Joanne Ryan (Lalor, Australian Labor Party) Share this | Link to this | Hansard source

I'm pleased to rise in support of the Aged Care Bill 2024, which is in response to the Royal Commission into Aged Care Quality and Safety findings. The bill delivers on our election commitment to fix aged care. The royal commission passed down 148 recommendations for aged-care reforms: 136 have been addressed since the tabling of the report in 2021; 94 have been addressed by the Albanese Labor government since coming to office. This bill responds directly to recommendations from the royal commission into aged care and will address 58 recommendations in total. The bill will build on the aged-care reforms already put in place by the Albanese government. This includes $11.3 billion committed for aged-care workers to receive a 15 per cent pay rise. This is to make our aged-care workers feel valued by our community and to demonstrate their value, to demonstrate that, as Australians, we appreciate the value of the work that they do. And it ensures that the community understands the importance of the work they do.

We've improved the quality of aged care. We've seen nurses put back into aged-care facilities. We've seen improvements in nutrition rates. We've seen reductions in some of the behaviours that were highlighted in the aged-care royal commission. In that report we read about some of the terrible things happening in aged care. That interim report was titled Neglect, and for all those here in this place during the royal commission that pretty much sums up what we were seeing across our aged-care sector. Residential aged care has seen an additional 3.9 million minutes of care from registered nurses since the Albanese government took office.

The Aged Care Bill 2024 is a $5.6 billion package that will improve the way services are delivered to older Australians by providing them with support to live independently and with dignity as they age. At this point, I would like to thank the opposition for their bipartisan support in this process to get to this point, their support for the task force and for the measures in this bill. A statement of rights for older people and a positive statement of duty for providers will uphold and outline the rights of older people in the aged-care system and guides how workers and organisations must behave and make decisions under the new laws. It includes a single entry point to the aged-care system with clear eligibility requirements and a fair, culturally safe assessment process which brings together the different assessment services into a single system, which makes it easier for Australians to access and enter.

The framework for delivery of a range of aged-care services, including residential care, includes $4.3 billion in a new system of home care, the Support at Home program, which will replace My Aged Care, to support older Australians to stay in their home and in the community they love for longer. We'll have improved access to assistive technology and financial assistance to modify homes to make them safe, and we'll see 1.4 million older Australians benefit by 2035.

The Aged Care Bill means we'll have fair contributions from those who can afford to contribute to the cost of their aged care to make sure the aged-care system is sustainable into the future, but ensuring that the government takes responsibility for all clinical care, and mechanisms for the Commonwealth to find aged-care services, including aged-care related grant programs to providers. It has a new approach, regulating aged care which will balance explicit incentives for continuous improvement and high-quality care, including through new quality standards, stronger regulatory powers to protect people from harm and a new ministerially appointed complaints commissioner and whistleblower protections to make sure older people, workers and others have clear pathways to raise concerns about the quality of aged-care services. I know how important those provisions in this bill are for communities like mine. I know people will feel safer and will trust the system more readily knowing that those provisions are in place and knowing that there is a complaints commissioner.

We all lived through the behaviours that led to the royal commission and we heard about the conditions in many aged-care services during the royal commission. Of course, we then had the pandemic and the utter devastation that that meant for a lot of families. In my electorate, that was acute and critical. We lost a lot of our older community members during COVID in aged care, and I know that families would have welcomed, at that point, a complaints commissioner. They would have welcomed whistleblower protections because in parts of my community which are connected to particular aged-care services, they were ringing me—for me to be that complaints commissioner, if you like. Staff members working in the sector were doing similar. They were contacting people as much as they could to blow the whistle about what was potentially happening in our aged-care centres during COVID. We know that, once the infections were in place in facilities, they were very difficult to contain, and we know that that led to an enormous amount of angst and grief.

Several principles will underpin these new reforms. Australians will get the support they need and make a reasonable contribution according to their means, as the taskforce recommended. Everyone already in residential and home care will benefit from a no-worse-off principle based on their place in the system. The government will pay all clinical-care costs, with individuals contributing to the kinds of costs they would typically pay throughout their lives. The government will continue to pay for the majority of aged-care costs. The taskforce that was put together has looked at our system and how we might improve it. It has looked at the recommendations from the royal commission and has brought together and consulted widely with older Australians, their advocates, unions, providers and other experts.

The interim report by the Royal Commission into Aged Care Quality and Safety was titled Neglect, as I said. The first chapter of the report was titled 'A Shocking Tale of Neglect' and it did just that. It told a shocking tale of how the former government allowed Australians to be disrespected, neglected and basically forgotten. This bill puts in place measures, with support from those opposite, to ensure that we don't see that fragmented system repeated. It was a fragmented system that was poorly managed, unsupported and underfunded, and which saw our older people, who are very often vulnerable people, neglected, isolated and powerless in an uncaring and unkind system that did not deliver uniformly safe and quality care. This legislation tries to ensure the system that we're talking about is no longer fragmented. The aim of the government and the aim of the sector is to ensure that we're providing quality aged care.

There's a temptation to always want to look back when we're talking about aged care to what were very dark days and what were very dark scenes. But I am feeling really positive about the changes already made to the aged-care sector under this government. I am feeling really positive that post pandemic our aged-care system has recovered and renewed itself. When I visit the aged-care centres in my electorate, I find people working in the sector committed to quality care for the people they're caring for, and I find my residents in aged care happy when I visit and speaking in glowing terms, as they always were, about the people who are paid to care for them. That was always the case.

One of the key changes here that need to be considered, though, is the package around the new Support at Home program, because this is critical. We know that people would prefer to stay in their own homes for as long as they can, and this package will go a long way to supporting people to progressively make that choice. It's an important program. I lived the My Aged Care program with my own mother. The Commonwealth provided assistance for her to stay independent for as long as she did, and I know that this new version will be even better in supporting people at home to stay at home longer. Part of that is around the assessment process being a single entry point and not having to tell your circumstances or the story of your life over and over again to multiple people. That assessment, once made, can then be progressively reviewed. The Support at Home program will mean that people's clinical needs are met at home.

It is important work that is being done to bring this legislation forward and to create an environment where aged-care workers are feeling respected and valued. This is a sector that was under considerable pressure, both financial and in terms of public perception. It's important that the work that's been done across the last 2½ years had the sector at the table, prepared to embrace the new provisions, because it means that we can all move forward now with a view to our older Australians being cared for in a way that will leave us able to sleep at night, bluntly—because there were moments during the pandemic when that was certainly a struggle for me and for many in my community.

I'd like to pay tribute to Minister Wells for the work that she has done in preparing this. I'd like to thank all members of the taskforce for their work, under difficult circumstances, in coming together to reshape this sector and have a look at how it might be improved under this government. I'd like to again thank the opposition and the crossbench for the way that we've worked together to ensure that this is done in a bipartisan way.

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

Today I rise to speak on the Aged Care Bill 2024. Australia's aged-care system is facing a crisis. It's unsustainable and not effectively meeting the needs of our older Australians. With an ageing population, demand for care services is only going to grow, making it crucial that we develop a system that promotes the wellbeing of older people while remaining economically sustainable. In the next 40 years, the number of Australians over the age of 65 is expected to double, and the number of those over 85 is expected to triple. In Warringah, nearly 17 per cent of the population is over 65, with over 25,000 individuals entering their senior years. These numbers highlight the growing demand for aged-care services, particularly the increasing desire for independence and support to age at home.

