The pandemic has revealed failures of the system and, shockingly, 766 of our fellow Australians have died in aged care over the past 18 months. This is a damning indictment on the coalition's management of aged care.

This bill would amend the Aged Care Act 1997 to require all approved aged-care providers to always have at least one registered nurse on duty. That would seem like a no-brainer to many Australians. While this was a recommendation from the royal commission that the government accepted, so far the government has only committed to requiring a registered nurse to be on site at residential facilities for 16 hours a day. This is the classic marketing approach we expect from the man who leads this government and his pathetic excuse for a minister for senior Australians—a big announcement accepting the royal commission's recommendations but then in practice not following up. This is another clear example of the government's 'all announcement, no delivery' style of government, and they are consciously and willingly misleading elderly Australians that I represent in this place. In speaking on this bill relating to the government's response to the aged-care royal commission, I want to highlight some facts and figures that will be deeply uncomfortable for the government, or they should be.

Fact 1: the Prime Minister's changes to the Aged Care Funding Instrument between 2016 and 2021 has led to a gap in funding of between $2.1 billion and $2.5 billion from what the total funding position would otherwise have been. The key point here is that, because of the decisions of the Prime Minister when he was Treasurer, billions of dollars have been stripped away from the aged-care system over the past four years. And, for the record, this figure is based on analysis from the independent Parliamentary Budget Office. I say to the Prime Minister: these cuts have consequences, and we have seen vividly, in the deaths of hundreds of Australians, what the results of cutting funding to aged care are. Some may find this offensive. Well, what I find offensive is the very real risk that thousands of my elderly constituents will not receive the care and attention they deserve because of budgetary decisions of this government.

Fact 2: the aged-care sector is facing a massive workforce shortage in the coming years. In reference to the bill we are debating, there will be no capacity to respond to the royal commission's recommendations as the sector is 110,000 workers short of what they need. This figure comes from the Committee for Economic Development of Australia and their chief economist, Jarrod Ball, who recently said:

We will need at least 17,000 more direct aged-care workers each year in the next decade just to meet basic standards of care.

Let me repeat that: 110,000 extra aged-care workers will be needed just to meet basic standards of care, let alone responding to the horrifying neglect the royal commission revealed.

The truth is I have had the privilege of meeting with many aged-care workers, and they are passionate about what they do. They love what they do. They do it because they can have a meaningful impact on the lives of many senior Australians. But, whenever I talk to them about it, they say they find it so frustrating because, as they point out—and I have met with aged-care workers who have been in the industry for over 20 years—they could get a job at Bunnings and earn more than they do looking after some of the most vulnerable Australians in this country. That's unacceptable—that you could earn more at Bunnings than in looking after elderly Australians. They also make the point that there is very little capacity for training and skills development; there's a real lack of capacity for portability of skills and leave entitlements, which is really important given so many of these workers are casual; and there's a real variation in their employers' attitudes towards things like training to lifting equipment to quality care for their residents. So, if we are to provide a better quality aged care for Australians, and I passionately believe that we should be doing that, we need to address the workforce issues first and foremost.

Fact 3: also affecting aged care is the current intention of the Morrison government to privatise aged-care assessments. This isn't surprising; privatisation is something that's in the Liberals' DNA, and we should not forget that it was the Howard government that made very significant changes to aged care, bringing the private sector into aged care, which has led to the situation we face today. The Liberals' obsession with neoliberal economics and their cruel embrace of free-market economics at the expense of human dignity is not how Australians expect the elderly to be treated—as commodities—but that's what we see more and more with this government.

In speaking on this bill regarding the royal commission, I want to highlight that privatising aged-care assessments was not a recommendation of the royal commission and attempts by the government to do this have been condemned by the Australian Medical Association. The AMA President, Omar Khorshid, said last month, 'A market-based approach is a recipe for aged-care service providers to put profits before patients.' And we saw that during the pandemic, where the vast majority of the deaths in aged-care homes occurred at privately owned facilities, and the previous Labor speaker talked about Maserati-driving aged-care-home owners who were often delivering the worst possible care for their residents. I say to my constituents, particularly the elderly ones: I will continue to fight any move to privatise aged-care assessments, because it is the thin edge of the wedge that will just impose a greater profit motive in the sector.

Another problem in the aged-care sector is the long waiting list for home-care packages. For example, there's the case of Helen from Redhead. Helen's family came to my office at Saint Temple last year seeking assistance. Her home-care package had been approved to be upgraded from level 2 to level 3, and she was told that she'd been placed on a national priority system but that there was a waiting time of one year. The government was accurate in that forecast: her funding for the increase has just been approved one year later. So I say to this government: you can brag about how much you're spending, but when you're consciously holding back packages that you've promised to save money, you're doing a grave disservice to older Australians. The fact that we have a waiting list of over 100,000 Australians, who've been assessed by ACAT as being eligible for a home-care package but haven't received funding, is a disgrace and an assault on elderly Australians.

Another assault on elderly Australians is what's occurring in the home modification part of the aged-care sector. This must be a priority—the three tiers of aged care: home modifications is the first step. The second is home-care packages, and the third is residential aged care. The more that we can invest in the homes and services so our older Australians can stay in their homes, the better for them, for the community and for the taxpayer. But this government is intent on nickel and diming this particular area.

In my particular region, we've gone through a very traumatic experience where previously we had three home-care modification companies servicing the Hunter region, but two of those companies have withdrawn from the market, leaving only one home-care modification company. And the government hasn't reallocated funding, so that one home-care modification company is now dealing with a huge waiting list for their services. There's been no additional funding and there's no ability to bring on more staff to deal with the fact that the two other companies have exited the market. Instead, there's just a longer waiting list for people to get ramps installed, shower rails installed—critical fall precautions that will keep people in their homes longer, that will save and avoid trauma to them, that will save taxpayers' money in the emergency department of hospitals and that will delay any move to residential aged care.

These are the important aspects of aged care that this government should be addressing. Instead we've got this timid and limited response to one recommendation of the aged care royal commission, demonstrating that this government does not give a fig for older Australians. They make big announcements at budget time about how many billions of dollars they're putting into aged care, how many home-care packages they're releasing, but in the end the proof is in the pudding and this government does not care about older Australians, does not fulfil that sacred contract that we have with every older Australian to give them a dignified retirement. That's why we really need to reform the aged-care system, but sadly this government is not up to that task.

Susan Templeman (Macquarie, Australian Labor Party) Share this | Link to this | Hansard source

We support any steps that will fix the aged-care system, but this bill, like so much of what this government has done, is a very meagre response. It's a bare minimum. It's probably not even a minimum. It falls short of the sorts of things that older people who are in aged care and their families and the people who care for them should be expecting. The government has fobbed off or delayed or simply rejected key recommendations from the aged care royal commission, which was done, let's remember, because of how dire the situation was in aged care. Of the 148 recommendations, over half are not being implemented or are not being implemented properly, and this bill is no different, with alterations and a number of items missing from the original royal commission recommendations that this bill claims to be addressing. It's also very concerning that older Australians, the aged-care peak bodies, the providers, the workers and their unions, like the HSU and the nurses and midwives, were not consulted in the drafting of this bill despite the impacts that the things in this bill will have on them, considering it covers things like funding, workforce screening, governance and banning orders under code of conduct. These are all very significant areas of concern, and there should have been consultation. This is yet another example where we see the government producing stuff and not listening and talking with the people whose input they should be seeking.

