Sussan Ley (Farrer, Liberal Party, Shadow Minister for Women) Share this | Link to this | Hansard source

The aged-care sector delivers fundamental support to older Australians and it is critical that we are also supporting the sector to deliver their services so that Australians have access to the best care possible as they age. The coalition will support this legislation to permanently establish the Inspector-General of Aged Care and the associated statutory office because it is through this establishment that reform, innovative ideas and problems can and should be explored and change embraced.

The establishment of an inspector-general follows recommendation 12 of the Royal Commission into Aged Care Quality and Safety. It is important to note that it was the former coalition government who called for the royal commission, provided a detailed response to the royal commission's final report and committed almost $19 billion to support the aged-care sector and deliver respect, care and dignity to our older Australians.

The Inspector-General of Aged Care will monitor and investigate the Commonwealth's administration and regulation of the aged-care system and report their findings and recommendations to the parliament and to the public. This will instil greater accountability, transparency and understanding of the work that occurs across our aged-care sector. With an ageing population, we know the needs of older Australians continue to evolve in this country. That is why we must address some of the fundamental challenges that the aged-care sector is currently facing—so that we can better respond to and implement reforms to properly address those needs.

We know that the most prominent and urgent issue currently facing the sector right now is workforce. It is critical that in the upcoming budget the government outlines the implementation of a whole-of-care-sector workforce plan. This plan must be realistic and focus on both immediate and long-term solutions to ensure the prosperity of the aged-care system. We are yet to see such a plan from this minister. There are some immediate levers the government could pull, including reviewing visa processing times for care workers, and, most critically, supporting the sector to value and upskill enrolled nurses to become registered nurses and remain in the sector.

Just last week we saw Prime Minister Anthony Albanese break his headline promise to older Australians. During the election campaign, the Prime Minister promised that every aged-care home would have a nurse on site at all times by July this year. But now, the Albanese Labor government has finally conceded that the promise can't be delivered, because the workforce just isn't there. We on this side have been warning the government about this for months and months. We knew that their one-size-fits-all approach to aged care failed to consider the significant workforce challenges before the sector. These shortages are most critically felt by small, regional, rural and remote providers. But instead of listening, the Labor government has caused serious distress and uncertainty for aged-care providers and the older Australians they care for. And we are at a loss to understand if the government will respond to the pleas from the aged-care sector by amending and expanding the exemption criteria.

Of course, the coalition unequivocally supports older Australians receiving the best care possible, but bringing forward the royal commission's time lines and imposing rigid constraints on the aged-care sector is both reckless and damaging. The coalition hopes that by establishing an Inspector-General of Aged Care, the independent oversight this would provide would assist the government to better support the sector as a whole.

The coalition supports the independence of the inspector-general and endorses the separation of the inspector-general from the Department of Health and Aged Care, as well as other government bodies responsible for administering and regulating aged care. This is an important safeguard and guarantees the impartiality required to monitor, investigate and report on systemic issues across the aged-care sector.

I note the number of submissions from a range of stakeholders during the consultation on this legislation and I anticipate the Senate Community Affairs inquiry into the bills, which ensures that every provider, consumer and peak body has the ability to further participate in the legislative process. The royal commission recommended that the governance of the aged-care system be subject to such ongoing scrutiny and that is why it is so important the inspector-general is empowered to review these government agencies to oversee their performance and decisions.

As a country member of parliament, I am lucky enough to regularly drop in and witness the amazing dedication to care from both staff and management of our local residential facilities. What they do not need is an added burden in finding and employing nurses, carers and admin staff just to tick unnecessary boxes. The inspector-general will have an opportunity to readily identify the unique challenges that we face in rural aged care, to make recommendations and, I hope, find a government ready to quickly adapt to those needs.

When I travel to aged-care homes right across the country I am consistently told of the complexities of the current aged-care system, especially around the complaints mechanism. The coalition is pleased to see that within the explanatory memorandum of the legislation, the inspector-general will also focus their attention on reviewing existing complaints mechanisms. The inspector-general will also consider how complaints, both from consumers and providers, are currently handled and provide recommendations to ensure systems are continuously improving and operating fairly and effectively.

In summation, the coalition will support the establishment of an Inspector-General into Aged Care, just like we supported it when we responded to the royal commission's findings. It would be remiss not to note the wonderful work of the current interim inspector-general, Ian Yates, who has a critically important understanding of the current landscape of the aged-care sector. I commend my remarks on the bill to the House.

Carina Garland (Chisholm, Australian Labor Party) Share this | Link to this | Hansard source

Today I would like to address the significance and timeliness of this Inspector-General of Aged Care Bill 2023. It is a fact that if we are fortunate enough in life we get to age. It is really vital, though, that everyone in our community, no matter what their age, is able to receive care with respect, compassion and dignity. I'm really proud to be part of the Albanese Labor government, which is doing what should have been done by the former government in taking the necessary steps to ensure that our aged-care sector is transparent and accountable to the public. In my community of Chisholm in the eastern suburbs of Melbourne, I hear—unfortunately, too often—stories of neglect that people have witnessed through family members or have experienced themselves in aged care. It is a shame that this has happened in a country like Australia, and it is time that this kind of neglect occurs no longer.

As we know, the Royal Commission in Aged Care Quality and Safety was established in 2018 in response to community concerns about the quality of care being provided in aged-care homes across the country. I acknowledge everyone who contributed to that royal commission, who shared their—often very difficult—stories which revealed some things that I think have been very hard to accept occur in a country like Australia. But accept them we must, and make change we must. The findings of the royal commission ranged from disturbing to chilling, and highlighted the need for urgent reforms in the aged-care sector. One of the key recommendations of the royal commission was the establishment of an independent Inspector-General of Aged Care to monitor and investigate the Commonwealth's administration and regulation of the aged-care system. The inspector-general's oversight will drive accountability and transparency across the aged-care system, shining a light on uncomfortable, systemic issues and investigating their root causes.

This bill is a vital piece of legislation that will significantly improve outcomes for older Australians by ensuring greater accountability and transparency across the aged-care system. We know that the Royal Commission on Aged Care Quality and Safety identified significant shortcomings in the current aged-care system. This bill will establish an independent Inspector-General of Aged Care who will monitor and investigate the Commonwealth's administration and regulation of the aged-care system. The inspector-general will report their findings and recommendations to the government, to parliament and to the public. This will instil greater accountability and transparency across the aged-care system and help facilitate positive change for older Australians and their families—something we in this place should all agree is a necessary and appropriate measure. A measure like this helps to assure the public of Australia that this is a government that wants to be transparent and wants to be accountable, and this goes some way to restoring faith in government and institutions like the parliament.

The Inspector General of Aged Care Bill is a key part of our government's commitment to be open and transparent. It is a significant step towards restoring the public's trust in how our most vulnerable Australians are being cared for. This bill establishes an Inspector-General of Aged Care and a statutory office to support them in the performance of their functions. It's important to note that the inspector-general will be separate from other entities within the aged-care system—such as the Department of Health and Aged Care—to ensure they can provide effective, impartial and transparent oversight of the system. To inform their functions, the inspector-general will have coercive information-gathering powers. These powers will be balanced by appropriate protections to ensure that those assisting the inspector-general will respond with full and frank disclosure. This bill sets out a legislative framework within which the inspector-general will conduct reviews and publish reports. It is important to note that the reviews will not relate to individual complaints or actions; rather, the inspector-general's independent oversight will bring an impartial perspective to considering the complex issues into the aged-care system and allow them to make recommendations for improvement.

This piece of legislation gives relevant parties, particularly those subject to a proposed adverse finding, an opportunity to respond to any proposed finding before a review report is finalised. The inspector-general will prepare a final review, to be tabled by the minister in parliament within 28 days of their findings. The inspector-general may also compel a government body to respond to the recommendations in the final review report and publish their response in conjunction with that report. The consequential and transitional provisions bill amends the other legislation which governs the aged-care system, to facilitate the provision of information to the inspector-general that is subject to secrecy provisions.

Through nine years of neglect, the Australian public lost trust in our how most vulnerable Australians were being cared for. The royal commission was a damning assessment of an aged-care system in crisis. So many of us in this chamber and in our communities have heard firsthand some of the stories of neglect that people unfortunately were experiencing in the aged-care system. We've heard really distressing stories not just from the residents, of course, but from staff and carers in the aged-care sector, who have witnessed terrible things—chilling things—and it is high time that we have reform in this area. I would hope that something everyone in this place can agree on is that the most vulnerable people in our communities deserve the absolute best care and representation from us here in this chamber. It is my hope that this parliament will do what needs to be done to improve this sector.

After years of ignorance, the final report of the royal commission was a call to action to put people back in the centre of aged care. This bill is another step towards restoring trust between the Australian public and the parliament, which, unfortunately, was broken by the former coalition government. The Inspector-General of Aged Care will also play a crucial role in ensuring that the Australian public can have confidence in the aged-care system. Older Australians deserve the very best possible care, and having an inspector-general of aged care will go a long way to ensuring they receive it.

The need for change in aged care has never been more urgent. As our population ages, the demand for aged-care services is growing, and we must ensure that these services are of the highest quality and standards. This Inspector-General of Aged Care Bill is a critical step towards achieving this important goal. Whilst we appreciate that the aged-care system is complex and that addressing its shortcomings will require a comprehensive and coordinated effort, the Albanese Labor government is committed to this process—to getting it done—as we told the Australian people we would.

This bill is a crucial step towards transparency and accountability in aged care. The establishment of an independent Inspector-General of Aged Care will facilitate positive change for older Australians and their families. They will monitor and investigate the Commonwealth's administration and regulation of the aged-care system, shining a light on systemic issues and recommending improvements. The Commonwealth is not hiding from our responsibilities to some of the most vulnerable people in our communities. We owe it to our older Australians to provide them with the care and respect they deserve. This bill will go a long way to helping us make this a reality.

James Stevens (Sturt, Liberal Party) Share this | Link to this | Hansard source

I rise to speak in favour of the creation of the Office of the Inspector-General of Aged Care. In particular, I hope the inspector-general will have the ability to oversee the accuracy of the implementation of government policies that were announced in the election. From my point of view, I really do look forward to the inspector-general having a look at those policy documents—those bold claims that were made during the campaign, about pay rises of 15 per cent and 24/7 nursing in all aged-care facilities—and whether or not the government are accurately reflecting what they said in the campaign, now that they've got the opportunity to implement that as a government.