The Aged Care Bill 2024 is an important piece of legislation aiming to deliver significant reforms that ensure quality of care for older Australians. It also seeks to help seniors maintain their independence, especially through ageing at home. My electorate office in my electorate of Warringah regularly receives calls from constituents who need assistance navigating the complex aged-care system, and it's not just those needing it themselves; it's often family members finding it incredibly complex. The current system is clearly not meeting the needs of the community, and that's why I welcome the reforms. There have been long delays and difficulty in getting the level of care needed by people.

The Royal Commission into Aged Care Quality and Safety revealed hard truths about our system and horrendous stories of neglect. The final report, titled Care, dignity and respect, made 148 recommendations for improving the standard of care. Following the report, there have already been three legislative changes, and now this new bill responds to about 60 of the royal commission's recommendations, alongside those made by the Aged Care Taskforce. This bill will replace the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018. The new legislation gives the Aged Care Quality and Safety Commission increased regulatory powers as recommended by the royal commission. It introduces a new regulatory model focused on ensuring that registered providers offer high-quality care while being held accountable. Often the most important part of the feedback that we get from the community is: 'How do you know the facility you are proposing to have your loved ones live in is actually going to meet their needs?'

Accountability and oversight are essential in delivering better care, and I support the introduction of a statement of rights for older people in this legislation. Placing the rights of older people at the centre of the law is a necessary step to recognise and protect their dignity. However, I am very concerned. Alongside key stakeholders, I ask: how are those rights going to be enforced? There seems to have been a watering down of the initial intention when it came to that statement of rights. When I visited constituents and discussed this with them, many had concerns that a statement of rights for older people not just be window dressing but that it have some effect on their standard of care and treatment.

The Support at Home program, which would come into effect on 1 July 2025, is also another key change in this legislation. It will replace the current four Commonwealth home support packages. Those four will become eight ongoing classifications and there will be two additional short-term classifications, one for restorative care and one for end-of-life palliative care, and I welcome these changes. They aim to better support older Australians ageing at home, meeting their changing or developing needs and ensuring they maintain their independence. Of course, the additional short-term classification of restorative care will assist people to meet short-term increased needs. The sad aspect of palliative care one is that, of course, it is the end of life, so that assistance can make such a difference to the quality of life and to supporting the person and their family through that difficult time.

However, I would note that while these changes are good they do very little to address age discrimination and the huge gap that remains between services of the NDIS, aged care and other areas. It remains that those over 65 who have an accident or who develop a disability can still not access a similar level of support and assistance on the NDIS as those under 65. There is still a massive difference between the maximum level of support in these eight aged-care classifications, even with the additional restorative care aspect or home improvements, compared to what is available under the NDIS. Keep in mind the age of 65—many in this place are at that age threshold. While 65 has been traditionally thought of as a time of slowing down and maybe retirement, many people are incredibly active at 65 and are still contributing and working. If an event occurs that significantly changes that situation, it is still such an incredible contrast. Just because of that age threshold, the difference in dignity and support the people receive is still incredible. It is still an age discrimination that needs to be addressed.

A central feature of the Support at Home program is the no-worse-off principle designed to provide continuity and certainty for those already in the aged-care system. Of course, these are big changes. People have contacted my office, concerned about what it means for them if they are already in the system. The program also introduces a new assessment tool allowing for more tailored support. I welcome that but, again, the proof will be in the pudding in terms of how that assessment occurs and in making sure it is not just an automated, overly administrative process but that it is genuinely flexible and recognises the individual needs of people.

One of the key aims of the Support at Home program is a reduction in average wait times for care approval and access to services to three months. It is a significant improvement compared to current approval wait times of some 12 months or more. That delay is devastating, because we have had instances where some people have passed away while they are still waiting for their care approval. So I think it is incredibly important, when we look at this type of service, that the administrative side of it is effective, efficient and resourced well enough to make sure there is no delay in wait time.

I welcome the government's intention to reduce these wait times, but I have questions about how they plan to implement the ambitious reductions. If we've got circumstances going from over 12 months to now being done within three months, you have to question how. I hope this is going to be done sensibly and efficiently. I am also concerned about the measures that will be in place to ensure people are not neglected or forgotten during those wait times. Even if they are reduced to three months, a person's condition can significantly deteriorate in that time and a lack of support for their need can make a significant difference.

The new funding model requires older Australians to contribute more to their care cost—I know that's of great concern to some—in both the Support at Home care model and residential care. We know that, for this to remain sustainable with an ageing population, that contribution is necessary. The fees will be based on services used, with full pensioners making low contributions for some aspects of care. Part-pensioners and Commonwealth senior health card holders will contribute depending on their income and assets, and self-funded retirees will face higher contributions. Changes to residential care will include increased contributions to daily living costs and reforms to accommodation contributions. Both residential care and Support at Home care will be categorised into clinical care, independent services and everyday living care. In terms of financial contribution, clinical care will be fully funded by government and funded for everyone.

The second category, the independent services such as personal care, will require contributions. These will range from five per cent for pensioners to some 50 per cent for self-funded retirees. Everyday living services, the third category, which can include things like cooking and cleaning, will require the highest contributions, from 17.5 per cent for full pensioners to 80 per cent for self-funded retirees. I welcome that the contributions will have lifetime caps and aim to create cost parity between home care and residential care. Needless to say, these cost arrangements and contribution arrangements are complex but I commend the minister and her team for their diligence in working this out.

I note the bill has been referred to the Senate Community Affairs Legislation Committee for review; that will hopefully provide a careful analysis of its economic impact and the viability of the structure. For my constituents, I will endeavour to have more information as soon as possible and ensure that people are engaging with these changes and understand how to properly access the services and what these contribution models mean for them.

Our older Australians deserve to live with dignity, and the new aged-care bill represents a positive step in addressing the challenges we face as a nation with an ageing population. However, much more needs to be done to ensure that all Australians receive the care and support they need in their senior years. I recently visited St David's Village in Frenchs Forest to hear concerns from residents there, and the recurring theme was a desire for agency. Older Australians want to maintain control over their lives with autonomy in their services, independence in their living arrangements and choice in end-of-life care. Another key concern was how the government plans to communicate the changes, what transition plan will be in place and how the government plans to support people through these upcoming reforms.

Ensuring older people maintain agency during this transition is crucial. To help seniors, their families and their communities navigate the aged-care system, my office, like those of many other MPs, recently released a seniors guide to assist in organising aged care. What is interesting is that so many of the services are digital—they're online—but for many people that is incredibly complex. They just need a proper hard copy—a road map to using these services. The seniors guide has been an incredible success, demonstrating the importance of providing accessible information for informed decision-making. Much of the key information on aged care is assessed online via an online portal. By making this information available in a simple printed booklet, we've received huge feedback and appreciation from the senior community because it makes it a lot easier to navigate. I encourage the government to be mindful that, whilst we want the efficiencies of everything being online and digital, information remains accessible for all.

Lastly I'd like to mention that, when considering changes to aged care and how to improve that quality of care, we need to consider how these changes will impact First Nations Australians. The National Aboriginal and Torres Strait Islander Aging and Aged Care Council is working to better ensure that aged care policies are culturally safe and trauma aware for elders. It's a massive issue. For older First Nations Australians, the concept or the prospect of residential care brings back huge amounts of trauma, especially if they are part of the stolen generation. We have to make sure that, throughout this system and throughout legislation, we acknowledge the complexity and the challenge that First Nations Australians face. The council has made a submission on the bill to the Senate Community Affairs Legislation Committee and makes key recommendations.