When I visit my dad in his aged-care facility, I get an insight into the overworked, underpaid yet extraordinarily caring workforce who care for him and his fellow residents. I see their efforts to bring a richness, even during the pandemic, to the lives of every person that they care for. For instance, at the Anzac Day service for residents this year, my dad was absolutely resplendent in his sports jacket, with his rosemary and poppy, and his wearing of a multicoloured wig to mark Harmony Day was something my mum and I never thought we would see! But the big grin he had showed that he was really enjoying the attention and the engagement.

Older Australians like my dad helped build this country. They worked hard, they built businesses, they paid their taxes and they raised their families, and they rightly expect that the federal government will support them in their frailer years. That's what they deserve. It's what they've earned after a life of contributing to their communities and to Australia. But the Morrison government has consistently let them down, and I hear from people on a weekly basis who are struggling with the circumstances that their families face in aged care or that they fear that they're going to experience. After 21 reports the Morrison government knew that older people were suffering in aged care, but they didn't fix the problem. They had to be dragged to it, and they're still not fixing it. As Treasurer, Scott Morrison, the Prime Minister now, was actually cutting funding. His record proves that he cannot be trusted to fix aged care. Another three years of the Morrison government will not do it. After eight long years, there is still a crisis in many aged-care facilities.

In Macquarie, in the Blue Mountains and Hawkesbury, the aged-care centres have felt the pressure of trying to keep COVID out, and I want to take a moment to talk about that. In the months that they were waiting for the promised vaccinations, there was great fear about the impact COVID would have, and, even when residents were largely vaccinated, staff were not. It's beyond my comprehension that the government could not get its act together to vaccinate residents and staff at the same time. Clearly the lack of supply of vaccines kept the threat of COVID in aged care much higher than it should have been for longer than it should have been. The lack of coordination in the rollout—a federal responsibility, outsourced to the private sector—left many aged-care resident families and workers dismayed, and unvaccinated. It was a terrible failure of government. There were not any assurances to providers that they would have adequate staff to be able to manage all the things that happened to them when they had a break-out of COVID or even on a day-to-day basis so that they could ensure that family members could come in safely and visit relatives. I think we all know in here the loneliness that those residents have experienced. It's really something this government should be apologising for. There were ways to do it, but it needed resources way beyond the existing resources that aged-care facilities had. The government needed to support it.

I want to turn to the lives that were lost in aged care in my electorate during the pandemic. Based on the Commonwealth Department of Health data from just last month, there were 60 cases of COVID in three aged-care facilities. Forty-two were residents, and the remainder were staff. Eight residents died of COVID or COVID related causes. I can only express my deepest sympathies to the families who experienced those losses and to the carers who had been part of that person's life for the time that they had been in care. I hope that these are the last deaths and I welcome the government decision to provide boosters for aged-care residents. We do need to do what we can to keep people who are already vulnerable safe. And I do rest easier knowing that those looking after my dad are vaccinated, although I recognise that they can still catch COVID and they can still share COVID with each other and with the residents.

I think we've got a real opportunity to reduce the risks for people in aged care by much better use of rapid antigen testing. Rapid antigen testing was provided free by the government for some local government areas of concern but not automatically in mine, and most facilities missed out. It's had to be paid for by the facilities. It's a really useful tool, and when self-testing kits are allowed to be used from 1 November, it will be an even easier tool to use, not requiring nurse supervision to administer. It's an easier way to provide an extra level of confidence that workers are not COVID-positive. Rapid antigen testing can also provide much more confidence for facilities to open their doors to the families and friends of residents and the activities that so enrich the lives of people who live there. You do the test, you wait 10 minutes and you know with a reasonable level of assurance whether you're carrying a high viral level of COVID or not. To be able to hug their loved ones without a plastic shield is vital for residents in aged care, and it's equally vital for their family members, but these tests have to be affordable both for the facilities and the families. The deprivation that residents have suffered can't continue, and they have to be prioritised by the government. But, given what we've seen in aged care and given what we see in this bill, I don't have a high level of confidence in this government to put the needs of aged-care residents and their families first.

The system has been neglected for eight long years. It truly is a national disgrace. The Royal Commission into Aged Care Quality and Safety graphically highlighted the tragic outcomes of the neglect that some people had experienced, including maggots in the wounds of residents and two-thirds of residents being malnourished or at risk of malnourishment. These are things that the Prime Minister failed to listen to. He failed to listen to the urgency of the need that the residents, their families and the workers in the system were expressing, and the operators also expressed to me how urgent they thought the need to respond to the royal commission recommendations was. Their fear was that if it didn't happen now the opportunity would be lost, and that's what I fear when I see bills like this coming to this place.

There were 21 expert reports prior to the royal commission, 21 reports with really practical advice and evidence about what could happen. I want to turn to the issue of workforce, because nothing can happen if the workforce isn't reformed. There has been nothing to improve the wages for overstretched, undervalued aged-care workers, often women, often women who are working in multiple places. Aged-care workers are exhausted, there's no two ways about it, yet they remain extraordinarily resilient. What I often see, when I have had the chance to visit my father, is that it will be time for someone to leave but they'll hear a call from a resident and so, bag in hand, as they're about to walk out the door at the end of a goodness-knows-how-long shift, they'll just drop the stuff. They'll just leave it there and they'll go and attend to the needs of that resident. That's the sort of people they are. They're just not prepared to walk away. As we saw during the pandemic, though, they have lacked resources. I believe these workers need to be paid more and that there should be more of them.

One of the things that concern me in the government's response to the royal commission is the gift of $3.2 billion to providers in the form of a basic daily fee increase. We all thought there needed to be an increase in the funding that went to providers, but this one went with no strings attached to ensure that it actually went to care or food, not to management bonuses or a new office fit out. It's not necessarily going to the workers. It's not going to provide more workers so that they have a few more minutes a day to spend with somebody. Nor is it necessarily going to go to better food. A lot of providers are going to do the right thing, but what we saw in the royal commission is that the standards have to be set high so it's not a negotiable thing, so it's not a case of 'maybe we'll do it and maybe we won't'. We have to have standards, standards that we would be happy to accept were we residents.

The other major issue with the response from the government to the royal commission is the failure to clear the home-care package waiting list. I've heard my colleagues talk about their constituents who have long, long waiting times before being able to access the care that they have been assessed for and that have been found to require so they can stay in their own home, but they're just simply isn't a package available until someone dies or goes into an aged-care facility. The extra packages that have been included in the budget simply don't add up to fixing the waitlist that exists. That has to be a priority area.