What Labor said they'd do about the wage rise, in particular, is something I hope the inspector-general has a good look at. I certainly saw in my electorate and throughout the country—I'm sure it was the same—that they were going to give a 15 per cent increase to the aged-care workforce. So you would expect that, when the government put in their submission to the Fair Work Commission about wage increases for the aged-care workforce, that would have been the submission they put in. It's a fairly straightforward policy position to implement: if you're elected, when you come into government you correspond with the Fair Work Commission and you put in a submission saying: 'We would like to see the aged-care workforce get a 15 per cent increase in their wages.' What happened? Well, regrettably not that. What we instead saw was that the government adjusted that policy position, so when they said it was going to be a 15 per cent wage increase, the submission that the government ended up putting in was something quite different, quite clarified. It became a 10 per cent submission for 1 July 2023 and then the further five per cent by 1 July 2024.

I do not know who writes the Labor Party's policy documents but this person needs to learn about the power of the asterisk, because when they are writing these policy documents they need to add in these clarifications that they leave out of them that are very relevant for people to understand when they're casting their ballots. The Labor Party policy position on this needed to have an asterisk next to that 15 per cent, and it needed to say in the footnote: 'But what we really mean here is 10 per cent and then another five per cent.' Don't forget, of course, that 15 per cent was in an environment of dramatically lower inflation than we have since had in the intervening period between when the policy commitment was made and when the government made their submissions to the Fair Work Commission. The 10 per cent—which was 15 per cent during the election campaign; in a dramatically lower environment of inflation—would've really turned out, if the government had got their way, and thankfully the Fair Work Commission didn't fall for that trickery, to have effectively been a real wage increase in 2023 of about two per cent. In the campaign the government said they wanted to increase wages in the aged-care workforce by 15 per cent. When they were then elected and had the chance to implement that they were effectively submitting for a real wage increase of about two per cent for that workforce.

Thankfully, the Fair Work Commission ruled differently. They have given an interim order for a 15 per cent increase across a broader category of awards than those that the government submitted on as well, all relevant to the aged-care workforce. The policy that the government had in the campaign, that they then tried to wriggle out of through their submission to the Fair Work Commission, will indeed still be implemented at the 15 per cent rate. I welcome that, because with inflation running as hot as it is that 15 per cent is nowhere near the significance that it was meant to be when the policy commitment, that the Labor Party made and then tried to renege on once they came into government, was announced during the election campaign.

I wish the Inspector-General well in looking at that issue. I think it would be very relevant for the Inspector-General to advise the government on the need to be honest with the aged-care workforce, not tell them one thing in an election campaign and then submit something totally different when you come into government. The excuse for that, of course, was the deteriorating fiscal situation. So we've now got a government saying: 'We don't believe in wage increases necessarily if the fiscal situation changes.' I don't remember that in the fine print in the election campaign either. I don't remember them saying: 'Well, we'll give you a 15 per cent wage increase unless the fiscal situation deteriorates and then we won't.' That wasn't on any billboards or part of any slogans or on any television commercials. My advice to the government is to brief their ad agency on that additional wording into the future when they are making those commitments. If they could just make them honestly with full disclosure and make sure that the slogans reflect what they're actually going to do when they get elected.

The second one, of course, was quite significant. It was the 24/7 nursing care in all aged-care facilities, which we're now told won't be happening. The Labor Party said, in the campaign, that if they were elected to government they would implement this policy of having 24/7 registered nurses in all aged-care facilities. Now that they've come into government they're now saying that won't actually be possible. I look forward to the Inspector-General having a look at that, because, again, I didn't see on the billboards or on the television commercials any sort of caveat on that policy position about permanent, constant nurses 24/7 in aged-care facilities. I think that the Inspector-General would do well to look into that, to look at why it is that the government said in the campaign that they would implement that policy position and are now saying that they won't. It will be quite a revelation to understand what has changed from the government's point of view, what new information has come along.

There's no new information that I'm aware of around the challenges of implementing that policy. When the coalition was in government, we pointed out all the challenges that this government is now using as excuses for not implementing that policy. I think it would be good to see the Inspector-General get to the bottom of that as well. It would be very interesting to know why those opposite said things around wage rises and permanent nursing staff for the purpose of winning votes. They made those solemn promises, and people chose to believe them, which is a reasonable position for the Australian people to take. When a political party says, 'Vote for us and we'll increase wages for the aged-care workforce by 15 per cent, and we'll put in place 24/7 nursing care,' it's a reasonable proposition that, in some cases, people voted for them because they believed that's what they would actually do, but now they've found it's not happening. That is very regrettable, and there would be a lot of people out there who would feel extremely misled by the government around that.

The Inspector-General might do well to have a look at some of those issues, and whoever he or she may be can report back to this parliament. This legislation does provide for this independent mechanism, which we strongly support, to look at the system as a whole, to look at a range of different elements of how the aged-care system works and to provide advice to the executive of government and to the parliament. It was obviously a recommendation from the royal commission. I commend the former coalition government, which I was very proud to be a part of, for instigating that royal commission and bringing forward recommendations like this, which we are now in the process of implementing.

I think all of us in this House are very touched and impacted by the importance of the aged-care system, both as members of parliament and as merely human beings with family members. I would expect that, at some point, everyone in this chamber has had a family member that has had interaction with, and needed the support and care of, the aged-care system. My last surviving grandparent is currently in an aged-care facility, and he is getting an excellent standard of care. We are very grateful as a family for the fact that the aged-care facility he is in is doing an excellent job and providing him with care in these final stages of his life. With the challenges that have been thrown at the system, particularly around the COVID-19 pandemic, our family's experience has been that they have done an excellent job in some very difficult circumstances in the last few years.

As a member of parliament, like all others in this chamber, I regularly visit aged-care facilities in my electorate and meet with the leadership and management of those facilities and the people that are running system-wide aged-care networks in my home city of Adelaide and home state of South Australia. I'm sure we all share a very common objective of making sure that our aged-care system provides the highest standard of care for people in their last stages of life. It should be like at any stage of life—one where the greatest amount of support and comfort that is possible is provided.

Obviously, the royal commission was very confronting and had some very concerning revelations, but we are grateful for the fact that we have had that process and we can therefore engage with the recommendations to improve the system. Of course, reform in this area is very complex. We know the two royal commissioners did not completely agree on all of the recommendations that were provided through that royal commission process. We had some that were from one royal commissioner and some different perspectives in that same topic area from another royal commissioner. We respect that it is an extremely challenging area.

I just want to conclude by making some comments about the workforce, because I think this is becoming a very consistent, significant challenge in the care sector more broadly. I very respectfully say that I hope that people in the care sector know that, when we talk about the overarching care sector, we completely understand and respect that it is not fair to suggest that people working in the aged-care system are completely interchangeable or have exactly the same type of skill set and requirements as those in the disability sector or the healthcare sector or the childcare sector. There is very specific training and there are very specific talents that people have for the roles they perform. I don't in any way try and clump those people together and suggest that, if you work in a childcare centre, your skills and your capacities are pretty much similar to those of someone that works in an aged-care facility, because that's of course not the case whatsoever. But the commonality between these different roles within the care sector is that they've all got enormous workforce challenges and workforce shortages. These are particularly acute in regional and rural and remote areas.

I think it would make a lot of sense for us to have an integrated workforce plan. There is a consistency of the challenge across the aged care, disability care, health care and child care sectors. They are all sectors that have frightening workforce projection gaps between what the demand is—even currently, let alone going into the future—and what the supply looks like. I think we need to be very nimble and very broad in the way we which look for solutions, which are going to have a lot of elements to them. There is some complexity, and they're going to need an enormous amount of financial support to make sure that we are investing in building a workforce that is going to meet that demand.

It is absolutely not acceptable for us not to have a plan to make sure we deliver the standard of care that Australians deserve, whether they're in the aged-care sector, the healthcare sector, the disability sector or the childcare sector, whatever it might be. Even in education, in the teaching profession, these shortages are challenges. It is just unacceptable for us not to have a plan in place to ensure we have the workforce necessary to provide the highest standard of care for people that need it from those systems that we fund as a government. That is vitally important. It is becoming quite frightening to look at the outlook across all those various elements of care in our society, in our communities. So I urge the government to bring forward something of great substance and robustness and depth in this area of policy, in workforce planning in those areas, and to look for a variety of solutions that ensure that we can take that graph, which is diverging dramatically, and bring it back together so that demand and supply are meeting each other well into the future.

With those comments, again, I commend the work of the members of the royal commission. This measure is a recommendation of the royal commission. We in the coalition committed to implementing this after the royal commission's recommendations were provided to government, and we very happily support this bill progressing through the parliament. I commend the legislation to the House.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Inspector-General of Aged Care Bill 2023 and a related bill. As previous speakers have mentioned, it's not easy to place a parent into an aged-care facility. I think many MPs would know what that means. I say that, having for over more than a decade dealt with constituents who have gone through that process and the complexities that it involves. People get confused, some people are tricked, and people are disappointed.

This year, I've actually gone through the same process with my father in country Queensland, a process further complicated by being one of 10 children. My lived experience confirms there are a range of reasons that make it hard for families to make decisions. Just like hundreds of thousands of Australians, my family and I have, over the last few months, made the tough decision to put a parent into a nursing home—that horrible life journey from capacity, where they make their own decisions, to not having capacity, and other people step in, hopefully with their best interests at heart. They go from being a fully functioning member of society and transition to becoming somebody requiring care. There are black-and-white legal terms like 'capacity', but we all know there's a world of grey between those two legal concepts—a world of tears, a world of tough decisions. So I understand the conflict and the number of emotions and fears that people go through when making these tough life decisions.

These tough days for families have not been helped by the almost 10 years of neglect that can be laid at the feet of the coalition. 'Neglect' is an emotive term, but it is also empirical. Remember that that was the title of the interim report handed down by the royal commission into the aged care sector—Neglect. What a cruel word for the cruel world visited on some of our most vulnerable Australians, all those older Australians who helped to build our wonderful country, who sacrificed so much during the Second World War, seniors who worked hard, paid their taxes, contributed to communities and raised their families. Those folks have their names on our street signs but were then hidden away in some cold hard place where society saw no sign of them. They suffered, using that umbrella term, neglect.

Seniors rightly expect a federal government that will respect and support them in their frailer, more vulnerable years. That's what they deserve and what they've earned after a lifetime of contributing to society. We can't ignore this social licence. To do so would be a betrayal of civilisation.

I will point out that no Labor government is blameless, but the former coalition government consistently let our senior Australians down over the last decade. It was a rot that started when the member for Cook was Treasurer. In his first budget, he cut $1.2 billion from aged care by demanding efficiencies over four years. This was already a sector under strain. So, after 23 different reports, which I suggest were more about time wasting than actually achieving change, the Abbott-Turnbull-Morrison government knew older people were suffering in aged care and yet didn't fix the problems. They did very little to address the issues of malnutrition and substandard care in aged-care facilities. The coalition had nearly a decade to fix their mess and yet all that happened was the situation actually became worse.

