Pat Conaghan (Cowper, National Party, Shadow Assistant Minister for Social Services) Share this | Link to this | Hansard source

I am genuinely pleased to stand and speak to this motion, and I'm pleased that Labor has, as a priority, made a commitment to the aged-care sector. I spoke about aged care in my maiden speech when I first came into this place in 2019. I told a story of how when I was a young child—the youngest of five kids—after church on a Sunday morning, my father, who was the local doctor, used to take us to do his rounds around the aged-care facilities to see his patients. It's no secret that I hated it. I disliked it immensely, not because it was Sunday morning and I was a child but because it was so confronting, and it was sad and depressing. Even as a six-or seven-year-old, I recognised that. It was almost a place that elderly people were sent to to hide away. I remember having conversations with them, and those conversations just brought joy to the residents of the aged-care home.

In my maiden speech, I spoke about the need for a royal commission. I indeed did support a royal commission, and I support the recommendations that have come out of the royal commission. But I should recognise and acknowledge that, despite the recommendations, despite some of the stories that came out of the royal commission, the vast majority of aged-care facilities or homes do a great job, and the people that work there—the nurses, the aged-care carers—do a fantastic job more often than not, and they do deserve our recognition. They're overwhelmed. COVID made their job even more difficult. So we should acknowledge the great work that they have done. There are problems, no doubt, and we acknowledge that there were problems with the aged-care system, but we should actually acknowledge the great work that the nurses and the carers do.

As I said, I'm pleased to hear that Labor is committed to making aged care a priority, and I look forward to seeing that commitment in the forthcoming budget. But if I could just not so much offer advice but an observation: there are a few areas that are above politics—things like veterans affairs, child protection and, of course, aged care. They should be above partisan politics. They're just a few examples whereby bipartisanship rather than divisive politics should be applied, and that is what I am happy to do in opposition. I am happy to work with the government to improve those services, to work with them and offer policy and ideas that may be able to better the lives of those who, let's face it, have built this country.

I also think it's also important that Labor, the Independents and the Greens recognise that, whilst those systems aren't perfect, whilst in government we didn't get everything right, there was a great deal of improvement over the past five to 10 years. Examples of that include the last budget delivering $522 million in funding for aged care, which brought the total investment in response to the final report from the royal commission to more than $19.1 billion, delivering record investment in aged care: $13.3 billion in 2012-13 and $30.1 billion in 2020-23. I appreciate there is an increase in the funding, but there's also an increase in the population. Over 28 per cent of people in my electorate are over the age of 65. So it is a problem that will be ongoing. We have to work together—bipartisan politics working together.

One of the recommendations in the royal commission is to pay our aged-care workers better, and I couldn't agree more. I've spoken to many of them, and the work they do is tremendous. The pay they get is woeful. I'm probably getting out of my lane here, but all levels of government should be looking at better pay for our nurses for the work that they do.

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

I too rise to speak on this important motion and thank the member for Corangamite for her continued tireless advocacy for older Australians. I know that you have been an advocate for a long time as well, Deputy Speaker Sharkie. But the whole aged-care system in the past has been a total mess, and, as governments of all persuasions, we'll be judged in the future on how we looked after our older Australians, who have paid their taxes, fought in wars and basically built the foundations that we stand on today—in some cases literally, through their hard labour.

Since coming to power, the Albanese government has made a commitment and a priority to address and act on the recommendations of the royal commission. Our commitment is to return security, dignity, quality and humanity to our aged-care system, and that is a priority. For example, we've heard the royal commission and are introducing the requirement to have a registered nurse on site 24 hours a day, seven days a week. This will save thousands of stressful, expensive and ultimately unnecessary trips to hospitals, to emergency departments. What happens now if there is no nurse on the premises after hours, if one of the residents needs medical attention and there is no-one there qualified to provide that medical attention? They call an ambulance and they're just taken to the public hospital. This will stop a lot of that. Of course, there will be a mechanism for smaller facilities in some of the regional and remote areas. We understand it could be difficult to implement these changes, but that will be taken into consideration as well. But this exemption will only be on a temporary basis. In time, all facilities will have to be able to facilitate a registered nurse 24 hours a day on the premises. This is really important, because all older Australians, regardless of where they live, have the right to the same quality of care, whether they're in a city, in a rural or regional town or in a remote area.