When visiting a facility, or if they have someone in a facility, I think a lot of people have an expectation that the issue of having a nurse on shift for 24 hours a day has been fixed. Well, of course, it hasn't been fixed. That recommendation has been ignored and there's no requirement for a nurse to be on duty 24/7 in residential care. That's absolutely at the core of improving clinical care for frail Australians. Firstly, we should be helping people to stay in their homes for as long as they can and for as long as they want to—surrounded by their garden, their pets or all the things that keep them grounded in this world. But if they do go into care they also deserve to have that high level of care. The promise of mandatory care minutes for each resident is completely full of holes. It doesn't meet the royal commission recommendation, and we now know that cleaning and some admin will count as care minutes. Well—that's great.

The Morrison government have shown that they can't be trusted to fix aged care. Labor can. We actually care about it and want to see it happen. We have fought for it; we fought for the royal commission and every one of us wants to see older Australians, their families and their carers being treated with respect. This is a government that couldn't be trusted to vaccinate the aged-care workforce; they bungled it so badly that even now I don't think we know exactly how many aged-care workers have been vaccinated. For a long time, the numbers were so opaque. The government can't be trusted to fix the nutrition crisis that people experience in aged care and they can't be trusted to act with urgency on it—we've seen that. They can't be trusted to pay dedicated and hardworking workers properly and fairly, even though I'm sure they recognise how key the workforce is to delivering a high-quality aged-care system.

Aged care has always been a priority for Labor. Our workforce compact, which was designed to help fix these issues, was cancelled by then Prime Minister Tony Abbott just weeks after he was elected. That's what we need to judge this government on—not what they say, not the words that come out of their mouths, but on what they do. In aged care, they have failed.

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

I'm delighted to rise and enter the debate tonight about a critical issue facing us all. I'm particularly in strong support of the second reading amendment to the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021, because I want to talk about some of the systemic failures from the perspective of my local communities when it comes to aged care. I also want to talk about the inadequacies that the government has so far delivered in response to the royal commission and I want to raise my voice around the government's failures in providing safe and high-quality care for aged-care residents. Particularly, I want to place on the record the concerns, frustrations and genuine fears of many in my community.

In tonight's contribution, I will be referencing the outstanding work of local aged-care workers in my community—the outstanding management and staff who do so much with so little, thanks to this government—and also the impact that some of these changes have meant for the residents who I have spoken to and their families who have contacted me as their advocate in wanting a better deal for those in our community who aren't getting the care that they deserve.

We know that action to fix aged care has been a long time coming and that it's needed desperately. Tonight's bill, like much of what the government has provided in this portfolio after eight years, falls woefully short. Several key recommendations from the aged-care royal commission have been neglected and rejected by the government. As we know from previous speakers in today's debate, over 140 recommendations—more than half—will not be implemented fully or at all. This bill claims to be addressing the recommendations from the royal commission, but missing items and alterations that have been made mean this falls far short of what I believe the community expects.

The bill does make some small changes, and the proposed measures will impact residential aged-care funding, workforce screening, provider governance, banning orders and a code of conduct. Listening to previous speakers on this side of the chamber and the shadow minister, certainly these recommendations being put forward have been put forward without any adequate consultation with older Australians or any of the aged-care peak bodies. I've been privileged to sit down with a number of providers in my community—and across Australia—who have reached out to me and spoken to me about their sheer frustration with government policy and the sheer frustration of not being heard by the government orby a minister who seems to be either uninterested in or unable to deliver adequate reform.

Certainly, from tonight's discussion, policy changes have not had the impact for workers, and, in particular, the unions who represent some of the hardest working Australians—the aged-care nurses, the frontline allied staff, the people who provide round-the-clock care. When United Voice has brought their delegations to the parliament I have always been first in the queue, because I want to hear firsthand from workers. I want to hear their frustrations. I've visited workplaces in my own electorate and heard the sheer desperation and also the heartbreaking stories of workers leaving the sector because of inadequate pay or the fact that they are unable to deal with the complexities—the stress and strain of working in a system that is simply broken.

The aged-care crisis, in my opinion, falls firmly at the feet of the Prime Minister. He is responsible for the aged-care system. We need to go a little bit back in time to look at the Prime Minister's record in aged care, particularly when he was Treasurer, where we saw the damaging round of cuts that were made. But, also, there is the fact that he was dragged kicking and screaming to actually get the royal commission done in the first place. It was Labor who called for it, the opposition who rallied and championed a royal commission into this sector. We were told it wasn't necessary. We were told it wouldn't fix things.

Well, what the royal commission has highlighted is that our system is broken. We heard during the evidence to the commission about the horrific way that residents have been treated. Regarding the fact that two thirds of residents were malnourished or at risk of malnourishment, I have had experience with this that I would like to share with the chamber. My own mother was in aged care and was rushed to hospital due to malnourishment and dehydration. She had lost around 16 kilos in weight, she had continual UTIs and she was in enormous pain. She was admitted to hospital the week after the last federal election—rushed to hospital when I was visiting her with my cousin. She did make a lengthy recovery but, as a member of parliament and someone who stands in this place, when I look people in the eye to hear their stories, it's heartbreaking to know about the abuse and the difficulties of navigating the aged-care system. When we made the decision, with my mother's involvement, to change facilities, the complexities involved with navigating the system and the difficulties of residential aged-care deposits, the RADs—it was a really difficult period. I can only imagine, for someone with poor literacy skills or someone from a non-English-speaking background, or someone with not a lot of money, what that means in terms of trying to navigate the system. Let's face it, even trying to apply for Meals on Wheels through the My Aged Care portal is a battle.

I hope the bureaucrats listening to this speech tonight will take all this into consideration, because the system is not working; the system is broken. With a system that requires so much detail and has so much complexity to navigate, I worry about the future as we all get older—what this means for all of us—because we will all have to face this aged-care system. Certainly, in my time in this place, I'm dedicated to reforming, improving and enhancing this system so that no Australian will have to go through the difficulties that our family went through and that literally thousands and thousands of others have to deal with.

I want to make the remark that this is not a reflection of my own personal stance about the quality of care or the difficulties. It was simply the fact that the facilities that I've spoken to—and in our own family's example—did not have enough resources. They didn't have enough time, they didn't have enough care workers, to be able to check meals or to check hydration levels. The staffing levels were not adequate. It's that simple. So we do need durable improvements and lasting reforms that will make a real difference in the lives of our nation's elderly in the long run. As I said, 148 recommendations are not being implemented, or aren't being implemented properly. Nothing will change without reforms to the workforce; I fundamentally believe that.

There has been nothing so far to improve the wages of overstretched, undervalued aged-care workers. A couple of weeks ago I was at a local business, a cafe in my local suburb, and I ran into a former aged-care worker. I said to them, 'What are you doing here?'—because they were working at the cafe—and they said they had to leave the facility they were working for because they couldn't make enough money and because of the stress and the strain. That means we've lost the quality and knowledge of that person, in their leaving the sector. The $3.2 billion that the government is coughing up for providers has no strings attached. There are no guarantees that this will go to better care or better food. There are no guarantees that some of this money won't be wasted on management bonuses or fit-outs of new offices or new equipment for the top executives. I don't begrudge anyone decent pay, but you've also got to think about at whose expense that comes—what does that mean for the actual frontline workers in the facilities, who need more support.