The Albanese Labor government does not want older Australians—our parents, our friends and our neighbours—to experience the horrors of a failing aged-care system. A wealthy nation like Australia can and must do more to ensure that our seniors live lives filled with safety, respect and dignity. So now as the government we are doing what we can to make sure that happens. Obviously we came to government knowing that the aged-care sector was in crisis. We came to government knowing that it had been in crisis for nearly a decade and perhaps even more than that, as we might hear from other speakers. The warning signs were there. Our vulnerable and senior Australians and their families were crying out for a government to act. Over the last decade, there were those 23 reports and inquiries, studies, committee reports and a royal commission telling us that same consistent story.

That's why one of our first pieces of legislation as a Labor government was the Aged Care Amendment (Implementing Care Reform) Bill 2022. The minister for aged care said while introducing the bill that the aged care amendment bill was the beginning of the process of returning security, dignity, equality and humanity into aged care. Last week, the Albanese government introduced key legislation to continue to increase the level of transparency and accountability across the aged-care sector.

The Inspector-General of Aged Care Bill before the chamber today will establish a new statutory office, the Inspector-General of Aged Care, supported by a new statutory body, the Office of the Inspector-General of Aged Care. This bill demonstrates our continued commitment to improving the aged-care sector and building confidence back in a sector that has fallen so far in Australian eyes. This bill further adds to our government's response to the royal commission. It was a royal commission that should not have been needed, because older Australians should not have been left in such a parlous state of neglect. Once passed, the Inspector-General of Aged Care Bill will establish an independent body with coercive information-gathering powers so that they can turn up and knock on a door and compel people to answer questions rather than just giving people warning so they can scrub everything. You need to be able to turn up and inspect. It will give the Commonwealth's administration and regulation of the aged-care system expertise. The bill will give the inspector-general the necessary powers to investigate systemic issues across the aged-care system, including the complaints management process. We can't fix these problems without tackling them head-on, without fear or favour.

Very importantly, the inspector-general will also report findings and recommendations to government, parliament and the public to facilitate positive change for our older Australians. Reporting by the inspector-general will be public and must be tabled in parliament within 15 sitting days—lots of sunlight. This is necessary if we're to build trust, confidence and accountability in the aged-care sector. The inspector-general will also have the power to report on the government's implementation of the recommendations of the Royal Commission into Aged Care Quality and Safety, again a very important factor in making sure there is accountability and transparency in government processes. Governments cannot be left to say they will do something; they must be able to demonstrate that they've achieved it and that this action is accounted for.

The most important thing about this role is that the inspector-general will operate autonomously. The Office of the Inspector-General of Aged Care will be completely separate from the Department of Health and Aged Care and the other government bodies responsible for administering and regulating aged care. This will protect the independence and integrity of the inspector-general and bring an impartial view to monitoring, investigating and reporting on issues across the aged-care sector. The Royal Commission into Aged Care Quality and Safety highlighted a clear need for independent oversight of the administration and regulation of the aged-care system.

The commission also recommended that the governance of the aged-care system be subject to ongoing scrutiny. This means the inspector-general will have oversight, at a systemic level, of the existing government agencies with aged-care responsibilities. But it will not have responsibilities for the development of policy, nor for the administration, funding or delivery of the aged-care system. This approach preserves independence and mitigates any perception of a conflict of interest in the office's functions.

The bill enables the inspector-general to use their information-gathering powers to monitor decisions, programs, operations and funding under aged-care laws, to maintain a comprehensive understanding of what is occurring, what trends are emerging, what systemic issues are prevailing and what insights there are from a holistic view. This is all designed to assist the work of those incredible aged-care workers who, we all know, are doing their best every single day for the people they care for. It will give assurance to the public and aged-care bodies on the priorities of the inspector-general.

The bill requires the inspector-general to publish, each year, a workplan outlining the reviews they intend to conduct and when they intend to commence each review. This plan may be varied at the discretion of the inspector-general.

As mentioned earlier, the bill empowers the inspector-general to report to the government—also, equally importantly, to the parliament and the public—on the progress of implementing the royal commission's recommendations. Progress reports will occur annually to ensure that aged-care reform remains a priority. We know that there are many challenges. We know there are workforce issues. There are workforce issues in the electorate of Moreton, which is almost an inner-city electorate, and it's even more complicated in the bush. Older Australians and their families will see the benefit of the reform coming from these recommendations. This bill requires the inspector-general to undertake a detailed review and report to the government, the parliament and the public at the five-year mark and the 10-year mark.

This bill also makes sure that the royal commission will not be another missed opportunity, another one of those 23 reports sitting on the shelf gathering dust. It makes sure someone has the autonomy to say whether or not things are effective and to call out governments of whatever hue. As the minister said last week when introducing this bill, 'The bill I introduce today will steer a course to an aged-care system that deliver safe and high-quality aged care and underlines our commitment to holding ourselves accountable.' As a government, we now have the opportunity and responsibility to make sure that in the lives of our parents and grandparents in their senior years, our oldest Australians, there is humanity in the provision of care, and that, wherever possible, they are able to live their lives with dignity.

The royal commission, which many of us spoke about while we were in opposition, challenged this nation to do better. The legislation before the chamber will make sure that we do, and I commend it to the House.

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

Whether it be aged-care legislation or other legislation brought before the House, there's a concern for me that has emerged in the last couple of days, and it has been greatly disappointing. The member for Moreton has taken me to that place again, and I just want to put a couple of things on the record.

This bill confirms the new position of Inspector General of Aged Care and all the things that go round that. What disappoints me—from each side, not just outside—is that there has to be an attack on the other side in the process of any speech. There are actually no grounds for that. I can go back all the way to the Hawke government and to the criticisms of governments across that time over various issues. There were criticisms in regard to aged care. But remember, when we're speaking in this house, that we're speaking to everybody out there.

There are a whole lot of people who worked in aged care and were caring, responsible, engaging, loving people. They worked with people in aged-care facilities, and when they hear politicians today speaking about the failures of other politicians in the past to fulfil the needs of those in aged care, they think, 'Well, that didn't happen in my facility. What are they talking about? It must have happened in other facilities or we wouldn't have had a royal commission that had to find issues around aged care, that's for sure.' But every one of us have aged-care facilities in our constituencies. We know what's going on. We know what a great provider is. We know how people's lives are often changed, moving from their home to an aged-care facility, because we see them begin to thrive when they get the care that they need at that stage of their lives.

There have been three instances that have disappointed me in this parliament. Every time I've come into the parliament I've tried to bring in some reasonable decorum, especially in regard to the other side. I try to keep the individual out of it and talk about the policies of the government of the day, and that's expected. Has there been criticism of former governments over aged care? Yes, there has been. Have many been blown out of the water to an extreme? I will go back to when former member Bronwyn Bishop, the former Speaker and former senator, was responsible for aged care and there was an incident somewhere in Australia around a tiny bit of kerosene being put in a bath. That was beneficial, apparently, to the people who needed it. That aged-care centre having that kerosene bath became her absolute responsibility, and it was big news all over the place. It couldn't have been more disappointing.

The aged-care minister and ministers of the day are responsible for their portfolios. They can't be responsible for every individual acting in every aged-care facility across this country, especially when you know who, in my electorate alone, 99 per cent of the people working in the aged-care industry are dedicated to: their clients. It's not the highest paid job in the world. You need to be a very special person to be caring for older people. To give you some background in history, when I was first elected, the average stay in an aged-care facility was about 10 years. Now, in this day and age, the world has changed. That model of caring for people in community, born out of the bush nursing hospital, created across our country just after the war, said that, when someone was perhaps lonely, in difficulty and in need of care, they went in, possibly at an early age—sometimes under 60—and stayed in that village for a long time.

But times have changed so dramatically, and the way we care for people in their homes and the energy government puts into that means that people are not going into aged-care facilities until much later in their lives, and when they go in in the year 2023 they are far more frail than they ever were in the fifties and sixties. So governments have had to change with them. Each government that I have observed or served in had the same desire for care for people in aged-care facilities as any other government. I have heard the criticisms of the former Turnbull government, the former Morrison government and the former Abbott government today in this chamber. Those are disappointing, because each of those governments poured extra money into aged care every year. And so did the Rudd-Gillard government put extra money into aged care before that.

I can take you back to the start of the Howard government: there were reforms around aged care that cost the government greatly, politically, but which have proved to be a success over time. They were the right policies, but they were used by the opposition in the full knowledge that there's a political advantage if you strike fear and doubt into the Australian community about aged care. Who do they have in mind when issues like these around aged care come up, when we actually want to care for and make the industry viable? We call it an 'industry' now, because it is; it's a multi-multibillion dollar industry. Some are privatised, some are not-for-profit and some are quasi-not-for-profit organisations—there are churches which run aged-care facilities. They're big organisations—in fact, the smaller aged-care providers are being swallowed up where there's an advantage to the private provider.

That horse has bolted: it has gone, and governments are now under strain to keep funding up. I can remember in the last days of the Howard government that Mr Howard, the Prime Minister, asked me what I desired for my electorate and for Australia. He said to me, 'Russell, please, don't ask me for more money for aged care!' At the start, the Howard government was spending, I think, $2½ billion dollars on aged care. Then it went to six, then 12, 14 and 18. It was fortunate that the government at that time was able to fund those huge increases in aged care as our population aged. What did they want to do—your parents, my parents and those people that the member for Moreton talked about, who built this place and this country after the war; those people who committed themselves to the education of their children and to the growing of their own wealth and therefore the wealth of the nation; and those people who came here from war-torn Europe to make a new life, and so many more after them with their children to make a new life? They wanted to educate their children—that was the first thing. Even though English was their second language, they made sure their children spoke English and they made sure they got the best education they could afford for them; whether that was state, private or Catholic it didn't matter. They knew their future was through education, and it was. Those generations went on to be the doctors, solicitors and surgeons of this world. And the politicians: there's one sitting in the deputy's chair at the moment, Acting Deputy Speaker Vamvakinou.

They made great contributions. They age, and the interesting part is that when they age and go into an aged-care facility, even though they speak very good English in their older years they revert back to their old languages. They then need specific care from people who can understand that they've gone back to their old language, so we have specialist facilities by those communities, drive by a need to care for their elderly parents, although that generation mostly kept their own parents at home and there's still groups and societies in our country today that choose as best they can to keep their parents at home for as long as possible by keeping them in their household or having them move into their household when one or the other passes away.