A division having been called in the House of Representatives—

Sitting suspended from 10:25 to 11:01

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

When the Royal Commission into Aged Care Quality and Safety was released in 2021, it was a moment of reckoning for this country. It was the culmination of what I have described as a slow collapse, one that occurred over decades of the aged-care system in Australia. It was a collapse overseen by Commonwealth governments of all political stripes. The royal commission found the aged-care system was in such dire need of renewal that an entirely new aged care act was required. The current system simply could not be salvaged. It's the policymaking equivalent of knocking down the house and starting all over again. At the time the royal commission was released, I supported all 148 recommendations and called on the government to respond with action and funding not just words. The Aged Care Bill 2024 is an important step forward in responding to these recommendations.

In assessing the bill before us, I'm guided by the same values and principles that will always guide my work as the independent member for Indi: Will this bill improve the lives of people in the north-east of Victoria that I represent? Will this bill improve the lives of people all over Australia? Will it help older Australians age with dignity and empower them to enjoy all the richness of their later years? I know for the people of Indi, where we have a much higher proportion of older people compared to the national average and where, in our beautiful towns, many people move to retire, this crucial reform is absolutely essential to their quality of life. I also ask whether this bill will assist aged-care providers and aged-care workers.

This bill is about putting older people at the centre of our aged-care system; it's not about putting the providers at the centre of our aged-care system. But it's important to remember that aged-care workers—the nurses, the carers, the cooks, the cleaners and the admin staff—are essential. For many of these people, working in aged-care isn't just a job. It's a vocation worthy of dedication. If I turn my mind back a long way, I remember being a young matron of the Chiltern Bush Nursing Hospital, pulling my clothes on over my pyjamas at two in the morning to make sure one of my older residents received the care that they needed. I cared deeply about the residents under my watch, and I know that people working in aged care do too. They want to see a system that delivers the best care possible for their residents. I thank those who provide these services in Indi. I thank those places like Kellock Lodge in Alexandra, the rural city of Wangaratta, Westmont in Wodonga and St Cath's in Wangaratta. I thank all those who spoke to me about what the bill means to them, and I thank aged-care workers right across Australia.

It's important our aged-care system is sustainable now and well into the future. Australia is ageing. By 2026 more than 22 per cent of Australians will be aged over 65—almost triple the eight per cent of the 1970s. As our country ages, more people will enter the aged-care system and we need to set it up for long-term success—and that's a task that cannot wait for future years and parliaments; it's a challenge we must tackle right now.

In analysing this bill, with more than 1,000 pages of legislation and explanatory material, I'm guided by three key questions: Will it put the sector on a sustainable footing as our population continues to age? Will it provide regional Australians with equitable access to quality aged care? And will it enable more Australians to access home care without harmful delays?

The Aged Care Bill 2024 implements the first recommendation of the royal commission to create a new aged-care act built upon a rights centred approach to aged-care services. This bill impacts almost all aspects of the aged-care system. This includes changes to how at-home care and residential care are funded and establishes a new single assessment pathway for all aged-care services. It creates new powers of oversight and enforcement for the aged-care regulator and a new statement of rights for older persons, and they will underpin the sector. I will address each of these.

One of the biggest challenges introduced in the bill is to change the way people contribute to the cost of aged care, both residential and at home. While the government will continue to fully fund clinical services like nursing care, allied health and other therapeutic services, a revamped means testing process will ensure those who are able to will contribute more to nonclinical costs like personal care such as showering and everyday living like food or gardening costs. The government has made it clear lifetime contributions will be capped at $130,000, and how much you will contribute will also be means tested.

For those currently in the aged-care system, whether at home or in residential care, the government's no-worse-off principle is one we must hold on to and hold them to. This means that no-one currently in the aged-care system will see their contributions change; the new system will only apply to new entrants. When an older person currently receiving at-home support moves into residential care, they will keep their existing contribution arrangements or opt to move to the new arrangements. However, for new entrants, I hear concerns about this difference in contributions for clinical and personal care. I query whether a person should have to contribute for showering services when, as they age, they absolutely need this basic help. For people who are frail or have chronic disease, it is not an optional extra and can in fact be important clinical care.

One of the ways to ensure a sustainable residential aged-care system is to ensure it is financially sustainable. The bill seeks to address this by putting more money into the system. To be clear, the government will remain the major funder of aged care. But new provisions in this bill will enable aged-care providers to retain up to two per cent of the refundable accommodation deposit, the RAD, in residential aged-care facilities each year for up to five years. I cautiously welcome this change because I know how hard it is for providers in my electorate to balance their books. We know that in the past year almost half of residential aged-care facilities were making a loss from accommodation. This included facilities in my electorate. By making changes to the RAD and to room prices, we can help ensure providers stay open in our regional centres and tiny rural hamlets. Capital improvements are incredibly difficult to achieve, and I hope this changes that. However, I will be following the implementation of these changes very closely because we must ensure any increased revenue resulting from these changes will be reinvested into infrastructure and amenities that residents need, not corporate profits.

This bill also makes changes to the home-care system for older people so that more people can stay at home in their communities for longer. We know Australians want this. I welcome the government's investment of $4.3 billion into home care, and I'll be pushing the government to ensure people in regional Australia have equitable access to home care. There are a few major themes for people in my electorate of Indi when it comes to the home-care system as it currently exists. These themes include the waiting times for assessments, the long distances that must be travelled for care and the workforce shortages to deliver this care. Across my electorate, whether it be in the upper reaches of the Murray at Mitta Mitta or in the far south part of my electorate in the Murrindindi Shire, I hear from older people who do not receive the full benefit from their existing home-care packages because of the costs of travel for providers and taxis, and other travel costs for the participant, and this means their budgets are chewed up way too quickly.

I'm also concerned, as are the people I represent in Indi, that the new Support at Home packages will not be large enough for regional participants and these issues will be repeated all over again. This concern was echoed by Dr John Davis, a member of the government's Aged Care Council of Elders, who lives in Wangaratta in my electorate. He's concerned that there will not be enough funding in packages to cover the reality of the costs of gardening, cooking and cleaning. We must ensure new Support at Home participants are going to receive all the care they need and I'm hopeful the government's plans to expand the tiers of home-care packages from four to eight will address these specifically regional concerns. These tiers must be carefully considered to cover travel costs, in particular, and they must truly reflect the time it takes to keep a home clean and the garden under control.

Support at Home will be underpinned by a single assessment pathway, and under this new single assessment model, non-government providers can play a role in assessing new claims for support, not just government assessors. Providers in my electorate tell me that this new system is showing real signs of promise and hope that wait times for assessments will, in fact, meaningfully reduce. Because it's critical here. The implementation of these changes is the bit where the rubber hits the road. For too many people in Indi, long waitlists are stopping them from getting the support they need. Even for people who do not receive a funded package, workforce shortages and a lack of suitable providers in regional towns means it can be hard to actually get any care.

The bill will also establish a new, independent statutory complaints commissioner and expanded powers for the Aged Care Quality and Safety Commission. These were key recommendations of the Royal Commission into Aged Care Quality and Safety. I support these expanded regulatory powers because unscrupulous providers and workers must be held accountable. We heard shocking stories of abuse, neglect and violence during the royal commission and in the years since. The government must do more to protect vulnerable older people. A new complaints commissioner and expanded quality and safety commission, underpinned by a new statement of rights and principles that focus on the safety, health and wellbeing of older people and puts them first is indeed a good start.