Older Australians have helped build this country. They've paid their taxes, they've worked hard, they've raised their families and they honestly deserve the respect, dignity and peace of mind that a federal government should be providing to them at an aged-care facility. I know this is a complex piece of policy. I know this is very difficult. But we have to do better for older Australians.

We have to do better for the 12,580 pensioners that I represent in this place, with many of them coming to having to deal with tough decisions about what sort of care they have. In my community, I've got wonderful Aveo facilities; I've got Sinnamon Village, which is a terrific facility in the south-western suburbs of Brisbane; there's TriCare at Jindalee—amazing staff, but they are really stretched to the limit, and so many of them have become burnt out. Forest Lake Lodge is another great facility, down from my electorate office. These workers are tireless in their support, and the fact that they've got to come and advocate in their own time to their members of parliament—we should be doing everything we can to support them. And I would say on the record that many of them are begging for help and support. They simply cannot continue the work that they're doing. They love what they do, they love caring for older residents, but they simply do not have the resources to do it.

I really hope that the government understands the complexities of this issue and understands how hard it is for older Australians to navigate the current system. We've had 21 expert reports. The then Treasurer, Scott Morrison, now Prime Minister, decided to make those decisions about cutting funding. None of us want to hear the horror stories. None of us want to live the horror stories of what so many residents have gone through. But there is a trust deficit here with the Commonwealth government when it comes to delivering quality aged-care services. It is in black and white. It is as clear as day that, in the system that we have at the moment, the quality of care is not what Australians believe that they are entitled to.

After eight years, you have to ask yourself: is the government up to the task? After eight long years and a royal commission, half the recommendations of which have not been implemented, you have to ask: is this federal government shaping up to be one of the worst governments in our nation's history, full of dysfunction and chaos—and that's just this week? Each week we seem to go from bad to worse, with someone being held hostage or some sort of Hunger Games episode inside the government where someone is being held to ransom about a policy issue or someone threatens to resign, walk out or cross the floor.

The real losers out of this are older Australians, the residents who are fearful, but also their families. Particularly during the pandemic, there has been the issue of isolation. I won't even get onto what the member for Macquarie touched on in her speech: the issue of vaccination and all the promises that were made by the health minister. I would sit in this parliament and hear the excuses about 16 per cent, 72 per cent, four per cent or nine per cent. 'We just didn't do our job. We promised that, in every facility, every aged-care worker would be done by Easter, and that turned into May, June and July.' On and on it went. No-one from the government ever got up and said: 'We stuffed up. We didn't order enough vaccines. We didn't deliver what we said we would.' Maybe if they had there'd be a bit more confidence in the aged-care sector. But that was during the pandemic.

The government does have an opportunity now, in the dying days of this term, to do better when it comes to aged care. If they don't, older Australians have a very clear choice at the next election: they can continue on with a government not committed to aged care or to real reform, or they can elect a future Albanese Labor government with, hopefully, Minister Mark Butler—currently the shadow minister—who will deliver and will see real reform to give older Australians the respect, dignity and kindness that they deserve.

Graham Perrett (Moreton, Australian Labor Party, Shadow Assistant Minister for Education) Share this | Link to this | Hansard source

[by video link] I rise to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021. Like the earlier speakers, I do so through the prism of having helped people in my electorate go through the aged-care maze but also having dealt more recently with my elderly father, with all of the complications that come with that.

This legislation is part of the second stage of the Morrison government response to the final recommendations of the Royal Commission into Aged Care Quality and Safety. It implements eight measures. This inquiry has confirmed that our nation's aged-care system is broken. The first report of the royal commission was bluntly and accurately entitled Neglect, and barely anything has improved since. Of course, Labor supports action to fix the aged-care system. We're frustrated that it has taken the Morrison government as long as it has to get to this point. This is a crisis, and we are concerned that, yet again, the Morrison government will fall short when it comes to taking real action in a crisis.

Don't listen to the Prime Minister's words; judge his deeds. When the Black Summer bushfires almost turned the east coast of Australia to ash, what did the Prime Minister do? He bunked off to Hawaii. When the COVID-19 pandemic emerged in 2020, the Morrison government took too long to react. Labor called for wage subsidies, but the Prime Minister said it was dangerous and dragged his heels. Eventually he agreed to wage subsidies, but they should have started much earlier. Vaccines were eventually ordered, but not enough. He said we were at the front of the queue, but the queue snaked so far back around the block that he didn't realise we were actually last rather than about to enter the vaccination doorway. We see it again and again from the bloke who has been lolling around in The Lodge since he pushed Malcolm Turnbull down the stairs. Since August 2018 we've seen a lack of leadership when it comes to acting in a crisis, and we've certainly seen this in the aged-care sector since the coalition took office in 2013. The Morrison government has ignored key recommendations from the aged-care royal commission. Over half of the 148 recommendations are either being ignored or not implemented.

I knew there was a problem because my constituents have been telling me so. Here are a few emails I've received from my constituents about their aged-care experiences. One wrote:

My father is a tradesperson and ran a successful company for most of his working life. He started work after completing his national service and without a break he was still actively working part time at age 80. Surely he is entitled to live out the remainder of his life in the way that he chooses? Given the appropriate level of care then this should be possible. Sadly though this is not the case. As Dad's daughter I am his advocate. I am sure that he would not even be getting this level of support if I had not pursued this on his behalf.

Another constituent wrote:

Sadly, no one seems to have learnt a thing from the Royal Commission and the situation in the centre was too terrible and quite traumatic for my Mum.

I got to know some of the other residents while visiting my Mum, and they weren't as lucky as they had no one to stand up for them while they were being treated so dismally.

It would be great if there would be someone to stand up and make a change within the aged care community.

Yet another said:

Our families' only concern is our parents care, motivation and well-being to improve their quality of life.

My main concern is the staffing to provide the highest quality of care that all residents deserve. On many occasions there are no staff at ward D our parents nursing station. Minimum staffing requirements are absolutely essential because without staff, workers become tired and stressed and can't provide the best outcomes for residents. My mother walked out of the facility recently and was luckily picked up by a good samaritan and dropped at a local hospital where I was then contacted. The door alarm would have been activated but no staff were in the ward to hear the alarm.

Also the quality of food is of concern, one evening I stayed with my parents for dinner. They were given a hamburger which they didn't eat and their meal didn't appeal to me either. Variety of healthy, tasty and appealing food is essential. There should be food control random inspections.

I consider my parents are in one of the better residences compared to what I have seen but there are always improvements that can be made.

And, finally, one constituent set out some particular issues with the facility their loved one resides at:

1. MEDICATION INCIDENTS

There have been several incidents with medications. These have included:

•   wrong medications being dispensed

•   wrong medications being ingested

•   medications being missed completely

•   time critical medication not being dispensed in a timely manner after several requests by Dad to have his medication

2. BED LINEN NOT BEING CHANGED

3. PERSONAL MEDICAL EQUIPMENT NOT BEING PROPERLY CLEANED

4. URINE POURED DOWN VANITY SINK

5. ADVOCACY

•   If Dad passes before Mum, there is no longer someone on-site to advocate on her behalf.