That's why I just don't want to see aged care and an incident that happened in Victoria on the steps of the parliament brought into this place with this huge accusation against the Leader of the Opposition from the Attorney-General when he had nothing to do with it. It was a long bow. But he didn't only include the opposition leader in his attack; he included me as well.

A new member of parliament—I won't name her or what seat she was from—accused me of being a misogynist last night. She didn't understand. I don't know who wrote it for her, but it can't have come out of her experience of this place or me or anybody else. She said: 'I wasn't talking about you, Russell—not about you. I was talking about your party.' What does she know of my party? What does she know of the members? How could you say such a thing in this House?

When the new Prime Minister came in—and I've seen a few of them come in—he said: 'I want a better parliament. I want a more reasonable parliament.' Isn't it about time he started to pass it on to those on the floor of the parliament? A deputy Speaker shouldn't have to pull up a new member of parliament for accusing the opposition of being misogynists. Why? It's totally out of order. I don't believe she wrote the speech. I believe she's a good person.

When I'm talking about aged care, I'm talking about the care that goes right across the community too, because we reflect our communities. We reflect the electorate that we're from, and in my electorate, the electorate of Monash, I can tell you that, for aged-care provision, over all the time I've been in and out of this place since 1990 and from everything I learned about aged care before 1990, people were giving wonderful service and provision to their older people with respect and trust from the families that have their older people in those aged-care facilities. There was trust from them that their parents and grandmums and nannas will be cared for within that facility.

I want to finish by thanking everybody who's a retired aged-care worker not to take this personally. It is not an attack on you. It is only about so-called 'divisions' within this parliament. That type of attack has to end. The Prime Minister has given the lead. Let's follow the Prime Minister's lead—everybody in the parliament.

Zaneta Mascarenhas (Swan, Australian Labor Party) Share this | Link to this | Hansard source

A society should be judged on how it cares for its most vulnerable. My husband's nanna, Dawn Hurst, is 98 years old. She's an amazing and tough woman who's done a wonderful job of bringing up her children. She loves her children dearly and she's contributed to her community year after year. From the age of 95, her health deteriorated. It was really heartbreaking to witness this. Her daughters, who loved her so dearly, during this time basically decided to go on a family roster and stay with her 24 hours a day. They did this because they did not have trust or faith in the aged-care sector. They did this because they loved her, but they also did this because they did not have trust. At that time, we were seeing the horrors that were being shown through the Royal Commission into Aged Care Quality and Safety. They wanted to hold out for as long as possible to keep her out of that system. Eventually, Dawn's needs became quite high, and they found an aged-care home that they were happy with. But what this highlighted to me is that we need to fix the system. We need to make sure that this is not something unusual. We need to fix it for all Australians.

Our most experienced citizens have given our country so much. Heck, they built this country. They deserve dignity and respect in their oldest and most vulnerable years. The Royal Commission into Aged Care Quality and Safety received over 10,000 submissions and called over 600 witnesses. The commission consulted widely in its deliberations over an almost 2½-year period. What came from this shocked me. I felt shame. And it was worrying to see that there was a sense of acceptance of what was happening in our aged-care sector. In some of the cases that we discovered, residents were left soiled for extended periods of time due to understaffing. Nappy rash is something that babies experience; it's not something that our older citizens should experience. The average that was spent on residents' food was about $6 a day. Prisoners, in comparison, receive about $8 a day. Incontinence pads, in one instance, were left unchanged for 16 hours. There were also several cases of wounds being left untreated and festering. And then there was also malnourishment and weight loss due not just to the quality of the food but also to residents not being assisted with eating. No-one in my community of Swan would accept this and, really, no Australian would accept this.

But let me be clear: this is not about blaming workers, who are frequently overworked and underpaid, and who honestly want what's best for residents. Often, it's these workers who become whistleblowers, highlight these affronts and want to see increased dignity. What it's about is the system, and the royal commission highlighted that we need to fix the system. We need to set up workers and residents for success. I also want to recognise the workers for all they've done to help our elderly and vulnerable, and I'd like to acknowledge the work the United Workers Union has done to highlight some of the issues we're discussing today.

Unfortunately, we can't fix the problem without fundamentally understanding the problem. There's the saying that you 'can't manage it if you're not measuring it', but the system also needs to ensure there's integrity in the numbers and integrity in the complaints, and that complaints are being handled properly. There needs to be trust in the system. I'll read a quote from volume 1 of the interim report from the Royal Commission into Aged Care Quality and Safety:

People become unwilling to complain for fear that care will become worse, as they or their family member will be labelled as 'difficult' by the provider. Several submissions have highlighted occasions where the treatment of the older person deteriorated after complaints from family members—with neglect transforming into the withholding of care. It is disturbing that the aged care sector is not sufficiently mature or professional to listen to feedback from those who use and observe its services at close hand, particularly when the regulatory system appears so distant and ineffectual.

The thing that I'd say is that this systemic problem has not been fixed. A friend whose father is in aged care explained to me that her father had complained about a particular carer. That carer was then moved off his ward, but then other carers treated him differently because he complained. They treated him unfairly.

So that's what this bill is about. It's about sunlight. Sunlight is said to be the best disinfectant, and there's a sickness at the core of parts of this sector and that must be challenged by shining a light onto these practices and empowering complaints. That's exactly what this bill will do.

Another one of my constituents came to my office with a really serious aged-care issue involving misconduct. The aged-care worker had come into their home to provide care and assistance to them and, instead, this person received verbal abuse. It wasn't what they were expecting. This experience left them shaking. They have expressed that they would like to see greater transparency in aged care and that this is something that needs to be fixed. If action on the issue of transparency had been taken sooner, perhaps my constituent would have had a more positive experience.

Those who are in aged care are some of the most vulnerable Australians and we must stick up for them, and that's what this bill is about. All of us, whether it is the Department of Health and Aged Care, aged-care providers or the parliament of Australia, must be held accountable for the decisions we make and the outcomes that they create for our aged and vulnerable.

The Inspector-General of Aged Care Bill reinforces the Albanese Labor government's commitment to be open and transparent with the Australian public. This bill will establish an independent inspector-general of aged care who will monitor and investigate the Commonwealth's administration and regulation of the aged-care system. This is an inspector-general who will shine a light on uncomfortable and systematic issues and investigate the root causes. When you understand the root cause of a problem, you can come up with solutions to fix it. This is an inspector-general who will report findings and recommendations to government, to parliament and to the public to instil greater accountability and transparency across the aged-care system and, in turn, facilitate positive change for older Australians and their families.

This bill directly corresponds to recommendations 12 and 148 of the royal commission. Recommendation 12 said:

The Australian Government should establish an independent office of the Inspector-General of Aged Care to investigate, monitor and report on the administration and governance of the aged care system.

Recommendation 148 said:

1. The Inspector-General of Aged Care should monitor the implementation of recommendations and should report to the responsible Minister and directly to the Parliament at least every six months on the implementation of the recommendations.

2. The Inspector-General of Aged Care should undertake independent evaluations of the effectiveness of the measures and actions taken in response to the recommendations of the Royal Commission, five and 10 years after the tabling of the Final Report.

3. The Inspector-General of Aged Care should report on these evaluations five and 10 years after the tabling of the Final Report.

I believe in continuous improvement, and this is a characteristic of high-performing organisations. We always have to strive for better. Continuous improvement is actually a critical component of the resources sector. The thing I would say is that this is a culture that's important in all sectors. We should constantly be looking at what's working and what's not. This is a conversation that should be public. We should ensure that when systematic issues become apparent that the inspector-general prepares a final review report that is tabled by the minister in parliament.

What we as the parliament are undertaking is truly transformative. We are setting in place measures to grant dignity in older age and ensure quality care, which will contribute to the greatness of our towns, cities and country. The interim report said:

The Australian community generally accepts that older people have earned the chance to enjoy their later years, after many decades of contribution and hard work. Yet the language of public discourse is not respectful towards older people. Rather, it is about burden, encumbrance, obligation and whether taxpayers can afford to pay for the dependence of older people.

What we have brought before the 47th Parliament challenges this view, and I hope that our actions today meet the expectations of community and ensure that dignity and care is afforded to those in need. Most importantly, this bill is about restoring trust in our aged-care providers to do the right thing by residents; trust in our agencies to offer effective regulation and oversight of our aged-care providers; and trust in the Australian government to do the right thing by the community.

I think that it's important when we're in this place that we remember what we're doing; what we're doing is talking about people, who are at the heart of this bill. It's about someone's brother, or sister, or mother or father. I know that, for me, I could not do my job as a member without the support of my 84-year-old mother. In my culture, the idea of aged care is a bit of a foreign concept. The thing that I know is that, if there comes a time when my mother or father needs access to aged care then I want to make sure that they're getting the best care possible. I don't want it to be a unique experience for them; it needs to be amazing quality for all Australians. In the end, what this bill is about is happiness and health, and I want that not only for people in aged care but also for the workers too. Having access to a positive work environment is really important.

During the election campaign, the team and I knocked on 45,000 doors, and I remember one particular conversation that I had with a woman who was a migrant and had come to Australia. She had had an incredibly successful corporate career. She explained to me that she was watching the royal commission and could see that change was happening, and that aged care was going to be improved. She decided to go back to study and become an aged-care worker because she wanted to give back to the community. She wanted to be part of a system that was really positive and she wanted to spend time with our oldest Australians, to give them the dignified retirement and conditions that they deserve. I think that this bill goes to addressing that. I commend the bill to the House.

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

I rise to speak in support of the Inspector-General of Aged Care Bill 2023. Today I'm thinking about Edie Dryden. Edie is the north-east's leading centenarian. In fact, she's one of the oldest people in Australia. She celebrated her 107th birthday last year. She has six children, 19 grandchildren, 29 great-grandchildren and 47 great-great-grandchildren. Edie lives in residential aged care in Yackandandah. She lived independently until she was 101, and then she moved into a facility in the same town that she had first come to in December 1960. She has now lived there for over 60 years. We owe it to people like Edie not just to talk about fixing the system but to actually make it happen.

As the royal commission reported, our aged-care system is broken. As a result, too many older Australians are denied high-quality and safe care. Countless reports have told us so. Successive governments saw these problems and papered over the cracks. The system is opaque. We need to do better, and this bill is a step there. This bill establishes the long-awaited Inspector-General of Aged Care, implementing recommendation 12 of the royal commission report. The commission recommended an inspector-general to provide strong oversight to a system that for some time has fallen short of providing care and support to allow people to age with dignity. The inspector-general will have powers to identify, monitor, investigate and report on systemic issues in our aged-care system—the common, deeply rooted, complex issues. The inspector-general can also investigate the complaints system, which is a big concern for many of my constituents who have experienced distressing and unsatisfactory frustrating processes. Importantly, this bill brings a new level of transparency and accountability to the aged-care system. It will report to the parliament and the government on these issues, and recommend solutions to bring about real systemic change.