When I spoke to Jim Blundell, a resident of Mansfield in my electorate, he said that he wants to be listened to and to be heard by the new aged-care system. He wants genuine consultation with older persons to be at the heart of the new system, and he wants to feel safe to make a complaint when one is warranted. However, I share concerns of some older persons advocacy groups that not all rights under the act will be enforceable by the quality and safety commission and the complaints commissioner. I am also concerned about limited pathways for reviewing any decisions of the complaints commissioner, because if an older person does not feel that the response to their complaint is sufficient, they should have fulsome review rights. I urge the minister to consider any amendments to address this particular concern.

There are further improvements that the government should make to this bill. I support calls for amendments such as strengthening whistleblower protections, which the Human Rights Law Centre and Transparency International have said are not up to scratch and provide a worse level of protection than employees in the corporate or public sectors. I support their calls for an end to the fragmented, overlapping and inconsistent whistleblowing regime and the creation of a whistleblower protection authority. I also very strongly support calls for triennial reviews of the act. It's currently set at five years, but, as we know, that's a long time in aged care. Any unintended consequences should be looked at much sooner. I will pay close attention to recommendations from the Older Persons Advocacy Network and COTA Australia, and I thank them for meeting with me to discuss this bill and for their substantial and long-standing work in this area.

I acknowledge that this bill is part of a broader package of reforms, many of which I hope will benefit communities in north-east Victoria. While I welcome many aspects of this bill, I hear from older people and providers alike that it will do little if we cannot address workforce shortages. Regional communities in my electorate know all too well that this is often a significant contributor to the delays our older people experience in accessing the quality, reliable, affordable aged care that they deserve. The government must do much more to address these workforce shortages.

In conclusion, while this bill isn't perfect, it's a significant step towards fixing our aged-care system and a significant step towards learning the lessons of the royal commission and doing better by our mothers, our fathers, our aunts and uncles, our brothers and sisters and our friends and neighbours. I look forward to working with the government more to improve aged-care services, especially in regional Australia. I want to thank the minister for the exceptional hard work that it has taken to get us to this point. I thank her staff, the department and the many, many people who have contributed collaboratively to this bill.

I commend this bill to the House.

Sophie Scamps (Mackellar, Independent) Share this | Link to this | Hansard source

Before I entered parliament, I was a general practitioner. I felt close to all my patients, of course, but I often had a really special relationship with my older patients, and I treasured the opportunity to care for them. Older people are often so beautifully skilled in the arts of conversation and connection, and they were so appreciative of the care they received. They deserve our care, our attention and our respect, so I rise today in support of the Aged Care Bill 2024. Unfortunately, it took a very long time and a royal commission for this country and this place to properly grapple with all the ways in which our aged-care system has been failing older Australians.

The report of the royal commission shocked the nation. The royal commission has described it as 'a sad and shocking system that diminishes Australia as a nation', the story of which is 'a shocking tale of neglect'. Our aged-care system needs an overhaul, not only because of its deficiencies but also to cope with the projected increase in the number of Australians who will need its services in the future. In 2018 and 2019, there were around 515,000 Australians aged 85 and older—two per cent of the population. It is projected that, by 2058, that number will increase to 1.5 million people or 3.7 per cent of the population. The corollary to this, of course, is the diminishing proportion of working-age people in Australia, relative to the retired proportion. In Australia in 2019, there were 4.2 working-age people for every one person aged 65 or over. And by 2058, this will reduce to 3.1. The direct implication is that there will be proportionately fewer Australians both funding the aged-care system and working in the aged-care system.

However, it is hugely important not to think of older Australians as a burden. Ageism, like so many other biases in this country, is real. The Human Rights Commission reports that more than one in three Australians aged between 55 and 64—35 per cent of us—have experienced age discrimination. The most common forms of discrimination reported include being turned down for a job, being ignored or treated rudely and having disparaging jokes made about their age. More than one in four older Australians live in poverty, and we know the situation for Indigenous Australians is even worse, as they are twice as likely to live in poverty than non-Indigenous Australians. For whatever cultural reason, older people do not enjoy the same levels of respect, let alone reverence, that they enjoy in Asian and African countries and in the Mediterranean—respect that they deserve. After all, Australians aged 65 years or over contribute almost $39 billion each year in unpaid caring and voluntary work. If the unpaid contribution of those aged 55 to 64 was also included, that figure rises to $74 billion per year. If employment rates of Australians aged over 55 increased by five per cent, it would add another $48 billion to our economy every year. The contribution they can make in the workplace is immense. Experience and wisdom are powerful assets in any industry.

Older Australians are our mothers, our fathers, our uncles and our grandparents. Walking alongside them in their later years is a privilege. The mark of a civilised society is how it treats its most vulnerable. That's why I applaud the fact that this legislation is centred on the rights of older people. It is based upon the rights that older people in the aged-care system should expect.

What have the government already done? They have instituted 24-hour nurses in residential care and a 15 per cent increase in the pay for aged-care workers. This is a really good start to what must be a dramatic overhaul of the system. Since being elected as the member for Mackellar 2½ years ago, it has been my absolute privilege to run an electorate office that assists elderly constituents and their families with the aged-care system as one of its core functions. It is unfortunate that so many people need to turn to their members of federal parliament for assistance, however. We are usually an avenue of last resort for them on a range of issues. Nevertheless, it has been wonderful to watch my team ease constituents' difficulties navigating the aged-care support system. People seek our assistance in relation to all aspects of the aged-care system: the Commonwealth Home Support Program, home-care packages and residential care. Australians may not appreciate that while most of the national aged-care budget is spent on residential aged care, more than two-thirds of the people using the aged-care services do so from home.

There are clear patterns or themes to the difficulties my constituents have been facing with the aged-care system. These include long wait times for home-care package approvals and upgrades, sometimes up to 12 months; insufficient hours of care provided through the packages; high management fees which then reduce the available care hours; low carer allowances to families compared to the time they invest and compared to rates paid to home-care package workers and providers; quality of care concerns; system inefficiencies and perceived mismanagement; and inflated costs for equipment and services when billed through packages.

Here are a couple of actual stories my constituents have shared with me about their experiences with the aged-care system. I have changed the names of these people, whose stories I am sharing. Joan's father, who has Alzheimer's, recently deteriorated while in respite care after a fall. Despite accessing physiotherapy and dementia support, Joan and her father have been waiting nine months for his home-care package to be upgraded. Joan's mother, who is elderly and struggling with the daily care of her husband, desperately needs the extra support and is putting her own safety at risk.

Cynthia has been caring for her elderly mother on the northern beaches for years. After her mother suffered a fall and began receiving assistance through My Aged Care, Cynthia started noticing inconsistencies in the quality of service. Cleaners sent by agencies were unreliable and often unprofessional, with one alarming incident where two identified cleaners showed up unannounced, leaving her mother feeling unsafe in her own home. Despite having access to government funded care, Cynthia and her siblings found themselves stepping in to maintain the house, take their mother to appointments and manage day-to-day tasks that they knew could be done better by family members. Cynthia now wonders why family members who are already providing care out of love can't be paid through aged-care packages or the Commonwealth Home Support Program to ensure a higher standard of care.

Finally, Cora feels that aged-care providers and service companies are overcharging. She was shocked by the inflated fees for physiotherapy and equipment when she booked them through her My Aged Care package, costing much more than if she had paid for them directly. Cora worries that this is an abuse of taxpayer money, and she is concerned about the long-term sustainability of the system if the overcharging continues.

Moving now to the bill which has been introduced to address all of these issues and more, I applaud the government's adoption of the rights based model for the provision of aged-care services, which has been recommended by the royal commission as the best way to ensure access to quality, safe and timely support; to facilitate social participation and dignity; to allow for self-determination; and to provide freedom from harm, mistreatment and neglect. I completely agree that this is the appropriate framework for the bill, as do the experts.