This brings us to another problem, and that's the workforce issues. The pandemic showed us how stretched aged-care workers are. They often have to work across multiple sites to make ends meet. They are undoubtedly dedicated and committed. I've met some absolutely committed people in aged-care facilities that work there because they love the job and they are committed to older Australians, but they're also overworked, underpaid and undervalued. This is why the government is backing a real pay rise for aged-care workers. We have to make a submission to the Fair Work Commission in support of increased wages for aged-care workers. Importantly, we have committed to funding the outcome. In addition, we have established a wide range of programs to attract staff and support retention, including those registered nurses. Addressing working conditions for aged-care staff is essential if we want a good aged-care system and we want the quality of care to improve.

We are also committed to capping administration costs and exit fees for people receiving home-care packages. One of the complaints I get in my office is that the money that's allocated for a particular home-care package isn't actually going into the home care; it's going into administration costs. It's really important that the money that's given for packages goes into care. The royal commission found that up to 50 per cent of some home-care packages was eaten up in admin and management fees. During the pandemic we saw that, with some of the home providers, people were actually dying and care wasn't being provided, but there were multimillion-dollar profits, and people had Maseratis and million-dollar homes. It's just not fair on our older Australians. It's disrespectful of older Australians who are trying to continue to live independently in their own homes.

Money should be going on aged care or care in the home. Unacceptably high fees lead to older Australians missing out on the care that they need to keep living at home. We want an aged-care system that puts the customer and their care first. As I said earlier—it is so important—we will be judged as a nation in generations to come on how we've looked after our older Australians. It is not fair for those people in their twilight years, when they are putting their hand out for a bit of help and assistance. As governments we should be doing absolutely everything we can to assist these people.

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

Aged care is a huge industry and a very vital part of Australian life—caring for our nearest and dearest in their twilight years. It's a huge industry and it's under huge financial pressure. Many have seen reports in the aged-care literature that up to half of the aged-care facilities around the country are relying on their retained earnings from over 20 and 30 years to keep them in the black. That is very sad. But that's why we, in the coalition, when we were in government, made huge improvements in aged care. Everyone is on the unity ticket; we want the best for our older citizens. But I want to put some things on the record after I've made some comments about the Aged Care Amendment (Implementing Care Reform) Bill 2022.

Schedule 1, which is about having compulsory RNs onsite 24 hours a day, seven days a week, is going to be very problematic. I see the sentiment, and the government in the last term supported the concept but saw that there is a huge shortage of RNs in country areas, let alone RNs to staff, onsite, 24 hours a day. There are many small facilities that are actually closing wards at the moment because they don't have RNs to be onsite, even intermittently. It will be a huge burden for many of my rural and remote providers—and even my larger providers that have 300 and 400 people. They just can't get nurses. But in the last budget, we put a whole lot of money in to retain the workforce and keep them in the industry—hundreds of millions of dollars. We've got workforce retention bonuses. We've got training in occupational therapy and aged-care nursing happening in rural and remote nursing homes—all those things and a 14-point plan to grow the aged-care workforce. But more about that later.

The other thing to talk about is the exemption for the registered nurse requirement. I would like to know more of the details. Is this going to be a get-out-of-jail card so that places don't close? I think you'll find, whatever the exemption is written up for, they'll be flooded with people requesting exemptions. I have got concerns about whether there'll be penalties, or will aged-care facilities actually close as a result of that? I'm not saying it's not a good idea; I'm just saying the practicalities of it will be very difficult.

The issue about capping fees in home care is a very welcome development. The former Minister for Senior Australians, Stephen Colbeck, and the former Minister for Aged Care, Greg Hunt, were aware of some of the problems with price-gouging in the home-care space. A lot of the regulations to cap fees are fully supported by us because they were going to be done as part of the work-up for the Australian National Aged Care Classification system—the AN-ACC system—that's coming in to replace the ACFI. Just to put in perspective what they achieved, aged care was on a $13.2 billion annual budget from the federal government in 2013 when we assumed responsibility on the Treasury benches and government. When we lost office, it was up to $30 billion—that's per year. There's an extra $18.9 billion plus another $200,000 for workforce supplements in the ACFI changeover to AN-ACC, the basic daily fee supplements, the homelessness supplement, the viability supplement, the loading for rural and the loading for remote. There was so much good work done, and I'm really pleased to see this coming in, but please don't let people think that none of this was done in the former government and that it just appeared miraculously at the change of government. This was worked up for several years. We delivered huge improvements, and there's a lot more to go because aged care is so important for our senior Australians.

Cassandra Fernando (Holt, Australian Labor Party) Share this | Link to this | Hansard source

I rise to support the motion put forward by the member for Corangamite. Our older Australians worked hard their entire lives to ensure the generations that succeeded them benefited from their contribution to their communities and our nation. We have a duty to look after and care for them in their later years.