Ensuring our aged-care system is transparent and accountable is one step towards instilling the trust of families, older people and workers back in a system that has failed them for so long. Critically, the inspector-general must report on the implementation of the royal commission recommendations. I cannot say strongly enough how important this is. For so long, Australians have listened to royal commissions and not seen action. The royal commission into aged care was so powerful, so compelling and so distressing to Australians that it is incumbent upon every one of us in this place to stand tall and strong, and to insist that those recommendations are implemented.

When the royal commission handed down its report two years ago, I called, right then, for the implementation of all recommendations. Like other members, I stood up again and again in this place and called on the previous government to act urgently. I was frustrated by the pace of reform. I hope that now, under the watchful eye of the inspector-general, we will realise the ambition to implement all recommendations.

As the minister said in her second reading speech, we are at the precipice of the great next test of our aged-care system: the baby-boomer generation. Our population is ageing, and we need to ensure that our aged-care system places people at the centre of all aspects of that system. This bill is important to me because my constituents are older and more likely to rely on aged-care services, and this reform aims to improve their quality of life. Twenty-four per cent of my constituents are aged over 65 years—compared to a national average of 17 per cent. In my electorate, 2,687 people are in residential aged care and 2,129 people receive home-based aged care. The Hume region, in my electorate of Indi, has a higher rate of use of at-home supports—under both the Commonwealth Home Support Program and Home Care Packages—to help us age in place.

Before I came to this place I had the privilege of working in aged care. At the beginning of my career I was a director of nursing at a bush nursing hospital and aged-care centre. More recently, I was a volunteer director at a larger aged-care facility. I saw firsthand the challenges of becoming older in a small rural area, the challenges of finding workforce to care for those people and the challenges of being an administrator and a clinician. Now, as the member for Indi, I receive daily emails from constituents about their experience of aged care. I meet aged-care providers who are trying their hardest in the most difficult of circumstances, and I sit down with health and aged-care staff and talk about the burnout they're facing.

We have no shortage of suggestions of where the inspector-general could start on this important work of investigating and reporting on systemic issues in our aged-care system. Let's go to the first. The first is the aged-care workforce crisis. Staffing levels are at the centre of aged-care system failures. Aged-care workers in my electorate are hardworking, committed, professional and compassionate. But the workforce has been decimated from years of policy failure, the pressures of COVID and the lack of skilled migration. It's a battle to recruit and retain staff. One provider told me, 'As with most facilities, we are struggling for staff. Registered and personal-care staff applicants are almost non-existent.' Another told me, 'Our future depends on our ability to attract a workforce, which is a major issue in rural Victoria.' In the small town of Alexandra, I met a nurse in her 70s who'd come out of retirement to head up the nursing team because they could recruit no-one else. Alpine Health, which has aged-care facilities in Bright, Myrtleford and Mount Beauty, is offering $5,000 incentives and short-term accommodation for workers who take up a permanent full-time role. As CEO Nick Shaw said, 'The cost of employment is great for any small rural health service, but the cost of not having a competent and skilled workforce is even greater.'

We simply don't have enough clinically trained aged-care workers. Providing quality clinical care in aged-care facilities prevents unnecessary emergency department admissions, unnecessary transfers of elderly frail people to other locations, unnecessary distress to their family and friends and unnecessary pain and distress to those people in the last years of their lives.

In just three months, on 1 July, the 24/7 nurse requirement will start. This is a crucial part of raising the standard of care across the system. Our local providers support it, yet there are serious concerns that rural and regional providers simply can't find the staff to meet this deadline. We currently have 245 registered nurses in my electorate working in aged-care residential services—this isn't enough right now, and we're going to need a whole lot more. Frankly, I don't know where we're going to find them. I'm glad to see that the government will grant providers in rural and remote areas an additional 12 months to meet this requirement, but I'm concerned. I'm very concerned that even in 12 months we simply won't find them. I'm relieved that areas of my electorate where the staffing shortages are most acute are eligible for this extension of time, and I'll be keeping a very close eye on how our providers will be assisted to meet this requirement because, gee, they need assistance. They're desperate for it. If you don't fix the staffing crisis, you don't fix aged care. That's where the powers of the inspector-general are so important. So we need to monitor how the 24/7 mandate will be resourced and its impact on the system. The government says there are changes in the pipeline that will alleviate the growing aged-care skill shortage, and this includes a 15 per cent pay rise in minimum wages for aged-care workers and the return to normality of the skilled migration program. We need to monitor these changes to make sure that they have the intended effect, or if more is needed. We absolutely need to monitor and observe the impact in rural and regional Australia and tailor support, because there's isn't one-size-fits-all for any of this.

The second systemic issue really is the financial viability of aged-care facilities, especially those in rural, remote, and regional Australia, where there are so many facilities struggling to make ends meet. In fact, in the 2021-22 financial year, 74 per cent of aged-care homes in regional Australia were operating at a loss. We feel this, close to home. In the last two months, two aged-care providers in my electorate have sounded the alarm on the extent of their financial losses. One is experiencing losses of $100,000 per month. It's a fantastic facility, and we can't afford to let it fail, but the struggle is real. In rural and regional Australia, when providers go under, the consequences are felt everywhere. It's losing a major employer. It's losing a skilled workforce that has been painstakingly built. It's a blow, a serious blow, to the morale of a regional community. And it is devastating for the residents and their families who are forced to move away from a place in which they've chosen to age. Stories of husbands and wives having to travel hours or more to visit in places where previously they had been able to pop down the road are simply heartbreaking.

When there are not enough aged-care beds it affects the whole health system. In public hospitals across my electorate we have older patients medically cleared for discharge, but they're stuck because there's nowhere for them to go. This means fewer beds for inpatient services, and these beds are desperately needed for clinical care, treating chronic conditions, emergency procedures and important surgery. The federal government steps in to help providers who are going under, but this is at a cost to taxpayers. The Structural Adjustment Fund, which supports providers who are in financial trouble to exit the market or wind down operations, has paid out $51 million to 62 providers since December 2022, according to research from the Parliamentary Library. We should investigate what is causing these providers to end up in this position.

Finally, we should investigate the disgraceful state of residential aged-care buildings. Too many facilities, especially those in our small regional towns, are outdated and not fit for purpose. This is because successive governments have failed to properly invest in aged care. The royal commission called for a $1 billion investment into building and upgrading residential aged-care facilities every year from 2023. With proper funding, we would have the opportunity to upgrade our rundown facilities in regional Australia and give older Australians the quality of care they deserve. The Bright Hospital redevelopment precinct in the Alpine Shire in my electorate is one upgrade so worthy of the government's attention.

In conclusion, this bill is a good start, but I want to see the remaining recommendations of the royal commission implemented and I want to see that done urgently. One major recommendation was a whole new aged-care act, which, I understand, the government is drafting. And any new legislation must focus on the safety, health and wellbeing of older people and put their needs and preferences absolutely at the centre, absolutely first. Aged care is not just about supporting a person's basic daily living needs; it's about ensuring older people can contribute to socialising, be empowered to make decisions about their own care, and supporting people to achieve their goals for a meaningful, happy life.

In drafting legislation, the government must listen to any recommendation of the Council of the Elders, the Aged Care Advisory Council and all stakeholders to ensure that legislation is best practice. I recently met with Allied Health Professionals Australia, the national peak for allied health. The royal commission found that, although allied health services are fundamental is to aged care and particularly critical to maintaining a resident's wellbeing, they're underused and undervalued. In my experience in aged care, the impact of having a speech pathologist to assist with swallowing in someone who has had a stroke, physiotherapists to assist with continence management and to avoid falls, nurse practitioners are crucial to high quality aged care.

The royal commission called for allied health services to be viewed as a valuable service rather than a burden and should be intrinsic in residential aged care. Further, it called on this bill to be strengthened to ensure that the inspector-general is adequately resourced to fulfil their functions and recommended measures to ensure that the government meaningfully responds to the inspector-general's recommendations by setting out what measures they have taken in response and how effective they've been. I urge the government to consider these recommendations.

We need to make sure the work of the inspector is not left on a shelf gathering dust. We need to make sure that the older people in our society all across Australia, irrespective of who they are and where they live, have what they need for a meaningful, dignified final years of life, that their loved ones feel confident in that care and, importantly, that the workers who provide for them have a meaningful job as well, that they come home at night feeling like they've done all in their power to provide good, high-quality clinical compassionate care.

I thank the government for this bill and I'll be watching to make sure it's acted upon.

Tony Zappia (Makin, Australian Labor Party) Share this | Link to this | Hansard source

This legislation implements recommendations of the Royal Commission into Aged Care Quality and Safety, a royal commission which came up with 148 recommendations. In particular this legislation deals with recommendations 12 and 148. As the bill's digest states, the Inspector-General of Aged Care Bill 2023 establishes an Inspector-General of Aged Care and office with a function to monitor, investigate and report to the minister and parliament on the Commonwealth's administration of the aged-care system. This includes independent reviews to identify and investigate systemic issues, and making recommendations to the Commonwealth for improvement. The Inspector-General of Aged Care will need to undertake at least two reviews on the Commonwealth's implementation of the recommendations of the Royal Commission into Aged Care Quality and Safety. It goes on to say the Inspector-General will have coercive information-gathering powers, including powers to enter premises and compel a person to provide information or documents, or to answer questions.

The bill sets out a number of offence and civil penalty provisions, including for unauthorised disclosure of information, failure to comply with the inspector-general's information-gathering powers, or providing false or misleading information, and victimisation of people who provide assistance to the inspector-general. For the benefit of anyone following this debate or listening in to it, that sums up the intent and purpose of this legislation. But in my view, what the legislation also does is it highlights the current inadequacy that existed for years and, at times, indeed, an incompetency of the Aged Care Quality and Safety Commission, which, from my own observation, has over the years failed to adequately support vulnerable elderly people in this country. If that commission had been doing the job that the broader community expected of it, perhaps we wouldn't need this legislation today.

With respect to other agencies that are there to support older people within our country—and that includes the Commonwealth Ombudsman and the elder abuse offices throughout the states—whilst they were set up in good faith, I don't believe they have led to providing families with the services and support that they expect at critical times in their lives. Again, with respect to those agencies, perhaps we need to have a look at the powers they have, so that they can actually implement recommendations and enforce changes that are asked of them when we see an injustice or someone being dealt with improperly.