This constituent continued with some suggestions which are relevant to this debate today:

These may seem like small issues to some, but for people who have to live with these problems on a daily basis, it is simply not good enough.

Families are paying a lot of money for very average, and in some cases, below average care.

Minimum staffing numbers need to be set by governments. Care workers need to be more skilled. Care residents deserve to be heard and validated. Has anyone gone into Aged Care and actually spoken to the residents themselves? How about someone dignify them by asking THEM what needs to change?

I said that these comments are relevant, because older Australians, aged-care peak bodies, providers, workers and unions were not consulted in the drafting of this bill before the chamber. I know that seems unbelievable, but it is true. The Morrison government did not consult with any of those groups before this bill was drafted, despite the impacts it will have on older Australians residing in aged-care facilities. The providers, workers, unions and peak bodies—none of them were consulted yet all of them will be impacted.

Some of the changes in the bill include residential aged-care funding, workforce screening, provider governance, banning orders, and a code of conduct—not small changes at all! People involved in the sector would have had an opinion about these changes. Frontline workers may think that the measures in this bill are great although, equally, they may think that there are some practical concerns that the Morrison government has not taken into account appropriately. Their contribution may have improved this bill. At the very least, the aged-care sector deserves to have a say. Sadly, the Abbott-Truss, Turnbull-Truss, Turnbull-Joyce, Turnbull-McCormack, Morrison-McCormack and Morrison-Joyce governments never listen to the experts. They have had 21 expert reports that told them older people were suffering in aged care and they still can't fix the problem.

Not only did they not fix the problem, when the current Prime Minister was Treasurer, he cut funding to aged care. When he was just three months into the job as Treasurer he booked a $472 million saving to be 'redirected by the government to repair the budget and fund policy priorities'. So that was a decision of the then minister—the then Treasurer Morrison. This money was found by freezing the indexation of the aged-care funding instrument and by making it harder for providers to make claims under the subsidy.

The next year Minister Morrison raided the funding instrument again, finding a further $1.2 billion. The budget papers said that 'savings from this measure will be redirected by the government'. As far as aged care was concerned, the money vanished. As Rick Morton has detailed, according to one registered nurse with more than 30 years experience in aged care, the $1.7 billion that Minister Morrison broke off the funding instrument brought the sector to its knees. So this aged-care crisis is the current Prime Minister's aged-care crisis. Mr Morrison is responsible for the aged-care system and why it is currently a national disgrace.

The Morrison government's response to the royal commission fails to deliver enduring improvements or any lasting reforms. A skilled workforce in aged care is crucial—everybody knows that. The government have done nothing to improve wages for overworked and undervalued aged-care workers. The Morrison government are giving $3.2 billion to providers but with no strings attached. They won't be requiring that the taxpayer money goes to more care or to better food, things that would directly improve the lives of people in aged care. What could possibly go wrong?

The Morrison government have failed to clear the home-care package waitlist of 100,000. They have failed to implement the commission's recommendation that a nurse be on duty 24/7 in residential care. That's such an important, life-saving recommendation and yet the Morrison government just blithely ignore it. The royal commission recommended a mandatory amount of care minutes for each resident in care. The Morrison government's version of implementing this recommendation allows cleaning and admin to be included as care minutes. They failed to roll out vaccinations for the aged-care workforce in an ordered and timely manner, and still don't know accurately how many aged-care workers have been vaccinated. The Morrison government just can't be trusted to fix the aged-care system, and older Australians deserve better.

Older Australians built this country. They deserve better than a system that is unsafe, undignified and chaotic. Labor believes that aged-care workers should be paid more; we know that will flow into better conditions for the people who they care for. This would also help to recruit more staff—another issue confronting the sector, especially while international borders are closed. Older Australians and their families should not have to choose between unsafe care or no care. Sadly, the Morrison government cannot be trusted to fix aged care. Only an Albanese Labor government will reverse the neglect and make sure that everyone's loved ones are safer.

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

I rise to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021. Just listening to the member for Moreton, it occurred to me that some things need to be put in context. The first of those is that the so-called 'cuts' he referred to were not cuts at all. They were the efforts by this government to stop the growth in expenditure in aged care. Why did we do that? We did that because there are now three listed aged-care companies—SDR, Japara and Regis—who in all their prospectuses stated that their sustainable competitive advantage, compared with their competitors, was that they were better at filling out forms and gaming the system of funding that the federal government had instituted to maximise the amount of money that they got from the Australian taxpayer. So when I listened to the member for Moreton speak so eloquently, as he always does, about the needs of those people who are not wealthy, those people who do not have access to unsustainable riches and class-action lawyers and industry super and big unions, I was left to wonder why all of a sudden he is in favour of very wealthy listed companies in Melbourne getting access to untold riches from the taxpayer and this parliament not being in a position to ask whether they deserve it and whether they are actually providing the care.

Is that the sort of deep moral and intellectual bankruptcy we are to expect from the opposition on every issue this parliament deals with—that they would favour the interests of large listed corporations over that of people seeking care in aged care and nursing homes? Is that where we've got to in this parliament? Is that where we've got to in this country? (Quorum formed) Surprise, surprise! The Labor Party wants to shut down debate when we start talking about ideas—when we start talking about the endemic corruption of industry super, big unions and class-action lawyers. They are afraid of ideas. The member for Fenner talks and talks about ideas, but he doesn't want to hear the ones he needs to listen to. And I'm really surprised that the member for Moreton don't want us to ensure that taxpayer funds go to caring for people.

Before I came to this place, I had a business that provided goods and services to the aged-care sector. That business started roughly in 2004. My observations between 2004 and 2016 were that aged care in Australia actually became outstanding. I would go to trade shows in the healthcare sector in places like Germany, China and Taiwan—it was nothing compared to the locations that James Bond went to!—and I heard people from every part of the world talking about aged care and the challenges that their nations faced. It is little known in this place that Germany has a proactive policy of relocating people who require care as they grow older. They have a policy that enables people to be cared for in the Czech Republic and in Thailand, because they simply do not have the resources or the people to enable them to undertake that care in Germany. China has a very large number of people about to get very old. Traditionally what happened in Chinese society was that those people would be looked after in the homes of their children. But of course, under the communist regime, there has been 40 years of a one-child policy, which means that this traditional care model for people in China as they become older has broken down. So the Chinese government is looking for potential solutions for what they see as a crisis on their doorstep, a demographic crisis. When they've looked around the rest of the world, they have found that, in their view, Australia has one of the best systems in the world for caring for people as they get older.