The other big changes proposed in this bill deal with the funding of the aged-care services. Overall, the changes that the bill introduces will shift the funding model to a means-tested one, with co-contributions from aged-care users and the Commonwealth. The changes will mean that people who can afford to pay more will pay more. I agree with this in principle, because the system has become unsustainable and, with an ever-ageing population, the cost will only keep growing. It should not be contentious for people to pay for their own accommodation where they can afford to do so. If they cannot, the state steps in to assist. That is as it should be.

As to accommodation costs, the maximum amount providers can charge for rooms will increase from $550,000 to $750,000, which will now be indexed. That price can be paid by residents either as a refundable lump sum, as daily payments or as a combination of both. The lump sum payment can be made by way of a refundable accommodation deposit, an RAD. In this new bill, the RAD concept will remain in place, but those deposits will no longer be fully refundable. Providers may retain two per cent of the RAD per year for a maximum of five years. In her second reading speech, the minister explained that this is to ensure that residential aged-care providers can attract the investment they need to keep the current facilities open, to improve quality and to build new homes. With the trend towards an ageing population, new wings and new facilities will need to be built to accommodate greater numbers of people requiring care. Experts including Professor Kathy Eagar from the University of New South Wales noted that there is no corresponding requirement that any of this additional funding that providers will receive or profits they will make be spent on more or better services for residents. This is a missed opportunity. It seems a balance could have been struck between increased profits to aged-care providers and the care and service that those providers are required to provide to their residents.

What I think is absolutely critical to note is the stipulation in the bill that aged-care users will pay no contribution to the cost of their clinical or medical care. This is indeed fundamental to the objective of universal access to medical and health care. This is partly so that individual contributions can be targeted to services that support people's independence and everyday living costs, such as cleaning, gardening and accommodation. It is also welcome that there will be a lifetime contribution cap of $130,000 on non-clinical care contributions or cessation of contributions after four years. Finally, there is a 'no worse off' guarantee so that people already in or assessed as needing home care or already in residential care won't make a greater contribution to their care than they had already planned for.

Unfortunately, what constitutes clinical care, independence support and everyday living support is not included in this bill but will be contained in the rules. At this stage, therefore, it's hard to properly assess the extent to which people soon to enter care will be worse off under the new funding model. Advocacy groups like the Older Persons Advocacy Network are concerned about the lack of detail here. They are sensibly calling for modelling which will enable them to properly understand the real impact on self-funded retirees. This lack of detail and clarity also makes it difficult to decide whether to support the bill at the point when it comes before the House for a vote. It is akin to the government again saying, 'Just trust us.'

In summary, I support the aims of this bill. The system must be made sustainable and our elderly population must get the standard of care they deserve. The aim of universal access is critical. It is not perfect, but it is progress. I will continue to advocate for the government to continue their efforts to improve our aged-care system and support its residents. I commend the bill to the House.

Dan Tehan (Wannon, Liberal Party, Shadow Minister for Immigration and Citizenship) Share this | Link to this | Hansard source

Last week I saw how important aged care is in my electorate. I visited the Eventide Lutheran Home. About 50 of the residents gathered for morning tea, and they asked me to have a word with them, which I did, and then we went to Q&A. I've got to say: it was like question time and a bit more! They had questions on everything for me. In seeing all the residents come together like that, with some of the staff and with the manager, I saw an example of what aged care can provide to the community. It was wonderful to see. I say to all the aged-care providers right across my electorate: thank you for what you do. Having good aged-care providers in our country communities, in our country towns, is so important because it means that our residents can age where they've lived, that we can provide employment through our aged-care sector and that the community can visit their loved ones, the elderly, and don't have to travel to do it. That's why it's so important that we get any changes to our aged-care system right.

While I'm talking about great community events, it would be remiss of me not to mention another community event I did last week. I called in and saw the Hamilton VIEW Club ladies, who were having a luncheon which they do once a month to raise funds for The Smith Family Learning for Life students. They've been doing that for well over 45 years. What these ladies are doing for the community is wonderful. To give you a sense of the contribution they've made, some of the Learning for Life students they've helped have now grown up and are mentoring students through Standing Tall, a wonderful mentoring program in my electorate. That goes to show what our wonderful volunteer organisations can do. I take this moment to give a big shout-out to the Hamilton VIEW Club ladies; thank you for what you do on behalf of our community.

Getting back to the Aged Care Bill 2024: as I mentioned, that visit to the Eventide Lutheran aged-care facility brought home to me how important it is that we get these reforms right. The coalition, after commissioning the royal commission report, said to the government, 'We want to work with you in a bipartisan way so that, after the royal commission, we can get the reforms right that are needed for our aged-care sector.' What was detailed in the royal commission showed there was a need for us to change the way the aged-care system works in this country, and especially for us to have a look at what we can do about this new rights based aged-care approach. That's why we will have a new rights based aged-care act, and that is incredibly important.

We have continued to honour that commitment of working in a bipartisan way with the government to get this right. The government came to the coalition and detailed some changes they wanted to make. We looked at that and said, 'We think you actually need to make changes to the approach you're taking.' We have argued very strongly for making sure that the funding for rural and regional Australia is right. You have to remember the advantages that aged-care provision has in the city versus those in regional and rural Australia. This was a real focus of ours, to make sure we got it right.

As part of those discussions, the coalition was able to secure $300 million in additional capital funding through the Aged Care Capital Assistance Program for regional, rural and remote aged-care providers to upgrade their facilities, as well as additional care funding, particularly for regional, rural and remote aged-care homes. Targeted support for regional, rural and remote aged-care homes was not included in the government's initial proposal and that is why this was absolutely vital.

I know that in my electorate of Wannon it has always been the community that has sought to fund a lot of our not-for-profit providers through lots of volunteer hours because they know how important it is that people can age in the community where they live. But given the expense of regulation and everything that has been added to aged-care provision, it is now getting harder and harder for local communities to be able to support, especially capital upgrades, facilities and that is why this additional $300 million for these capital upgrades is will be so important going forward. It is crucial we understand that providing the care that is needed in regional, rural and remote areas can sometimes comes at additional cost and build that recognition into the system so our aged-care providers in rural Australia can get the additional assistance they need, whether it be for nurse provision or for any other provisions.

The government has listened to us and made adjustments, especially when it came to the provision of care in regional and rural Australia. The aged-care providers I have been speaking to in my electorate say that, from the headlines that have been detailed so far, the changes that have been proposed through this package look okay but, once again, they do want some more detail. That is why we continue to reserve our final position on this bill until this package and this legislation go for a proper Senate inquiry. Once that inquiry hands down its report, it will be a lot clearer what adjustments still need to be made to this bill.

One of the things mentioned previously was how much will be in regulation versus how much will be in the legislation. Until we know exactly what is going to be in the regulation and how it is going to be framed, there will be some uncertainty as to the final details and the impacts that these aged-care reforms might possibly have. We have to make sure that we get it right.

There a few things that we have also insisted on which I think are really important. We insisted on grandfathering, so everyone who is in the system and everyone who has begun the process of entering the system will not have the rules changed on them. They can rest easy knowing that these changes will not impact them and that is incredibly important, because a lot of families are doing it tough trying to provide the aged-care support for their elderly loved ones. They do not need changes which upset the apple cart because a lot of them have planned and planned meticulously to enable their loved ones to be able to get the support they need, so the last thing we want to be doing is pulling the rug from under them, especially given the cost-of-living crisis, the cost-of-doing-business crisis, that so many people are facing at this moment.