The real issue about all of this also goes to the process by which concerns are raised with the various agencies. The reality is that that process in itself has been the cause of much of the grief that we have heard about and the grief that was raised in the royal commission—and, indeed, in the other 22 inquiries or so that have been carried out in the last couple of decades. One of those inquiries was a parliamentary inquiry of the Standing Committee on Health, which I was a member of at the time. Time and time again, we heard similar concerns to those raised with the royal commission. I will touch briefly on some of those concerns, because, at the end of the day, it's those very concerns that I suspect this legislation is trying to deal with.

The truth of the matter is we know that there are a lot of good operators out there, and that's the reality. There are a lot of good operators. But there are also some very poor operators. And those poor operators, even since the recommendations of the royal commission were handed down, continue, in my view, to be poor operators. That's not because of the staff they employ, but, rather, because of the management practices that they have. And, as the previous speaker referred to, in some cases they claim they are unprofitable and financially stressed, and, therefore, they can't provide adequate funding to pay for additional staff or even for the quality of care that is expected of them. The truth of the matter is that many of those operators have staff that are absolutely loyal, and if it weren't for those staff I guess the service would be even worse. These are staff that are underpaid, who work under enormous pressure and are often working unpaid hours because they care for the people they are looking after. They work under incredibly difficult conditions and are often undertrained and, in terms of total staff numbers, understaffed. They work in a very difficult environment. Most of those staff, in my view, are doing an extraordinary job, and I thank and commend them for it.

But the reality is this: every time an issue arises within one of those centres it's very rare for the families of the person involved, or for the person themselves, to raise a complaint. Firstly, that is because they believe the complaint will go nowhere. Secondly, it's because they fear that if they raise a complaint they'll be subjected to further punishment and their life will be made even more difficult. I have spoken to family members who say to me, after they have come to my office for assistance, 'We're afraid to raise the matter with any external agency, because our parent in the aged-care facility is likely to be treated even worse.' Another reason people don't complain is the inability of those agencies to intervene. That is a genuine concern. I accept that in some cases those agencies have limited powers. But the fact they have limited powers is of no help to the person who is within the facility and needs additional support.

Furthermore, I believe there's a level of incompetence within many of those agencies. I know the laws have been changed and the administration has been changed, but when you hear stories of agencies advising centres in advance that they'll be calling out to do an inspection, it beggars belief as to what they expect to find by doing that. When you hear of agencies that say they're only going between nine and five, when the truth of the matter is that these centres and the people who live within them are there seven days a week and 24 hours a day, with most of the poor care occurring outside the nine-to-five hours, you wonder where the logic is in them saying, 'Oh, we only operate from nine to five.'

The third area—and I hear this time and time again—is staff themselves. These are staff who, for whatever reason, firstly, care about the residents within their care and, secondly, need the job they have. Therefore, they too are unwilling to raise concerns about what is happening within the centre where they work, out of fear of retribution on themselves by management. I have had people contact me both anonymously and having given me their names and having said: 'Please keep this confidential. I cannot afford for my name to get out there, but this is what's happening in the centre where I work, and something needs to be done about it.' People who work within the centres see the inadequate level of care on a daily basis and want to do something about it because they genuinely care, but the truth of the matter is that they can't. Those are the sorts of concerns that I hope this new position that is being established by this legislation is going to be able to address, if not directly then at least indirectly.

I want to touch on two other matters in the time I have. The first is the home care packages themselves. I note that the Albanese Labor government introduced legislation in December last year to cap care management fees at 20 per cent and package management fees at 15 per cent. I applaud that and support it, but it's come to my attention that some of the operators are finding ways around that. Whilst the legislation has every good intention, the reality is that those operators who want to do so find ways to circumvent the intent of the legislation and are still overcharging their clients.

I will use the case of one person. I won't name the person. This person had a package of $35,000, of which $4,000—and I'm talking in round numbers—was contributed by the person themselves. Of that $35,000 package, the person worked out that, in real service to him, the net amount was about $11,000. The rest of the money was going into admin services to the provider of those services. When the caps came into effect, the provider of the services found a way to circumvent that and is still taking about the same amount of money. Again, that's no fault of the legislation. It simply highlights how, when you want to do something in this world, there is always a way around the laws in place.

The last issue I wanted to raise with respect to all of this is an issue that has arisen more so in recent times. I haven't had time to check, but I don't believe it was addressed in the royal commission findings. It is a matter that has been brought to my attention in my office on several occasions. In recent days, there have been several reports about it. I'm referring to the issue of the intervention of the public trustee in managing the affairs of a person who has perhaps been diagnosed as not competent to look after their own affairs. I'll quote one particular story that was published by the ABC on 26 March, only a few days ago, because I think it really encapsulates what I'm trying to say. The story says:

He is being kept against his will in a nursing home at a cost to him of more than $75,000 a year.

He's been denied access to his own medical and financial information—all in the name of protecting him.

It then goes on to quote the person himself:

I've got no rights at all and I haven't done anything. I've been in business all my life. I've paid my taxes and done everything.

…   …   …

I'm in an aged care facility with very old people that go to sleep in the mess hall and all this sort of stuff. I don't belong there. I belong in my own home that I've worked hard for all my life .

This is a person in his late 70s who's got the early stages of dementia. Those were not the words of a person who has lost his mind but rather the words of a person who has lost his freedom and his rights.

I have personally spoken to people in similar situations in my own state—people who have now been diagnosed and how that occurred I don't know—who now in the care of the public trustee, a state government office. They are right throughout Australia. It seems to me there are too many examples where these offices show no more compassion or empathy than the corporate service providers in this world. I would expect better from state government offices. Even worse, and this is the critical point, they are at times financially exploiting the person whose affairs they are managing the money for. The stories I referred to from the ABC go into a lot more detail about that. I don't intend to do that today, but I simply raise this as a matter of concern that also needs to be addressed.

With respect to the that person I referred to earlier on, the person in his late 70s, I note that the Western Australia Auditor General has called for an urgent review into the state's public trustee, and I commend that line of action. I think that is very appropriate. It will be interesting to see where it leads. The point I'm really making though is that these issues, these concerns, I believe from my observations and from the stories I've read, are very widespread. This is not an isolated case. And it is time that people under the care of the public trustee, right across Australia, are looked at in terms of are they being properly cared for, do they deserve to be in the condition they are in and should they have more rights about managing their own finances and their own wellbeing in the future as to whether they should be at home or not? I have spoken to residents in aged-care facilities who have been put there for the convenience of others and who quite rightly don't deserve to be there and with a little bit of support at home could be living in their own home. People have all their faculties, have a clear state of mind and know exactly what is happening to them and would be able to care for themselves in their own homes if they had a little bit of support.

I believe this legislation is a good step in the right direction. I hope the Inspector-General will be able to delve into some of the matters that I and other speakers in this debate have referred to and bring some accountability and transparency to the process of managing people under aged-care services in this country. I commend the legislation to the House.

Nola Marino (Forrest, Liberal Party, Shadow Assistant Minister for Education) Share this | Link to this | Hansard source

I'm pleased to support the Inspector-General of Aged Care Bill 2023 and the role of the Inspector-General of Aged Care for a number of the reasons that've been outlined by previous speakers, but in particular the capacity to provide that independent oversight of, or for reviewing, systemic issues and constantly drive improvement. For those of us who've had a loved one in residential aged care we understand very well the need for this role, and I can speak personally having had my mother in that situation.

The former coalition government accepted this recommendation and committed to establishing the Inspector-General of Aged Care for that express purpose of providing that independent oversight of the aged-care system to provide the transparency, the accountability, the confidence for all involved, be it the families, be it the individual—that monitoring reviewing process and the public reporting capability that goes with this. In my view it will increase the transparency. That's something for us, in this House, to make sure does happen and to have that process that occurs across the aged-care sector in general.

For me, being a rural and regional MP, I really will be looking for what comes out of the role of the Inspector-General in relation to rural and regional residential and aged-care facilities, given that they face additional challenges in providing services into regional areas. That often involves a lost more cost. And the more remote these facilities become the greater the challenges they're currently facing. Yes, we committed, in government, another $19.1 billion to the sector to assist in this process.

All of us know we've got some wonderful aged-care facilities in our electorates and wonderful people who work very hard. They really do care about the people they care for and we want to enable those people to do so even more.

One of the issues our residential aged-care facilities are currently facing is around the requirement for 24/7 registered nursing available in each home environment. That's really concerning for the aged-care facilities in regional and more remote areas that literally have no chance of doing this, and we know there are so many of them in regional and more remote areas and even in my part of the world. This has put a level of stress and pressure on my wonderful aged-care facilities, which are working their hearts out, literally, to provide really great care to the wonderful people they look after. But this has added another layer yet again, and they are very worried about what this will mean for them. Again, this is where I hope to focus on the specific issues in rural, regional and remote areas. How are these actual facilities going be able to provide that 24/7 care? I've spoken to a number of those in my part of the world, and there is no doubt they are desperately concerned. They're already getting a cross in a box because they are unable to provide that full 24/7 care, and they're concerned about what this means for them as an aged-care provider ongoing.

We know there's a need for another 20,000 or 21,000 additional workers. A UTS report says fewer than five per cent of surveyed aged-care facilities actually have the direct care workforce needed to meet this 1 July deadline, but I don't know where the government thinks, in regional and remote areas, these nurses are going to come from. They're physically not there and they can't attract them. We've raised this repeatedly with government. There is a different issue for rural, regional and remote residential and aged-care providers. Where will the additional registered nurses, enrolled nurses and workforce come from when there are labour shortages right around Australia? What I don't want to see is where we take workers from one part of the health sector simply to move them to another. That creates pressures and stresses everywhere. Also, in WA the government has moved to a one-to-four staff ratio during the day and one to seven at night, and that's in the health sector, which adds to the challenges of supplying the staff. I don't want to see rural, regional and remote areas lose any aged or residential care providers. We are struggling to get them and keep them there, and we have been for some time. You know, 64 per cent of the facilities in major cities operate at a loss, but it's 70 per cent in regional, rural and remote facilities.

I spoke to a provider not long before coming here last week, and they said the process to even apply for and administer an exemption takes an extensive amount of time for people who are already under the pump. They're a small facility in a regional area struggling for staff now, and they've got to go through this process of applying for and administering this particular application for an exemption and keeping that up to date. There's a constant reporting time attached to it and additional cost for them, taking those good people away from the job of looking after our people. They simply cannot source the required number of registered nurses. They've been looking overseas and in Victoria; they're simply not available. The facility, when at capacity, are going to actually need eight to nine full time to be able to service that 24-hour cycle for the number of people they have in their facility.