I think back to 2004 when I walked into my first aged-care home, which was a UnitingCare aged-care home in Croydon, and, as the doors opened, the smell of ammonia that escaped was overpowering. I remember, at a Royal Freemasons home in Parramatta, walking past a lady who was quite distressed because she had been calling for care for quite some period of time. But, as the private sector came into the provision of aged care, quality and service went through the roof. I think of Arcare—

An honourable member: An outstanding company.

an outstanding company, a company that really makes me wonder, as a sprightly 51-year-old, whether it would be okay for me to move into one of their facilities at Warriewood. I think of Signature Care, which is providing four- and five-star quality care in rural and regional settings that many of the not-for-profit providers, whether it be UnitingCare or otherwise, simply are not dedicating the resources to providing. These organisations are providing incredibly good quality care in terms of the services that they provide. I think personally, from my observation, that the group that has done more to stop older Australians, our tribal elders, from getting the care they deserve is in fact this parliament. We have heaped regulation after regulation after regulation onto aged care so that innovative, entrepreneurial people who take caring seriously, take compassion for older people as their calling in life, have been prevented from providing different care, more care, services that people want, by this parliament, who have decided that the smartest 151 people in the world actually sit in this chamber and we are so smart that we can tell you what care a person in Broome requires versus a person in the south of Hobart, that we know that model of care from one end of this country to the other. But the truth is we don't. We don't. The people who the member for Moreton talked about, the people who are engaged on a daily basis in the provision of this care, know better than any of us ever will what an individual needs, requires and should have to ensure the last years of their life are some of the most satisfying that they can have—or, at least, are satisfying.

When this parliament—and I was part of that vote—referred the aged-care sector to a royal commission to investigate the problems that some aged-care providers were having, I have to say this thought went through my mind: can you think of a group less suited to undertake this investigation than lawyers—who are known for their care and compassion!—opining on the entirety of the aged-care system in this country, a system that is globally seen as one of the best in the world, one that other nations want to replicate? But so it came to pass.

Those opposite say, 'The government isn't interested or aren't accepting all the recommendations of the royal commission.' Let me tell you why. The two commissioners themselves disagreed. You had the Chief Medical Officer of Australia sitting in front of them saying, 'These are all the plans we had during COVID,' and then they had the counsel assisting saying, 'Oh, you didn't explain; there was no plan,' which was just not true. Simply put, it was not true. So now we have this report that has come from a royal commission staffed by a bunch of lawyers.

The member for Moreton asked how many people have spent time in aged-care homes. Well, I'll put my hand up. I have spent a lot of time in aged care. I have seen the best and the worst providers of aged care throughout this land, and I know that the people who have been able to provide better care have been the private sector coming into this market and reimagining what it should look like. The people who have prevented them from providing even better care than that are this parliament, because we've told them what they can and cannot do from Canberra rather than say we do not know.

The member for Moreton said the government has rejected provisions like 24-hour nursing. Let me tell you why we did that. We did that because there are small towns dotted throughout this country who, if you brought in that provision, would lose their nursing home. In other words, the people who want to be close to their loved ones—their wives, their husbands—in the last few years they have on this planet would not be able to access an aged-care home if this parliament decided, 'No, you cannot have a perfectly good, caring environment for your husband or your wife because you can't find a nurse to work 24-hours,' even though you don't need a nurse, even though you're highly unlikely to ever require one. We should endorse this bill and we should vote for it, but, most of all, we should support the best aged-care sector in the world. (Time expired)

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

I rise to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021. This bill addresses eight aspects of the report of the Royal Commission into Aged Care Quality and Safety, including residential aged-care funding, screening of aged-care workers, code of conduct and banning orders, incident management, governance, and information sharing. It also establishes the Independent Health and Aged Care Pricing Authority. It will be associated with some $200 million of additional funding for the sector and oversight bodies.

There are 11 recommendations from the royal commission that are addressed by this bill, and I note that the peak bodies of the aged-care sector have expressed their dismay at the lack of consultation with them on the changes presented in this bill. I would encourage the government to improve on its process of consultation with the experts within the field, especially with those who are impacted by the changes, in advance of further reform. One would think that the lesson had already been learnt with the outcomes of the royal commission and the horrendous stories that shocked the Australian public, but there is still an inability for proper consultation with the sector when addressing reforms. This is particularly relevant to the new pricing model proposed under the legislation, the impact of which remains unclear. Some providers fear that they may be worse off under the new funding arrangements, but the government has refused to establish a better-off-overall-test for this new funding model, which is a concern. I welcome the adaptation of the NDIS worker-screening model to the aged-care sector. However, given the nuances of the two sectors, I believe it would be beneficial if aged-care providers were able to provide input and feedback on the screening process.

Schedule 3 of the bill establishes a code of conduct and banning orders for aged-care staff. While this is a welcome development, I note that peak bodies, such as Leading Age Services Australia, have significant concerns with the broad and vague terms of the code of conduct and the high penalties of up to $55,000 for breaches. These penalties may even be levied against volunteers. Their concern is that it is easy for different people to have different views about what 'acting with respect' means. The detail is important. They are also concerned that the code of conduct is duplicative in many instances because nurses and other allied health professionals will be subject to the aged-care code in addition to the relevant codes for their profession. The question will be: are they aligned or will there be discrepancies?

The new governance requirements established by schedule 5 of the bill make sense for larger organisations, including having a majority of non-executive members and a minimum number of clinical members. However, again, smaller owner-operated bodies may struggle to comply with these new requirements. I appreciate that exemptions may be granted, but I strongly believe it would be better to have more-specific guidance in the legislation or regulations around arrangements for different entity structures.

Overall, I welcome the bill and the progress towards implementation of the aged-care royal commission recommendations. The bill and the establishment of the code of conduct, governance and screening models will make some progress towards the complaints of aged-care workers in my electorate and those around Australia. But we still have a number of concerns from local nurses and aged-care workers. Aged-care workers in my electorate have highlighted to me the lack of training and oversight of carers, leading to compromised quality of care service among those providers. They've told me that there is a real gap in the care received by participants, depending on the carers allocated. Patients without family or close relationships or under public guardianship are often left behind with inadequate support. They have alerted me to instances of long waiting times for assistance, of poor hygiene in facilities and in the home and of staff administering medication to control behaviour. These stories are not unfamiliar. Many of them we heard during the royal commission.

This bill and the standards and conduct measures will go some way towards improving the conditions, but more needs to be done. We need to recruit and train the 40,000 additional workers promised to the sector. We need those additional staff urgently to improve the timeliness and quality of care for those most vulnerable in our society. Registered nurses remains a vexed question. There's still an unwillingness to address this issue. Registered nurses in my electorate who work in this sector—and, as the member for Mackellar said, they are the ones on the ground, who are doing the work—strongly believe that having a registered nurse allocation 24/7 to all residential facilities will greatly improve the quality of care outcomes for residents and other staff and reduce pressure on hospitals and emergency services. It is not good enough to claim an excuse that some areas in regional areas won't have access. We need to make sure we train the workforce and make registered nurses available to facilities. There should not be a difference in standard of care. We need to progress the requirement to have registered nurses on staff at residential aged-care facilities at all times. It makes sense, and it will improve the quality of care and outcomes for our already stretched health systems. This needs to be prioritised.

It's important for me, as the member for Warringah, to hear from families, from people participating in aged care and engaging with the system, and from professionals in that system. So I recently implemented a Warringah aged-care forum to hear from them directly. Implementation of the aged-care royal commission recommendations was a key issue raised at that forum. In my electorate of Warringah, there are 18 residential aged-care facilities. The purpose of the forum was to allow my constituents to raise their concerns and ask for guidance and assistance and for me to give them practical steps from an expert in the industry, as well as to hear their complaints and concerns.