I am proud to support a government that began delivering on its election commitment to bring back security, dignity, quality and humanity into aged care the day after the 47th Parliament was sworn in. A decade of negligence towards our older Australians by the former coalition government led to the crisis in aged care. It resulted in a royal commission that should not have been needed, for a sector that should not have been left to decay, for people who should not have been neglected. The Royal Commission into Aged Care Quality and Safety showed us that we had to do better, and the Albanese Labor government's monumental legislation focused on delivering this promise.

I would particularly like to draw attention to the Aged Care Amendment (Implementing Care Reform) Bill 2022, which will implement several urgent aged-care reforms that complement the government's response to the aged-care royal commission. From July next year, the bill will lift care and quality standards by introducing a new responsibility for approved providers to ensure that a registered nurse is present on duty at each residential facility every single minute. This will reduce the numerous stressful, expensive and unnecessary emergency room trips and ensure that our older Australians living in residential care facilities have access to the nursing they deserve. A constituent mechanism will provide the framework for tightly targeted and time based exemptions only applicable in certain circumstances, such as smaller facilities in regional and remote areas. It will recognise the difficulties faced in rural and remote areas while ensuring providers do not utilise the framework to bypass the delivery of quality aged care. The government has established several programs to attract staff and support the retention needed to meet this new responsibility. This includes scholarships, support for clinical placements and new nurses, and nurse retention payments of up to $6,000 annually.

The bill will also put into effect the government's assurance to cap the amount chargeable as administration and management fees to those receiving home-care packages. This reform will enable the government to maximise the funding available to over 210,000 Australians receiving home care, with up to 50 per cent going towards administration and management.

Many of my family members work in aged care, and I grew up hearing stories about how little recognition they receive despite the incredibly challenging nature of their work. Their crucial importance to the health of every Australian was laid bare during the COVID-19 pandemic. The Albanese Labor government has prioritised the lives and livelihoods of working people since the beginning of its term, and it is not different with those in the aged care sector. Early this month, the government advocated a real pay rise for aged-care workers to the Fair Work Commission and committed to bearing the total costs of the increase. This is because the current government believe that everyone must receive the recognition and support they need and deserve.

It is essential to remember that the government's reforms are only the beginning of its work to solve the aged-care crisis. Significant consultation with a range of stakeholders is underway to inform robust and evidence based policymaking that will be enshrined in delegated legislation. This will be supplemented by new transparency and accountability measures in the bill, which will help older Australians, their families and policymakers make informed decisions about providing care. With this bill, the Albanese Labor government is taking the right steps in ensuring we leave no stone unturned and no person behind.

Russell Broadbent (Monash, Liberal Party) Share this | Link to this | Hansard source

Firstly, a shout-out to all the aged-care workers, staff, management, cleaners, nurses and other lines of aged-care providers—those people that right now, as we speak, are actually delivering services to our older Australians. I've spoken about ageing in place quite a bit. Ageing in place means that you can stay in your own community. It's important to every member of this parliament. Some of our facilities are tiny. Some are very large. But, from Moe to Trafalgar, to Drouin, to Warragul, to Leongatha and Korumburra, and from Phillip Island to Wonthaggi, to Foster and Neerim South—I just know that all of those facilities, right across my electorate, are providing the best service they possibly can and the best they can afford in the circumstances they're faced with tonight. So it's a big shout-out to all of those people, because they've been so disappointed in some of the things that have come out of the royal commission, particularly where they took it on board themselves. Everybody actually thought that they were the ones that were out of order, delivering the wrong service, and that wasn't the truth at all.

In regard to the royal commission, and listening to what has been said by members of the government today, the reason I have been very reticent on the royal commission recommendations is that I have to see how those recommendations actually affect the people in my electorate who are providing the services to older people. The full-time RNs are one issue. I don't even know yet who is going to be exempt from such a ruling. Is it going to be 12-bed facilities? I haven't got those in my electorate, but there are many electorates across Australia that have aged-care places with only 12 beds. Is it going to be because you're regional or remote, or have an inability to get particular staff at any given time—is that going to be a reason to get an exemption? And will my not-for-profit nursing homes feel that they're under threat if they can't get the nurses? What's going to happen?