The other thing that we fought for is a much fairer deal for hardworking Australians—for those people who are struggling to make ends meet at the moment. We wanted to make sure that there was the inclusion of a much lower taper rate to ensure equitable contributions for Australians who have worked hard all their lives. That was something that we obviously impressed upon the government as well. We also fought for the maintenance of a lifetime cap on care contributions, across both residential and home care, to provide certainty to families as they're thinking about what could be the final financial contribution that they need to make.

Importantly—and I know this is important, because this is one of the largest pieces of feedback that I got from my aged-care provider boards—you've got to remember that in regional and rural Australia, and it's one of the things that I love about regional and rural Australia, is you get volunteers. You get volunteers that go on the not-for-profit boards of our aged-care facilities because they understand how important those facilities are. They're prepared to give up their time to make sure that aged-care provision continues in our community—whether it be in Casterton, Hamilton, Warrnambool, Portland, Camperdown, Ararat or Colac. Right across the board, we've got people volunteering to make sure there is aged-care provision.

The idea that these people, all volunteers, could face criminal penalties for circumstances which may be completely out of their control was, I think, the wrong approach to take, and a lot of the feedback I got from the people volunteering on those boards was, 'Given the high regulatory environment of aged care, why would you volunteer if a mistake could end up with you in jail?' I think it makes perfect sense to change this removal of criminal penalties, because otherwise what would have happened was these volunteers would have said, 'Sorry; we're not going to volunteer anymore on these boards,' and then you wouldn't have aged-care provision in our communities. You have to remember that the vast majority of people who provide that aged-care provision—whether it be in Mortlake, Winchelsea, Lorne, Apollo Bay or all those other facilities that I've mentioned—want to do the right thing. I think it absolutely made common sense to make sure that they wouldn't face criminal penalties.

The other thing that we fought very hard to remove was something called the 'worker voice'. This was about forcing unions into every aged-care home in the country. You have to understand what this would mean, especially for these not-for-profits that I'm talking about. If all of a sudden they're dealing with unions' right for entry, unions dictating to them everything that needs to happen in an aged-care facility, these boards, which have wonderful volunteers, and the staff that are doing a wonderful job caring for our elderly would see their workplaces upturned through the unions marching in the front door. Taking out what was nefariously called the worker voice was also incredibly important. It means—once again, we've got to have this inquiry—is that this bill is in a far better place than where it was when the coalition started discussions with the government.

Obviously we've still got a long way to go because there is that inquiry and the feedback that comes from that inquiry. We'll be making sure that we interrogate this legislation fully. The recommendations that come back from the inquiry are going to be really important in making the final decision on our side as to whether we ultimately can support this legislation or not. Changes like securing that extra $300 million, taking out the worker voice, making sure that those working Australians who have worked hard all their lives can have certainty around what they're going to be paying when it comes to aged care, and more, have made this bill better. But we'll wait and see what comes out of the inquiry to decide our final position on the bill.

Angie Bell (Moncrieff, Liberal National Party, Shadow Minister for Early Childhood Education) Share this | Link to this | Hansard source

It's always a privilege to talk in the chamber about aged care, our older Australians and the care that they are given. Of course, I have many, many providers in my electorate of Moncrieff on the Gold Coast, and I do enjoy regularly visiting those residential care homes. I always look forward to chatting with the elderly residents about their concerns, and I look forward to doing that next week when I visit a few in the Nerang area of my electorate. Whilst we're talking about aged care, we're also discussing in-home care.

But I would like to say hello to those residents across Moncrieff in all of the aged-care facilities, those at Homesteads in Nerang and those in Earl Haven, which has some assisted living units. I'll be visiting there next week with the state candidate for Gaven, Bianca Stone. She is running for that seat at the state election. She is an incredible person with a great history and will be a remarkable MP, I'm sure, in the next Queensland parliament. I would like to give a shout-out to all of those people. I look forward to meeting you again next week.

We can all recognise the importance, of course, of a strong, dignified and world-class aged-care system that supports all older Australians now and into the future. When I think about the baby boomer generation or even when I think about my grandparents, I think about my grandmother who was in an aged-care home in Adelaide for some years. I visited her a number of times, and I reflect on the care she received from the workers in that environment who cared so deeply about her in her last years. And now, in my own family, my father and my aunts and uncles are getting to that age when they might be looking at getting some in-home care assistance or, certainly, leaning on the services and providers that are around the country.

This is an important area that needs reform, and the coalition has been working closely to try to improve the Aged Care Bill 2024. But, with more than half of aged-care homes across the country currently operating at a loss, an ageing population and a growing desire to age at home, there is definitely a need for that sector reform that I talked about. We need a system that provides dignity and clarity for older Australians. This legislation delivers on the first recommendation of the royal commission appointed by the coalition to implement a new rights based aged-care act. In response to the royal commission, I'll note that the former coalition government provided more than $18 billion in funding to support the immediate needs of the sector. I recall Minister Hunt, who was the minister at the time, and the fantastic job he did with his four key pillars for the aged-care sector reform and the funding that went along with that. I congratulate him on the previous work that he has done. I also congratulate Senator Ruston, who has done so much work on this particular bill that's before the House, working with the government to make it a much better bill. While it's not perfect, it's much better than it was.

The coalition provided a clear offer to work with the government on sensible aged-care policies because we need a system that's strong and sustainable to support future generations, and that's probably my generation. I see the member for Bass is here. Our generation is probably next after our parents, and so this is something that's so important to a large proportion of our population and their families.

I want to be clear about this package because these are Labor's reforms. This has not been co-designed by the coalition. So, whilst we have been able to make some changes, we're still not a hundred per cent on Labor's package, but the coalition has worked tirelessly to ensure that the government's reforms are fairer, particularly for Australians who have worked hard all their lives to save for their retirement. All of our families have worked very hard throughout their lives and paid their taxes, and, in their twilight years, they must be looked after.

I want to commend the work, again, of my colleague Senator Ruston for her efforts in negotiating on this bill and making sure that we're able to fight for the inclusion of grandfathering arrangements to ensure that every Australian who has already commenced their journey of ageing will not be impacted. All of us have commenced that, haven't we? Nobody is getting any younger day by day, so it's only a matter of time before a larger proportion of the population have to lean on the aged-care sector for that support and help. But those Australians who have already commenced their journey of ageing within the Commonwealth system will not be impacted by these changes, and I think that's a really important point—to make sure that there is grandfathering applied to this so that there is certainty across the sector moving forward.

That means that older Australians who are currently in the system, including those on home-care waitlists, will not pay one cent more for their aged-care journey. That delivers certainty where there was known before with this package. A fairer deal for hardworking Australians ensures the inclusion of a much lower taper rate, to ensure equitable contributions for Australians who have worked hard all their lives to save for their retirement, and ensures that the federal government, not the consumer, will remain the majority funder of aged care. I think that's also a very important point. As I said, I've watched my parents work their whole lives and pay their taxes, and they should be looked after when they're on the pension—and, particularly, looked after well. It's so very important that that assurance is there as our population ages.

Many older Australians who have paid their taxes and done the work don't have the benefit of superannuation either, and I think that's really important to highlight. So they don't have that nest egg to lean on in retirement or when they need to go into a home, where they have that support and assistance, or when they need in-home care. So there is certainty for families who have had loved ones in care for many years, as well as the inclusion of a time-limited cap for residential aged care to ensure that older Australians and their families will only be required to contribute to care costs for four years.