How on earth do you fund and manage that in a regional and remote area? It's just so hard on them, and they are desperately worried as to what this means for their facilities. This has put on another layer of stress and pressure they do not need when they're doing a great job as it is. It is very difficult and expensive to attract suitably qualified overseas trained nurses as well, if you can find them. They've tried using a third party, an agency, to help source these nurses. They've even gone to the expense of subsidising accommodation for those people they can employ in a regional and more remote area. It's already affecting their star rating—the tick in the box; the cross in the box—that they cannot provide 24/7. This is not okay. They are very good facilities doing a great job. This will have a greater effect when the clinical care minutes apply post 1 July. What I don't want to see is that the respect and value for those places is undermined because they can't tick that box, yet they're providing very good quality staff. They are already struggling to survive. And what will happen to our people that live in small, regional communities when they can't access a residential aged-care facility in their own community? That connection to their community needs to be for life—life and wherever it brings you. I have a list of some fantastic places, but each one of them is under the pump for different reasons. There is a whole different model of aged-care delivery in regional and rural areas.

In the time that I have, as the co-convener of the Parliamentary Friends of Dementia and Palliative Care groups, I encourage everybody out there who's watching to pay attention to their of end-of-life care planning. Put plans in the place to manage your end of life. Make sure you get exactly what you want, where you want. Take control of that and do that work.

To assist some of the residential and aged-care facilities that are dealing with increased numbers of people with dementia—and Australia's going to be dealing with this—Dementia Australia is a leader in technology apps, and only yesterday they were here in this house demonstrating cutting-edge technology to improve the experience of dementia for everyone. With professional Graham Samuel and the amazing Maree McCabe, Dementia Australia provided a tech showcase demonstrating and showing the virtual reality dementia experience technology. This is a very good tool for training purposes for people providing aged care and residential care. What was really disturbing was the meeting I had with Megan about people dealing with dementia from babies to the age of 18. That is also something we need to be considering in this space. Everyone who attended and tried the technology was so impressed, and many didn't even know such technology existed to educate and train residential and aged-care staff and carers. I strongly encourage any and every residential aged-care facility and the dedicated people who work there to take advantage of these practical training opportunities.

They recently introduced the BrainTrack app to learn about your own brain health throughout your life and track your cognition over time using virtual reality technology. That's where your end-of-life early planning comes in, so you can get things sorted. There's Ask Annie, a free mobile app that offers short learning modules for healthcare workers. There's Talk with Ted, a workshop using an artificially intelligent avatar to simulate a typical conversation experience between a care worker and something living with dementia. There's A Better Visit, a free tablet app designed to enhance a really good interaction between people with dementia and their visitors, particularly for those living in residential care. I've had that experience with my own mum in how to communicate well. I went and did a workshop along with my sister so that we could make what is a really tough, heartbreaking situation with dementia the best we could make it.

We also heard from a wonderful woman, Bobby Redman, a retired psychologist who was diagnosed with frontotemporal dementia and is a very active community member. She talked about how she's able to live independently and continue to be active in her community with the help of technology. She lives alone without a family carer: in her own words, 'Technology is my carer.' Bobby was at high risk at home: she was burning food, leaving taps on and suffering falls. She didn't want to move into residential aged care, so she worked with researchers, she sourced timers and alerts to turn off her cooker, she uses a cane, and she wears a falls alarm and a GPS tracker. Her unit is monitored with unit sensors to make sure she's active and moving between rooms, and she has alarms on her phone to provide personal reminders of what she's supposed to be doing at any given time. Most importantly for Bobby, she has been able to retain her freedom and her independence, and to be safe at home and in the community, with that technology. Why is that so important? Deputy Speaker Freelander, I think you would know. For those of us who have shared the dementia journey with someone we love, and suffered along with them, anything that improves the quality of their lives is what we so desperately want—and they want it too. It's what people suffering from dementia desperately, desperately want. There's no doubt that dementia breaks the hearts of those living with, and of those of us who love those who are living with dementia.

And this is going to become even more relevant, Acting Deputy President Freelander, as you know best: last month the Australian Institute of Health and Welfare announced that dementia is now the leading cause of disease burden for Australians aged 65 and over. It's the second leading cause of death for all Australians, and provisional data shows it's likely to become the leading cause of death. So I encourage everyone to go to the Dementia Australia website at dementialearning.org.au/technology. I encourage people to have a look at what's available there for so many families and individuals affected by dementia. Anything that helps in both the experience of the person living with dementia and the family and friends who support and love them and want them to stay as independent and connected for as long as possible is good. Please take advantage of these technologies.

I really want to encourage anyone over the age of 18 that if you don't have an end-of-life care plan in place, please do so. None of us are guaranteed tomorrow, no matter what our age is; none of us knows what's ahead. But what is within our power is to make plans for the day that we cannot speak for ourselves. I had a very good friend who found herself on the floor of her kitchen, having had a severe stroke and unable to speak for two days after that event. She spent her last days in a facility, able only to move a couple of fingers and not able to communicate. If that were you, what would you want? What would you not want? Please make sure that you put in place advanced care plans to take care of all the things you need to take care of. Make sure that you plan for the things you want and need whenever that end of life comes.

Kylea Tink (North Sydney, Independent) Share this | Link to this | Hansard source

I want to start by acknowledging the member for Forrest and many of the things that she just said and shared. I thank her for being so generous with her stories and I echo much of what she actually said about the concerns she raised and the way that she encouraged those over 18 to take a moment to think about what they'd like as they age. Let's be honest about it: none of us should ever take lightly the opportunity and privilege it is to grow old.

Some of the most influential people in my life have been my elders, whether that was my grandmother or my nan, my great-aunts and uncles, my current aunts and uncles or just those around me who I have always loved and respected. Never have they denied me the opportunity to learn from their experiences, so it is with a sense of responsibility that I stand to speak for them on the Inspector-General of Aged Care Bill 2023. While they have shared their positive life experiences, I have also been there to witness the challenges they faced as they aged—from end-of-life care being offered in rooms with no air conditioning and with temperatures over 38 degrees Celsius outside; falls in centres that left them dealing with further surgical interventions; or simple confusion as the system closed in around them, moving so quickly that it became foreign and often frightening.

With that said, I do stand in full support of this bill, which establishes the new Inspector-General of Aged Care to provide independent oversight of the age-care system. The 2021 Royal Commission into Aged Care Quality and Safety concluded that Australia's aged-care system needed major reform. It provided 148 recommendations to address the systemic issues prevalent within the aged-care system, and I support the implementation of these recommendations in full. I'm pleased to see that this bill begins the work of implementing some of these recommendations, namely: the need for stronger governance. Enhancing aged-care governance through new and independent oversight is important for the integrity of our aged-care system. I appreciate that the inspector-general will be able to shine a light on the effectiveness of the system, identify areas of concern and recommend improvements where appropriate.

Those aged 65 years or older account for over 16 per cent of the population in North Sydney. They make up a very sizeable and respected part of our community and, gratefully, it's expected that this part of our community will grow. How this community is treated and cared for as it grows is critical, and it's a long-term national issue for Australia. It's reported that there are currently nearly 76,000 operational aged-care places in New South Wales. However, ongoing systemic issues brought to my attention by both aged-care residents and providers in North Sydney include the rising cost of care, workforce shortages, skills shortages and substandard care. These issues can be helped by a legislative response, such as this bill and many others like it, in order to create a healthy aged-care system in Australia.

I welcome the inspector-general's duties to monitor, investigate and report on the Commonwealth's administration of the aged-care system, and to do so independently. The aged-care system is a large and complex system that includes a range of programs and policies that need to be administered with integrity. The systemic issues that exist stem from problems inherent in the design and operation of the aged-care system. The royal commission provided us with the insight required to fully drive a positive change in the operation of the system, and we must fully embrace that opportunity. We cannot afford to let this potential for positive change pass us by. The same urgency with which these recommendations were presented is the urgency with which we must deliver on them, and that starts with this bill.

Urgent reforms must be met with adequate reporting and monitoring processes, and an inspector-general can bring the oversight necessary to achieve this. If people can't trust that the government is acting with their best interests at heart, policies become less effective, workers and residents will not support reform, and the aged-care system will continue to suffer. Rebuilding trust in the administration of the aged-care system is critical to its long-term success. The inspector-general's role in overseeing the aged-care complaints management process is a particularly welcome part of this legislation. The royal commission showed us that the importance of a transparent and effective complaints-handling process cannot be overstated. Complaints can be a window into the quality and safety of care, and managing the complaints process well is imperative in ensuring quality and safety standards are met.

Finally, I support the provision of a framework for the inspector-general to publicly report to the minister and parliament on the Commonwealth's administration of the aged-care system. Transparency in the reform process is critical to its success. To have nothing to hide is a position we want the system's administration to be in. As this bill is considered, we must look at it through our current human rights framework, which, while far from perfect, requires us to consider our obligations to protect individual, social and economic rights. The aged-care system needs to be a system of care based on the universal right to high-quality, safe and timely support and care, to enable people to exercise choice and control, to ensure equity of access and to provide for regular and independent review of the system.

There are a number of serious concerns coming out of the aged-care sector, calling for further reforms. As a result of consultation with the sector's stakeholders and aged-care residents across North Sydney, I've learnt of the following key concerns. Firstly, the cost of administering and receiving aged care in Australia is rising to unsustainable levels, and it is inevitable that the reforms being called for are going to increase these costs further. A better system, quite simply, will cost more. The Parliamentary Budget Office has projected that, over the next decade, government spending on aged care will increase by four per cent a year, after correcting for inflation. This means that aged-care spending will be growing significantly faster than the rate of all Australian government spending, which is currently predicted at 2.7 per cent. By 2030-31, aged care will account for five per cent of all Australian government expenditure, compared to 4.2 per cent in the 2018-19 year.

The financing of aged care relies on Australian government payments funded by general taxation and other revenue, supported by contributions from older people receiving care. As it stands, the Australian aged-care system is gravely underfunded, and it is compromising the quality of care available. Funding levels are based largely on historical precedents and ad hoc decisions, which bear little direct relevance to the actual cost of delivering care. For the quality of aged care in Australia not to be compromised, the Australian government must accept responsibility for driving these rising costs and must do all it can to help communities, individuals and providers cover them. If government funding isn't meeting the needs of the sector, which it currently isn't, then care becomes compromised and substandard.

