Rachel Siewert (WA, Australian Greens) Share this | Hansard source

I am disappointed to hear that we will not be getting support from the ALP. I have said in this place before, in relation to the mechanism of legislative review of the bills that they are talking about, that there is no chance of getting that up. It puts it off into the never-never, and we need to be dealing with this issue now. The sector, I understand, has been making a number of proposals to government in order to be able to provide some opportunity and time for longer term measures to be put in place that do address the issue around sustainable funding and develop a sustainable funding strategy for aged care. I think there is agreement around the chamber that that is needed. Where we disagree is the ad hoc changes that are being made and the taking out of so much money from the aged-care sector—in particular out of the complex behaviour care matrix, because of the impact that will have on frail patients.

I am aware that we need to be addressing this issue, because we know people who are going into residential care are much frailer. That means that straightaway when they are going in they need much higher level care. I am not confusing that with the high care and low care that we are moving to get rid of; I mean in terms of the level of nursing care and personal care that is required. That is why the complex healthcare part of the ACFI is so important.

Earlier on, I was quoting from and talking about the Ansell strategic report. That also acknowledges the challenges. It says:

These challenges to providers and Government reflect the change in the physical demands of residents in residential aged care settings and the advancement of home care services in Australia. It is also a reflection of the maturity of ACFI which was introduced over 8 years ago. In combination, the aged care sector is managing an unsustainable system in which:

1. The ACFI mechanism does not accurately allocate resources based on contemporary resident need. This may result in core activities not being funded and creates potential wastage of resources directed towards lower priority activities that do attract funding; and

2. Increasing frailty among the resident population is creating an escalating burden on the taxpayer because of the funding regime which is heavily subsidised by Government.

It goes on to say:

The Living Longer, Living Better legislation has provided some scope to address inequities within the system and facilitate greater levels of contributions from consumers toward their care. However, the increasing resident dependency levels makes it difficult to achieve balance under the current system.

It then says:

The result is that the 2016 Budget cuts will fall directly upon providers of the care, with no avenues to recover the losses from residents, other than cutting their services.

Obviously, decreasing clinical support for residents with escalating complex care needs in not going to be sustainable. The funding instrument and the wider system must now change.

That is what should have been done before they made these ad hoc cuts.

As I understand it, the sector is providing some alternative approaches that involve the government not proceeding with the ACFI changes from 1 January next year. They are making a range of other suggestions. I do not know how the government is receiving them, but, as I said, the upshot of that would be to allow time to develop a sustainable funding strategy where we are not seeing these ad hoc cuts. I would add to that that these cuts should not go ahead, because they are already having an impact, and that the government should start a process that looks at whether they reform ACFI or come up with a whole new instrument. That is obviously going to take some time. Let us not proceed with these cuts that are already having an impact. Let us take some time and develop a sustainable funding strategy for the way forward that actually takes on board the issues I have just been raising, that the sector has raised and that consumers have been raising.

I urge senators to support this disallowance, because we should not be making on the run, every couple of years, ad hoc funding decisions that are not consultative, that cut care and that are going to have an increasing effect because of the acuity of the people who are going into residential aged care and the residents who are in home care, when we start seeing the impact of cuts for other services. It is time that we recognised that these cuts do cause uncertainty. I urge senators to support this disallowance, which will allow time for us to have a much better informed and consultative approach to sustainable funding into the future.