The government's original proposal saw no cap on home care and a $184,000 cap on residential aged care only. We gained the concession that no older Australian will ever pay more than $130,000 for home care and the non-clinical care in residential care combined. These were concessions that Senator Anne Ruston and the coalition were able to negotiate for a better deal for our older Australians. We secured $300 million in additional capital funding through the Aged Care Capital Assistance Program for regional, rural and remote aged-care providers to upgrade their facilities, along with additional care funding for regional, rural and remote aged-care homes.

It's unsurprising that the Labor government included no targeted support for rural, regional and remote aged-care homes in its initial proposal, because regional, remote and rural Australia is not on the government's mind. The government is chasing the city vote, not the regional vote, and that's why it wasn't included in this package—because the Labor government doesn't care about regional Australians. It's the Liberal and National parties that care deeply about regional Australia, and that is why we delivered that in this package.

We strongly pushed for the removal of criminal penalties from the bill following serious concerns that their inclusion would force the exit of highly capable staff from the sector, in fear of being criminally punished to a level not seen in any other industry. You should not be going to work in fear of a criminal penalty—unless you have committed a criminal act, of course—so we've managed to remove that from the government's package of bills here. The government wanted aged-care workers and even volunteers to be criminally liable under the new act, so we fought hard for the changes to make sure that Australians who have worked hard all their lives to save for their retirement are dealt a much fairer deal.

The coalition strongly believes the government needs to be talking with older Australians—with the stakeholders—their families and the sector, bringing them to the table and taking them on the journey of aged-care reform, because they are very substantial reforms to the sector. They've been excluded from this conversation for far too long. That's why we fought for an open and transparent Senate committee inquiry which will bring out all the questions and bring the stakeholders to the table to ask the questions they like of the government on what they are doing in terms of reform across the sector, and what implications that has for aged-care facilities, for their residents, for their workers and for their families.

We strongly encourage anyone to participate in this inquiry process, to make sure their views are heard and to make sure the government listens to their views. This is the opportunity, during the Senate inquiry, to do that. We look forward to having an open conversation with older Australians and the aged-care sector through that Senate inquiry process about the government's proposed reforms, and we welcome Australians putting their views forward and asking the government many questions about the future of aged care in this country.

Allegra Spender (Wentworth, Independent) Share this | Link to this | Hansard source

Today I rise to speak in support of the Aged Care Bill 2024, a bill that, while no silver bullet, marks a step towards rebuilding the structure, reputation and sustainability of Australia's aged-care system. I congratulate the government for bring this bill forward, and I commend the coalition for their constructive engagement in the process and helping to build a robust piece of legislation.

I was recently invited to visit an aged-care facility in my electorate to mark the awarding of an Order of Australia to a resident, Kalman Bloch. Please indulge me for a moment while I commend Kalman and his family for the contribution he's made in my community over many years. He's been a Lions member for the last 50 years, and that was why he was recommended and awarded the Order of Australia. His commitment to his community, to volunteering and to helping people in times of need was remarkable, and it was wonderful to celebrate that with his daughter, grandchildren and great-grandchild as well. It was a very special event, and it was at an aged-care facility. During that visit I spent about an hour or so with residents and staff, and I was struck by the genuine decency, humanity and connection shared between staff and residents. I witnessed genuine compassion and care, and that is what all of us seek and want for our families.

We all fear ageing, and gradually losing our faculties and the independence we take for granted for so much of our lives. We also fear becoming dependent, whether on a spouse, friends, carers or our children. A well-functioning aged-care sector is a critical part of our social security safety net and provides assurances that the worst of ageing can be managed with dignity, respect and compassion. But I fear in recent years we have lost faith in that safety net.

The need for reform has never been clearer. The Royal Commission into Aged Care Quality and Safety painted a harrowing picture of the failings of our current system. It showed us that too many older Australians have suffered not just from poor service but from neglect and, in some cases, even abuse. The stories that emerged from the royal commission were heartbreaking. We heard of elderly residents left in soiled clothing, of people going days without adequate food. It revealed the human cost of allowing the system to drift away from a model of care concentrated on the rights of individuals, their wishes and their autonomy. COVID-19 further exposed the fragility of this sector to external shocks. It showed us the system was stretched to capacity and unable to adapt to a crisis, leaving both residents and aged-care workers at significant health risk.

When I speak to care providers in my electorate, they talk about the challenges they have to deliver the growing need not only in my community but also in communities around the country; the challenges in building more facilities and providing more beds; and the challenges of getting the right staff in to support this incredibly important work. As a daughter who has recently lost two parents, one of whom was desperately afraid of going into aged-care facilities, that fear that many of our community have—that they will not have the facilities in place and will have to move to other parts of the country where they do not have the same connections to friends and families that they have in their local environment—is a real concern.

Speaking briefly on Wentworth, one thing that startled me the most is that the aged-care provider, who is a provider of many aged-care facilities around the country, said they have as much of a problem getting aged-care workers in Wentworth as they do in some rural electorates because of the enormous cost of living and cost of housing in communities like mine. So there are some really significant challenges in the sector.

However, we need to be honest: the sector has been failing. It has failed residents, it has failed its staff and it has failed its community. But, when I go into aged-care homes and when I talk to other aged-care providers, I think that there's a really important reminder that the majority of the sector is deeply committed to the preservation of dignity and quality of life for elderly Australians. The system has been broken but it is not beyond repair, and I think this bill goes some distance towards doing that.

As I said, I commend the government for working closely with stakeholders and with members across the parliament to produce a bill that has received broad support from the sector and from aged-care community representatives. There are still some areas to strength, and a significant part of this bill is actually in regulation, but stakeholders that I have spoken to have acknowledged the improvements to this bill since the exposure draft. It is clear that the government and others have been listening to the voices of those most affected by these issues—older Australians, their families and workers. Once again, I commend the opposition, the coalition, for their engagement, and I know that my community does appreciate the changes that were made based on the opposition's feedback.

This bill represents a substantial overhaul in the way that aged care is provided in Australia, explicitly legislating a rights based model that acknowledges every Australian's right to age with dignity. It also introduces revised funding arrangements that acknowledge the roles of both home care and residential care in addressing both capacity constraints as well as the wishes and needs of elderly Australians. This new rights based framework is grounded in the principle that older Australians should be able to access quality, safe and timely care and was a key recommendation of the royal commission. However, as a number of organisations have pointed out, these rights are not enforceable under the act and will rely on the Aged Care Quality and Safety Commission and complaints commissioner to ensure that these rights are upheld.

The Aged Care Bill provides civil penalties for infringements on registered provider obligations, and I think this is a really important part of the bill. I know that there is some concern that these don't go far enough but I also recognise that we need to find the right balance here to make sure we are not only working constructively with our aged-care providers to ensure that bad actors always face the full force of the law but also that we recognise there are many people and many in the sector who are working constructively and genuinely to improve quality of care and look after their residents in an effective way. We need to strike the right balance.

The funding arrangements proposed in this legislation appear to be sensible adjustments to the current user-pays system, although I note that the community eagerly awaits the release of rules that will actually determine the individual fees that will be charged. The bill maintains a means-tested co-contribution system based on a service's need with different funding arrangements, subject to whether a required service is considered clinical care, independent support or everyday living. This co-contribution model has caused some concern that the service quality of aged care will become dependent on ability to pay, and, while the government has noted incentives for providers to provide ratios of supported residents, this is not mandated and is an area we do need to closely monitor.