When there is doubt and when there is uncertainty, you put uncertainty into the marketplace, especially for management groups that are volunteers. It would be the same in other members' electorates. You've got all these volunteers on boards. They're doing a wonderful job—a really hard job—making these facilities work in difficult times. The very large private organisations that have all their management and facilities in one spot, perhaps in one state, are totally different to what's happening at Lyrebird Village. Lyrebird Village in Drouin, though, have just amalgamated with a not-for-profit Tasmanian company, which is great. Because of the imposts that we as governments have put on these voluntary organisations, they looked into the future and said, 'I don't think our future looks very bright.' And they were very serious. They took it very seriously about projecting into the future and where they're going to be. So all their overheads have now been taken over by another organisation, which now frees them to just deliver the service and make sure that, in longevity, that facility is going to be there. They've also said that, if the new organisation decides to change and doesn't want to activate the Lyrebird Village anymore, if they sold the facility off, all the money would have to go back to the local community. That's not a bad deal.

I just want to take umbrage at the proposition that there was a decade of negligence. That's just not true, because I was very close to every decision the government made all the way through. A lot of the decisions that are coming through the new government today, the new Labor government, are things that have been worked on by a very special public service for a long time to bring them to this point, and now they're coming to fruition. I hope that the new arrangements will give some respite in some very difficult situations that we are facing, but I am afraid we are facing a very difficult time in aged care, as we have for a long time. It's changing all the time. The home-care facilities in my electorate are falling to bits, so we've got some difficult times ahead. I'm happy to work with the government of the day to make things better for all of our constituents.

Kristy McBain (Eden-Monaro, Australian Labor Party, Minister for Regional Development, Local Government and Territories) Share this | Link to this | Hansard source

I rise today to give an update to my communities on the Aged Care Amendment (Implementing Care Reform) Bill 2022. When I travel across my electorate, from Bombala to Yass, I'm listening to locals on the importance of aged-care reform and how much it's needed across regional Australia in particular. This bill implements three of our government's urgent election commitments that put security, dignity, quality and humanity back into aged care. These include supporting aged-care providers to get 24/7 registered nurses, capping home-care charges and greater transparency and accountability from aged-care providers and services.

My mum worked in aged care for the last 15 years of her career, and my nan spent her last years in an aged-care facility during the initial COVID outbreaks. I've heard firsthand from my mum about the importance of putting residents front and centre in any care plan. Mum talked about this part of her working life as being a privilege. For Mum, caring for, connecting with and protecting those who contributed to our communities was far more than just a job. But too many of her work colleagues just weren't making enough money and were required to work over multiple facilities.

This government made a submission to the Fair Work Commission in support of increased wages for aged-care workers and is committing to fund the outcome of the case. This government recognises that older Australians living in rural and remote areas deserve the same quality of care as those living in metropolitan Australia. This bill will introduce a new responsibility for approved providers of residential care and of specified kinds of flexible care to ensure they have a registered nurse on site and on duty at each residential facility 24 hours a day, seven days a week. This can only lead to better health outcomes for some of our country's most vulnerable residents. Importantly, rural and remote providers will be required to meet that particular standard of care. There are going to be exemptions because we need to demonstrate that there are appropriate arrangements in place to ensure the quality of care for and safety of residents. But, noting that there are particular challenges in the workforce at this point in time, we don't want our rural and remote providers to miss out.

More than 210,000 older Australians are currently receiving home-care packages, many in regional Australia. I've heard in Braidwood, in Tumut and in Eden the difficulty of accessing home care because administration costs have depleted the approved care package to the point where services cannot be provided. The bill reflects the government's commitment to capping the amount that can be charged for administration and management to people receiving home-care packages, and to removing exit amounts altogether. This measure will provide pricing transparency and enable the government to cap these charges. It also requires information from residential aged-care services and provider expenditure to be publicly available because we know clear information helps people make clear decisions. I support the transparency of information because it will help to level the playing field between community-based aged care and for-profit aged-care centres. We have seen the continual withdrawal of services from the regions, such as the closure of Roy Wotton Gardens in Eden and Currawarna in Bombala. Information will help us better understand the forces that are driving withdrawal across the regions.

We need to respect older Australians in care and receiving care at home, and I'm proud to be part of a government that is putting care and dignity back at the heart of aged care. A big thankyou to all of those aged-care workers—the nurses, the carers, the cleaners, the cooks, the administrators. It has been a particularly difficult few years across my electorate, from bushfires, where residents were being bussed out of particular areas, to floods to COVID. We appreciate the work you do. We thank you for the work you do in caring for our families. We are behind you, we support you and we want to get this right not only for you but for the residents of these centres.

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

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