The main themes that arose out of the forum were difficulties in navigating the application and assessment processes; questions about how to instigate either home care or residential aged care; the need to alert people to the option of the Commonwealth home support package, which can often be used as an interim support while people are on these very long waiting lists; and guidance on choosing a provider or aged-care facility, as well as other community resources that may help. The key issues raised included the very long waiting lists; convoluted and arduous application and assessment processes; the need to have a registered nurse on staff at residential care facilities 24/7, whereas at present there is no obligation to have a registered nurse on site at aged-care facilities at all times; the need to improve carer and staff ratios dramatically, because the statistics are horrific; the need for families to have pre-emptive contingency plans in place to prepare for abrupt changes in circumstances; guidance on estate planning and end-of-life preparations and assisting families on how to navigate these; and how and when the royal commission's recommendations would be implemented in full. These are the key concerns of residents of Warringah.

So I welcome this bill, as it progresses 11 recommendations of the royal commission. But, unfortunately, many of the concerns voiced by my constituents in the forum won't be directly addressed by this bill. I've written to the minister to raise the issues that came up in the forum, and I hope these will be engaged with and there will be some action in that respect. The bill lays some of the groundwork for improvements to the sector, but we need more progress on the implementation of the royal commission recommendations, including the establishment of staff ratios and registered nurses. This is probably one of the single biggest changes that could occur to improve the very real outcomes and the actual care of our most vulnerable.

We need government to commit to removing the age discrimination between the packages provided to people who acquire disabilities under the age of 65 and those who acquire them over 65. This is the big elephant in the room. It just doesn't get addressed by the government. It's a bucket that keeps getting pushed around. It's incredible discrimination that's still allowed to persist. While you're adapting so many compliance and standard measures from the NDIS to the aged-care sector, you should also make sure that the packages provided to participants are equitable and fair.

So I commend the government for implementing some of these measures, but I urge the minister and the government to listen to the professionals in the industry and implement more of the recommendations. We know Australia has an ageing population, and we need to do more to ensure that those most vulnerable are properly cared for in their old age. It is our responsibility, and it's the responsibility of everyone in this place.

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

Following release of the final report of the Royal Commission into Aged Care Quality and Safety, the government has committed to reforms in the aged-care system. These overarching reforms can't come soon enough. For my older constituents, for their families and carers, and for workers in aged care who put in so much effort, these reforms need to happen now. I'm pleased to hear from the government that the new research based model for calculating residential aged-care subsidies, the Australian National Aged Care Classification, will be designed to take into account additional costs for those who provide services to vulnerable groups and for small regional providers, such as those in my electorate, who face additional challenges to sustainability compared to those in the metropolitan areas.

While I await the report of the committee, I am in favour of the establishment of a nationally consistent preemployment screening and code of conduct for workers in aged care, aligned with those for workers in the disability sector. However, almost a third of these workers are estimated to be working across both aged care and the disability sectors. This, again, begs the very pertinent question of why aged-care workers are paid up to 25 per cent less than those who provide support to people living with a disability. Both are doing vital work and important work, and their efforts should be valued and paid equally. I call on the government, as I have before in this House, to support the work value case to this effect before the Fair Work Commission right now. It would do tremendous good for the government to support this application.

The extension of the residential care Serious Incident Response Scheme to home and flexible care to provide equivalent protections to those receiving aged care at home or in community settings from the middle of next year is also a sensible measure. New governance and reporting requirements for approved providers of aged care are also welcomed. We do need to take this opportunity to ensure sound governance and reporting form the bedrock for a new aged-care system. I, therefore, urge the government to provide for better reporting on related party transactions, staff hours, make-up, complaints, food and nutrition, particularly given the increased funding to providers for this purpose and charges levied for administration and management opposed to the direct provision of care. I understand the carveout included in this bill, based on consultation with consumer peak bodies, is designed to help those providers with fewer than five governing body members and 40 consumers manage the impact of new governance requirements. This should help to ensure that smaller regional providers, for example, are not overwhelmed, which could push older residents to find care further from their communities.

I'm pleased to see the facilitation of greater information sharing in relation to noncompliance of providers and workers between Commonwealth bodies across aged care, disability and veteran affairs sectors, with appropriate safeguards in place. Improved powers to request information or documents from a provider or borrower regarding refundable accommodation deposits with an extended five-year period of liability for misuse of such deposits are indeed welcome.

I've discussed with Senator the Hon. Richard Colbeck, the Minister for Senior Australians and Aged Care Services, how such concerns can be flagged to consumers earlier so that they are present at the point of sanction. This should be another area where prospective residents of aged care are ensured access to all of the information they need to choose their residential aged-care provider.

Beyond the measures of this bill, I don't believe a person should be charged up to half of their home-care package in management and administration fees. I will therefore be asking members in this place to support my bill to cap those administration and management fees, to ban exit fees and to increase transparency on pricing information for providers.

I await the report of the committee before indicating Centre Alliance's formal position for this bill. I urge the government to do more to implement the recommendations of the royal commission and to work with all members in this chamber to deliver an aged-care system that truly has older Australians at its heart.

There are a couple of other issues that I would like to mention. One of those, which was also mentioned by the member for Warringah, was one of the recommendations of the royal commission, and that was to ensure people who are over 65 years of age who acquire a disability are not discriminated on based on their age. Right now, if you are 64 and you break your neck, you can access NDIS; if you are 66 and you fall over and break your neck, the best you can have is a level 4 package of My Aged Care, and that does not provide the level of support needed to ensure someone can stay at home. It is a huge gap in policy and one that we must address as a matter of urgency. We also need to address the lack of dental care support for people who are pensioners. Dental issues account for around a third of preventable hospital admissions in our nation.

We have to keep working on this royal commission and making sure that all of the recommendations are implemented; we can't allow the findings to sit gathering dust on a shelf. I would urge that we form a joint committee of both houses with people from right across the parliament—essentially, a working group—to make sure that we can continue to put older Australians and the needs of older Australians front and centre and in this place.

Julian Hill (Bruce, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021. The royal commission into aged care revealed what can only be described as a national disgrace. At some level, I think that every Australian would feel ashamed of what was revealed. And that report was also a report card on this government. The royal commission saw fit to call the report Neglect. It comes after eight years of attacks, budget after budget, on pensioners in this country. The government is in its ninth year and I think the Prime Minister is hoping that the nation might experience collective amnesia, not just about his failures on vaccine and quarantine but for the fact that this Prime Minister was actually the Minister for Social Services and was the Treasurer who cut $2 billion from aged care. He's now pretending he didn't do it. He forgets actually that TV cameras record stuff that you say and that budget papers can be accessed from history, year after year. He forgets these things, that Australians can actually look at his record and judge him on his record.