There are provisions that allow for more a sustainable sector, such as allowing services to retain up to two per cent of the refundable accommodation deposits, which the sector has been requesting for some time. This will have an enormous impact on the ability of services in my community to expand, grow and invest.

I want to briefly note why this is important and why the whole legislation is important. Our community is aging. The great joy and the great benefit of this is that Australians have a greater chance of living healthier lives for longer in our country, but we also need to recognise the impact that that has on our tax system and on our ability to fund the services that are most important. Back in the 1970s and eighties, there used to be six younger, working-age Australians for every older Australian over the age of 65. This is now under four, and the expectation is that, in another generation, it will be under three.

We do know that the community is aging, so the burden and the cost of actually providing quality services are going to increase. We do need to face how we're going to pay for that and pay for that in a way that shares the burden appropriately across different generations and across different people's ability to pay. I do acknowledge that this bill goes some way to trying to address that in a way that is fair, particularly for those people who are already in the aged-care system and have made their plans, but that is also thinking forward.

A key part of the legislation which I'm really happy to see is the emphasis on home care. When I talk to people in Wentworth who have had engagement with the aged-care system, one of the things they talk to me the most about is how difficult it is to get home care in a timely way. When you're assessed for a package and you're on a waiting list, by the time you actually get the package you're often significantly more unwell, as you have not been able to get the services you needed right then to support yourself. This can often precipitate having to go into aged care, which, had you got the right services in your home when you needed them, you potentially wouldn't have needed to do. So I think this emphasis on home care is really important.

This bill will introduce greater flexibility, allowing older Australians to receive early interventions and a high level of support, including services like meal preparation, cleaning and personal care, with an easier transition between different levels of care when needed. I also commend the government for expanding the end-of-life care pathways to allow more people to access palliative care in their homes. I have experience of this on a personal level, having seen my father go through palliative care. He had the great benefit of having a wonderful palliative care team that he relied on very much at the end of his life. It is really important that we acknowledge the importance of palliative care for individuals and their families at end of life. It also gives people a chance to die at home, an aspiration that many, many people have but that many fewer reach.

Apart from the integrated assessment pathways, I still hold some concerns about the wait times to receive some of these home-care supports. When an older person, as I said, is deteriorating, receiving timely care is absolutely essential, and I would ask the government to more explicitly address this issue in their work and in their future legislation.

I also would like to acknowledge that a significant amount of the reform will be delivered through delegated legislation. While I understand the need for the bill to pass quickly to implement these much-needed changes by next year, I know that the community eagerly awaits closer scrutiny of the aged-care rules, which include the final quality standards, the code of conduct and how fees will be calculated.

Again, this bill is a positive step towards a better model of aged care in Australia, but the market based model means that the success of this legislation hinges critically on the ability of providers to provide adequate services, not to mention addressing the issue I identified earlier, which is the shortage of aged-care workers. In 2021, the Committee for Economic Development in Australia estimated that we would have an aged-care worker shortage of 110,000 by 2030. Bills that legislate rights and standards are promising, but, unless we have a suitable and sustainable workforce, the standard of care and quality of care for aged-care residents are likely to continue to be unmet.

I mentioned before how much this issue affects my community in Wentworth, where the chronic shortage of aged-care workers means that aged-care providers can't expand in the way that they would like to in my community, and they are really concerned about their ability to continue to attract great aged-care workers. I am concerned—I'll be honest—that the government isn't doing enough in this area. I want to outline that, while they have brought in a migration policy to attract aged-care workers from overseas, my great concern with that model is that it is tied up with, basically, an agreement between the aged-care workers and the unions, which is the only way that those special fast-tracked visas can be accessed. I have real concerns about that because many of the providers I've spoken to do not have those union links at the moment and would like to be able to work with other groups, such as Fair Work or other government institutions, to be able to access these workers without having to necessarily agree to all of the requirements that the unions impose on them, because in some cases they feel that they are unnecessary or onerous. I am concerned that their migration settings are not yet pulling that way.

The other issue I always come back to is that, in this place, we as parliamentarians are very good on imposing obligations on businesses, and in aged care it's absolutely critical, but we should also be constantly thinking about how we make sure that we are rightsizing the burdens that we put on individuals and on care providers. How do we make sure that we can still allow for innovation, growth and productivity in sectors like aged care, because this is an increasing part of our economy? How do we make sure, particularly for our frontline workers, that they're spending time on the care they want to give, rather than on paperwork and bureaucracy?

I used to work in a hospital, and I have worked in education. The consistent feedback I got from the nurses, the doctors, teachers and the principals was that they were spending less and less time on the things that mattered to them most, the things that were the reasons they got into the sector in the first place: their desire to provide care and education to people. They were spending more and more time on bureaucracy. I think every government needs to aspire to constantly rightsize this, to constantly come back to say: 'Here's this regulation. It's there for protection, but are there other ways of providing that protection while still giving people flexibility and unburdening the frontline workers so that they can do what they do best, which is to provide care and education to those who need it?'

In conclusion, while I believe that this bill represents a good reform and a significant step forward, there is still further to go. We must continue to push for greater investment in the workforce, in particular. We must address long wait times for care and ensure that reforms are implemented in a way that truly benefits older Australians but also allows innovation and productivity growth in the sector.

Michael McCormack (Riverina, National Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

Last sitting week, the Albanese Labor government introduced its new Aged Care Bill 2024 to the parliament. We, as the coalition opposition, think that the bill ought to go to the Senate Community Affairs Legislation Committee for inquiry. As you can see, there are a lot of pages to it. There is a lot of work that needs to be done. It is an improvement, but there is still a long, long way to go.

Late last year, I held a roundtable with aged-care providers throughout the Riverina and the central west. They expressed to me their deep concerns about the aged-care sector. They are at the forefront of what is seen by them, by residents and by many in society as a failing system. It's become a whole lot worse under this Labor government.

The roundtable that I had originally came about after discussions with John Knight, the chair of Uralba Hostel in Gundagai. Gundagai, like many communities in my electorate, has an ageing population. Indeed, in many places in rural and regional Australia there are ageing populations, and people are desperately worried that when they reach that time of life when they can no longer look after themselves that there won't be a bed, a place, for them in the community in which they've lived for most, if not all, of their lives. It is simply not right, not fair, not equitable and not economical that they just get shipped away hundreds of kilometres, in many cases, from loved ones, family and friends and away from the communities that they love and cherish. They're left to spend their twilight years, which should be their golden years, in communities that are foreign to them. This is of particular concern in rural and regional Australia.

I was interested to hear the member for Wentworth express the same view, and she is in the largest city in Australia. If it's an issue in Sydney, then it's certainly going to be an issue in rural and regional Australia. In remote Australia it's going to be even worse. To that end, I was particularly aggrieved by the fact that Labor initially did not intend to have funding for rural and regional Australia committed as part of this act. The coalition secured $300 million in additional capital funding through the Aged Care Capital Assistance Program for regional, rural and remote aged-care providers to upgrade facilities. This was in addition to additional care funding, particularly for aged-care homes throughout country Australia. This is important, necessary and vital. Targeted support for rural, regional and remote aged care homes was not included in the government's initial proposal. And—

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

Do you want to finish your sentence, Member for Riverina?

Michael McCormack (Riverina, National Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

I'd only said the word 'and', but I'm in your hands, Deputy Speaker.

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

Okay. The time allotted for the debate has expired, unfortunately, and the debate is interrupted. The member for Riverina will be given the opportunity to continue his remarks at a later date. The debate will be made an order of the day for the next sitting.