According to the Aged Care Financing Authority, approximately 31 per cent of home-care providers and 42 per cent of residential aged-care providers reported an operating loss in 2018-19. The exacerbating impact of COVID-19 was not reflected in these statistics. An aged-care provider in North Sydney reports that 60 per cent of residential facilities are already operating at a loss, and costs are only going up. The short- to middle-term outcome will be decreased care and services. The medium-to-long-term outcome would be that hundreds of residential homes will have to close their doors, causing distress to existing residents and nowhere for future residents to go. With home care not an option for many of these residents, the only alternative for care would be to go to hospital into an already overcrowded primary healthcare system, which is already unable to cope with what it is facing.

The effect of an overburdened primary health system is to further strain the aged-care system. The hindrance to accessing adequate health care is a serious issue in aged care. It increases the burden on aged-care workers to provide care they are not trained for and should not be required to provide. The increasing burden on aged-care workers is a huge concern. The compounding expectation for aged-care workers to perform duties outside their job description is a result of a workforce shortage and poor policies. Workers are incredibly strained in their ability to meet the level of need present in aged care. For example, aged-care workers in North Sydney have expressed concerns to me about being subject to the NDIS regulatory system separately to the aged-care regulatory system. The workload this creates is unsustainable for them. They are calling for a uniform set of regulations. You can understand why the workforce is struggling, and why care has reached in some cases substandard levels.

As a result of COVID-19 and the exhausting demands on our aged-care workers, there is not just a workforce shortage in the Australian aged-care system but a skilled workforce shortage. The pandemic has caused a huge loss of workers from the sector, and financial strain is being felt by a majority of aged-care providers. A report presented by the University of Wollongong as part of the royal commission found that, on average, each resident in a residential aged-care facility is currently receiving 180 minutes of care per day, of which 36 minutes are provided by a registered nurse. It concluded that staffing levels within large parts of the Australian residential aged care fell well short of good or even acceptable practices. The royal commission calls for a standard of 215 minutes of care every day by 2024, of which 44 minutes are to be provided by registered nurses. In addition, when fully implemented in 2024, the standards should always require at least one registered nurse is on site at each residential aged-care facility.

The government's election promise to implement two of the three recommendations relating to the workforce shortage will require 14,626 new workers in 2023-24 alone and another 25,093 workers the year after. Around-the-clock nursing in aged care and mandated time spent caring for each resident will create a shortfall of about 25,000 workers over two years. This represents a real and an unattainable short-term goal, and we need longer term solutions to improve the sector's ability to attract new workers and retain skilled and experienced ones.

The recommendation in the report states that aged-care workers should have good-quality and easily accessible ongoing training and professional development opportunities available to them. It is recommended the skills national cabinet reform committee should fast track the development of accredited, nationally recognised short courses, skill sets and micro credentials for aged-care workers. Another proposition that I support includes the improvement of the relevant visa requirements so that skilled migrants can fill job shortages. But the fact remains the gap between what we need and what we have is fairly, it would appear, insurmountable at this stage. These issues of rising cost, workforce shortages, skills shortages and substandard care are shared sector-wide. The current state of the aged-care system in Australia is a detriment to our aspirations towards human rights. As I said earlier, the findings of the royal commission have provided us with an opportunity for positive change in the operation of the system that we cannot afford to pass by. I will continue to hold the government to account, and I look forward to continuing to work with the minister and her team as she progresses this essential work.

In conclusion, I want to offer my thanks and respect to those providing services and care in this sector, as it currently exists. I have met some truly incredible people and witnessed much compassion and commitment among those who work with the residents of these facilities. While there is much talk about what is broken in this system—it's very easy to try to find scapegoats—the reality is that the system requires us all to lean in towards it and accept our responsibility in how we can work towards improving it.

I thank the government for bringing this bill forward. I commended it as a really positive first step. I recognise the significant challenges that we still have in front of us to actually bring this significant reform about, but I do want to commend this bill and the decision of the government to improve the governance of the aged-care sector. I look forward to contributing to further reform strengthening Australia's aged-care system.

Andrew Gee (Calare, National Party, Shadow Minister for Regional Education) Share this | Link to this | Hansard source

I rise in support of the Inspector-General of Aged Care Bill 2023 and the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023. The care and treatment of our nation's seniors has to be one of the most vitally important priorities of our country. One of the most common queries I receive from constituents in my electorate is on aged care. Moving a family member or loved one into aged care is a decision people across our nation are faced with daily, and it is not an easy one. Within the sector, staffing is tight. Wages have been an issue; they've been too low. Aged-care facilities are operating at a loss. With a stream of reforms on the way, active engagement with the sector and the appointment of an inspector-general of aged care is a good move. It's the right move.

The purpose of the Inspector-General of Aged Care Bill 2023 is to establish an independent inspector-general of aged care to monitor, investigate and report on the Commonwealth's administration of the aged-care system, to provide oversight of the Commonwealth's aged-care complaints and management processes and provide a framework for the inspector-general to publicly report to the minister and parliament on the administration of the aged-care system. Ultimately, the bill intends to facilitate a positive change for older Australians and the sector generally, which is something I'm very supportive of.

We know what an incredibly challenging industry and sector it is at the moment, and just how important it is to get this right. It is my hope that the inspector-general can be a key factor in getting that crucial reform right. The primary purpose of the inspector-general is to monitor, investigate and publicly report on systemic issues arising from the range of bodies within the aged-care sector. While the inspector-general does not have the power to impose corrective orders, it will have the ability to make recommendations for policy and sector improvements to enhance the lives of those living and working in aged care.

Our aged-care facilities, particularly our regional aged-care facilities, need all the support they can get. I was interested to hear the comments of the member for North Sydney, and I was reflecting on the commonalities of issues affecting both city aged care and regional aged care. Recently I met with representatives from Three Tree Lodge, an aged-care facility in Lithgow in our electorate. It's fair to say that they were exasperated. They told me, in no uncertain terms, that the aged-care sector is in crisis. Their facility is almost operating at a loss, and many other facilities already are. Three Tree Lodge raised the government's first Quarterly financial snapshot of the aged care sector with me. This report showed that 66 per cent of aged-care homes were operating at a loss for the period of July to September 2022. The report outlined that the net loss before tax per resident per day is $27.90. In addition, 70 per cent of aged-care facilities in rural and remote regions operated at a loss from July to September 2022. Three Tree Lodge attributes these losses to inadequate funding and indexation, workforce pressures and service challenges that mean having to pay higher agency fees, higher travel costs and higher maintenance due to distance and contractors' availability. And, as we've heard in this House previously, there is also the workforce shortage, which continues to cause major difficulties for the sector.

We all know how incredibly important a pay rise is for aged-care workers. I would consider it essential. The drain on aged-care workers during COVID and the resulting rapid change in the sector has been immense, and we owe an enormous debt of gratitude to all of our frontline workers who did so well during the pandemic. We wouldn't have been able to get through it without them. I often visit our aged-care facilities and I'm always impressed by the caring, compassionate and kind way staff members approach their work. They are truly unsung community heroes. They deserve their 15 per cent wage increase. They are most definitely worth it, as cost-of-living rises have made it all the more essential. While I note the government has agreed to fund an additional 10 per cent from 1 July 2023, and a further five per cent in 2024, there has been no indication if on-costs will be funded within this—not to mention rapidly rising inflation, meaning that, as it stands, aged-care providers are left with increasing costs from all angles and with limited government support. So I urge the government to step in and fund the full 15 per cent from 1 July.

The need for a collaborate approach for reform within the aged-care sector, specifically in relation to time frames for change, has been made clear to me by Three Tree Lodge. During this period of reform, it's critical that the impact on providers in terms of cost, financially and to individuals within the sector, is adequately managed. The pressure on smaller, community based providers in regional, remote and rural Australia to manage reform at the current pace is seeing these providers question their viability. That's what Three Tree Lodge is doing at the moment. They love what they do, but they're questioning whether they can continue.

The move of an older person into an aged care facility can already be very daunting, and when regional aged-care facilities close the results can be devastating for older Australians and the communities they come from. It's exacerbated by that tyranny of distance that we experience in our regional communities. When our regional aged-care facilities close, residents are forced to move. Sometimes they must move long distances from their homes, away from their support networks and away from the communities they have known and loved. They are taken away from their loved ones, and health outcomes for them can be adversely affected. Because of that tyranny of distance, visiting residents in faraway aged-care facilities is made all the more difficult, particularly for older Australians who may not have the capacity to drive those longer distances. The isolation builds when our regional aged-care facilities close. Local jobs are lost, as are generations of work by the local community groups who built them. Facilities like Maranatha House in Wellington have been built by the community for their community members so that they wouldn't have to leave Wellington to find great aged care.

Regional aged care and, indeed, all aged care must be protected. I ask the government to recognise the vital role it plays around regional Australia and to recognise the importance of our community-run facilities and how difficult they are all finding it at present. I would encourage the government to continue to engage with our aged-care providers, particularly our regional ones, and recognise the many challenges that facilities, like Three Tree Lodge in Lithgow and Maranatha House in Wellington, are facing every single day. Their vital work must continue, and we must give them all of the support that we can. I commend the bill to the House.

Anika Wells (Lilley, Australian Labor Party, Minister for Aged Care) Share this | Link to this | Hansard source

The passage of these bills through the House today marks an important step in the Albanese government's mission to bring transparency and accountability back into aged care for the benefit of older Australians. As the member for Swan said in her contribution, 'Sunlight is the best disinfectant, and the Inspector-General of Aged Care will shine that light.'

The bills establish an independent Inspector-General of Aged Care who will impartially monitor and investigate the Commonwealth's administration and regulation of the aged-care system. As recommended by the royal commission, the Inspector-General will look at serious and ongoing problems associated with the design and operation of aged care through a systemic lens—issues that have proven to be persistent, complex and interconnected. The bill also empowers the Inspector-General to monitor and report on the implementation of the recommendations of the royal commission, which, as the member for Indi said, is a very important tool to make sure the final report isn't just another report that collects dust.

I thank the member for Chisholm, the member for Moreton, the member for Swan and the member for Makin for their support for this bill. I know that people like Dawn in the member for Swan's community elected them to this place to make sure that we had a Labor government to create a better future for aged care. I especially thank the member for Moreton for sharing his own experience of helping his dad transition into an aged-care home. Like so many Australians, I know improving our aged-care system is a deeply personal issue for him.

I note the proposal of the Deputy Leader of the Opposition, who is here with us, to create a workforce plan. That is something that would have been helpful at any point over the past nine years when they were in government as the workforce crisis spiralled out of control, which we are all now left to clean up. I also thank the member for Indi and the member for North Sydney for their contributions to the debate on this bill, and I would add the member for Clare to that as well. I commend these bills to the House.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.