It was also this government, in the shadow of COVID, which cut Medicare rebates. These were sneaky little cuts introduced in July to hip, hand and shoulder surgeries, further hurting senior Australians. It is this government's plan to force age pensioners onto the cashless credit card, creating the cashless pension card if they win the election. The attacks on pensioners and senior Australians never stop with this mob. But the aged-care record is an absolute disgrace and it should, as I said, appal every Australian at some level. Neglect: maggots crawling out of wounds left untreated; nearly 50 per cent of senior Australians in care not receiving enough nourishment and food; using drugs to sedate people because there weren't enough staff to provide adequate care; staff not paid a living wage across most of the country; and 28,000 senior Australians dying while waiting for a home-care package at the right level. I note, from talking to my electorate, that many are too scared to go into aged care, so run down has the system become in the ninth year of this government. The government know this; they can't get up and blame Labor or the states, because it's their ninth year in office. It was this Prime Minister that cut billions of dollars from the aged-care sector, further driving down the quality of the system. There were 21 expert reports this government had before the royal commission that they failed to act on.

The royal commission should have been a watershed moment, a moment of national unity and with a determination right across this parliament and the country finally to act. But what have we got from this government? It's a weak, half response that's an insult to older Australians who built this country. Of the 148 recommendations from the royal commission, the government has not even responded to around 50 per cent of them—or did not respond in any adequate fashion.

This bill here implements a few of their responses; just a few. It's the sort of response you have when you don't actually care and you just want to try to do enough so you have some talking points and people think you're doing something. You kick the can down the road, thinking that you'll probably lose the election and that it will be Labor's fault somehow and that you can blame us for their nine years of neglect and mess. The recommendation from the royal commission—and you wouldn't think this is rocket science, even for this mob—said that there should be a nurse on duty in a nursing home for 24 hours a day. Maybe 'nursing' home is the clue here! The royal commission said to have a nurse in a nursing home 24/7. The government hasn't responded: just silence, nothing to say.

Aged-care workers across the country are exhausted, overstretched and underresourced. We saw in the pandemic that they lacked resources through the Commonwealth's failed response in Victoria last year. That led to hundreds of unnecessary deaths. The government didn't have a plan and then, when they scrambled for a plan, they couldn't even implement their own plan. And the workers are underpaid. The government's response? Nothing to improve wages, nothing. They gave $3.2 billion of taxpayer funding to the private nursing home providers with no strings attached—not a guarantee that it would flow through to adequate food or do anything to boost wages; just a present.

Aged-care workers do a wonderful job in incredibly difficult circumstances—it is not work that I could do—and they get very little pay. Frankly, part of that is because it is a female dominated industry. Can you imagine if this was a male dominated industry—if people would put up with aged-care workers and indeed early childhood workers, in these female dominated industries, being paid less than people stacking supermarket shelves? I've got nothing against people who stack supermarket shelves—also critical work—but we need to value these caring professions just as highly. Labor believes that more funding is needed to provide these workers with a living wage.

This bill is flawed. Stakeholders complain of a lack of consultation. The government, after introducing their own bill, even before it has left this House and got to the Senate, are introducing amendments to their own bill because they know it is flawed and they have made mistakes. The government are choosing to implement worker screening instead of the royal commission's recommended national registration scheme. There are weaker governance standards than the royal commission recommended—one of those half responses—and we've got this little freedom of information exemption. Currently providers are exempted from FOI, from families being able to find out what has really gone on with their loved ones. The royal commission recommended that this exemption be removed, but that's not in the government's bill. Major amendments are going to be needed to this bill in the Senate.

Older Australians deserve better. They built this country. They and their families who love them deserve better than this unsafe, chaotic aged-care system under this Morrison government. People have a right to expect that the government will support them decently in their frailer years and ensure a system that doesn't neglect people in the way we have seen. This issue impacts everyone—this shame of the government's neglect of aged care—whether it's senior Australians in care, older Australians looking down the next decade or so and thinking, 'What happens to me?' or people who are worried about their parents and grandchildren who worried about their grandparents.

All of us hope to be old one day, because the alternative is an early death. My mother died some years ago in palliative care. I nursed her at home for 10 months. It was one of the greatest privileges of my life. Indeed, I believe one of the greatest privileges of anyone's life is helping someone who you really love to die with dignity. I learnt first hand just how special the people who care in these circumstances are, the palliative care nurses. My mum was a nurse. I remember the conversation. She said to me when we were chatting: 'Darling, I'm sad to be dying a bit too soon. I'm only 70. But, on the bright side, one of the blessings is you won't have to worry about me with dementia and I won't have to think about going into care or a nursing home and trying to dodge a bullet and find one with decent care.' I don't want other Australians to ever feel that way in the future—that they should see an upside in an early death at 70 because they are too scared of what awaits them in the Morrison government's aged-care system.

This bill does not fix the problems. It does not address the royal commission 's findings. It does none of that. It's a half-baked response—I won't say the half 'a' word, but you know what I mean, Deputy Speaker—from a government that do not care. They are in their ninth year. They've failed senior Australians. They attack them budget after budget. This bill is an insult, and I condemn the government for it. (Quorum formed)

Tim Wilson (Goldstein, Liberal Party, Assistant Minister to the Minister for Industry, Energy and Emissions Reduction) Share this | Link to this | Hansard source

The Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021 implements eight measures to deliver the second stage of aged-care reform in response to the royal commission and to ensure senior Australians receive high-quality and safe care. The bill introduces new subsidy calculation methods to fund approved providers to replace the outdated funding instrument and encourage innovation and investment in the aged-care sector. It establishes authority for pre-employment screening for the aged-care workforce and provides authority for an enforceable code of conduct and banning audits. These new regulatory arrangements will work together to effectively manage and prevent unsuitable workers from entering or remaining in aged care and the broader care and support sector, and will ensure approved providers and their workers, in governing persons, are held to account for their behaviour.

The bill extends the serious incident response scheme from residential care to home services to reduce the risk of neglect and to protect vulnerable senior Australians receiving aged-care services in their home and in the community. The bill also introduces strengthened provider governance arrangements to improve the transparency and accountability of providers, and will change the culture from the top down. Replacing the current disqualified individual arrangements with a suitability test will bring further regulatory alignment with the National Disability Insurance Scheme.

The bill will facilitate the sharing of information among relevant prescribed Commonwealth bodies about providers and workers operating across the care and support sector who may not be complying with their obligations. Regulatory alignment in this area will improve the consistency of quality and provide safer protections across the aged-care and support sector while reducing the overall regulatory burden on cross-sector providers. Increased financial and prudential oversight will build the sector's financial resilience and improve its accountability, and the expanded functions of the Independent Hospital and Aged Care Pricing Authority will support transparency and evidence based assessment of the costs involved in delivering care.

These amendments have been developed as a result of significant consultation directly with stakeholders as well as through the extensive consultation undertaken during the royal commission. I thank members for their contributions to the debate on this bill. The health, safety and wellbeing of senior Australians is of utmost importance to the government and is driving our plan for the generational reform of the aged-care system. I commend the bill to the House.

Tony Smith (Speaker) Share this | Link to this | Hansard source

The original question was that this bill now be read a second time. To this, the honourable member for Cowper has moved an amendment that all words after that be omitted with a view to substituting other words. The immediate question is that the amendment be disagreed to.