Concetta Fierravanti-Wells (NSW, Liberal Party) Share this | Hansard source

I'll start by saying that it's good that Senator Polley has brought this notice of motion on aged care because it does afford me the opportunity to go back in history and put on record, Senator Macdonald, some additional facts—most especially going back to when Labor was in power and what they actually did in the aged-care space. At the 2010 election, then Prime Minister Gillard said that if she was re-elected then aged-care reform would be her second term priority. Of course, during the 2007-2013 term, Labor presided over 20 reviews and inquiries into aged care and ageing issues, including three by the Productivity Commission. Like many of the Gillard government's goals, this was yet another empty statement masked as an achievement.

As I indicated, there were all these reviews when Labor were in government. One of these reviews was, very importantly, the landmark report of the Productivity Commission, which was delivered in 2011. It was a two-volume report entitled Caring for older Australians. At that time, as shadow minister for ageing and for mental health, it was certainly a document that I was very familiar with. Senator Polley comes in here and says, 'Those opposite haven't responded to the latest inquiry.' Let me remind the chamber that it took the Gillard government over 250 days to respond to the 58 recommendations within the Productivity Commission's landmark 2011 report. That response took the form of a $3.7 billion package over five years—of which, can I just underline, less than $580 million was new money. Of course, like most things that those opposite do, the package was announced in April 2012 and it represented an assortment of cherrypicked recommendations with lots of political spin. You can't have a Labor announcement without lots of political spin, can you, Senator Macdonald?

Senator Ian Macdonald interjecting—

Of course, there was myriad fine print that the stakeholders started to understand only after the election. This report was comprehensive and it looked at and recommended a total overhaul of the system. It referred to the structural changes that were going to be needed to meet the needs of our ageing population into the future, and it talked about an ageing population—a significant increase in the number of older people. It talked about the increasing incidence of age related disability and disease, especially dementia. It looked into the rising expectations about the type and flexibility of care that was being received. It looked at community concerns about variability in the quality of care. It looked at the relative decline in the number of informal carers and, most importantly, it looked at the need for significantly more nurses and personal care workers with enhanced skills, such was the breadth of this report. As I said, in the end, all those opposite did was cherry-pick this report and, may I say, not very successfully.

What was clear from their much-lauded Living Longer Living Better package was that everyone except full-paying pensioners would pay more for their care. At the time, we did not oppose this package but, in the end, what we are seeing is that, today, we are now paying the price of this policy and the failure of those opposite to take the necessary reform that they should have taken when they were given this opportunity. Of course, whilst we saw that packages were increased, nevertheless, it came at a price. We saw fees capped. We saw fees increased. Also, there was means testing for the cost of residential care.

Senator Polley also asserted that we failed to look at retirement living. I would remind Senator Polley that retirement villages are actually under the auspices of state governments. They're not under the auspices of the federal government. If I recall my consultation with the sector at the time, I believe that there's actually been work done on this at the federal-state level and there is no appetite for retirement villages to be regulated by the Commonwealth.

I came, and have come, to this area with experience. At age 23, I was the founding board director of an aged-care facility in Wollongong. As I said, I was the shadow minister before the 2013 election. During my time as shadow minister, there were about 2,400 aged-care facilities in Australia at that time and I visited almost a third of those aged-care facilities. There is an overwhelming number of very, very good aged care-facilities in this country. Often you would walk into an aged-care facility and externally it may not be the most luxurious place, but what is vitally important in any aged-care facility is the level of care. It is the attention to the care needs of our older Australians that makes that place a very good aged-care facility.

My father also had dementia and, unfortunately, lost his battle with dementia. My mother is in an aged-care facility at the moment. In any discussion about aged care and aged-care reform, one has to take into account the changing cultural diversity of Australia. One of the things that has always been very dear to my heart is to ensure the care of our older Australians from culturally diverse backgrounds, especially those who get dementia. Often older Australians lose whatever English language they had and revert not just to their language of origin but, in many cases, to their dialect of origin, and that creates complications.

Why have I gone through this? I have gone through this because, going back to the 2013 election when those opposite say that they undertook massive reform of the aged-care sector, we, at that time, understood the important work that the Productivity Commission had undertaken and our 2013 election policy took into account the Productivity Commission report and its implementation. That meant the system needed a major overhaul, not just tinkering.

I have to commend Minister Wyatt for the work he has done. He is certainly moving in this direction. There is, of course, more work to be done. But what is really important is the political will. It's all very well for those opposite to come in here and bleat about the need for reform, but any reform in this area needs to have strong bipartisan support, because you need political will to undertake this reform. We cannot have those opposite saying that they want reform but then, all of a sudden, when you do put forward propositions—which at times may be difficult—doing what they usually do, and that is politicise and scaremonger in relation to these issues, as they have done in the past.

Let me look at some of the issues. As has been said, annual funding will increase to record levels—by $5 billion over the forward estimates—from $18.6 billion in 2017-18 to $23.6 billion in 2021-22. We are providing record aged-care funding of almost $20 billion this year. Aged-care spending has increased by an average of more than six per cent each year. That is, on average, $1 billion of extra support for our older Australians each year. We are also adding an additional 13,500 residential aged-care places and 775 short-term restorative places. Since the last budget we are delivering 20,000 new high-level home care packages to support our older Australians to remain at home, and by 2021-22 over 74,000 high-level home care places will be available. That is an increase of 86 per cent on 2017-18. Also important is our investment in the mental health services of our older Australians in the community and in residential aged care to improve mental health services, especially for our older Australians who are aged 75 years and over, and provide new mental health services in residential aged-care facilities.

Of course, it is also necessary to police quality care in our aged-care system. We are also bringing forward $90 million this financial year to support quality in residential aged care and aged-care capital works in regional, rural and remote Australia. We are also examining options for a more stable, certain and efficient residential care funding tool to replace the current Aged Care Funding Instrument, which has been recognised by the independent Aged Care Financing Authority as no longer being contemporary—as being inefficient, too subjective and lacking the necessary stability in achieving outcomes. The development of the new funding tool is being led by the University of Wollongong—of which I am very proud; Wollongong having been where I was born and raised and where my electorate office is at the moment. The University of Wollongong will provide a report to the government by the end of this calendar year. Of course, any new tool that is adopted by the government will, of necessity, involve a better and more efficient way of allocating the funding pool. We are not considering any options that would reduce the funding pool.

I would now like to move to the specifics of the Aged Care Quality and Safety Commission Bill, which contributes to our government's commitment to ensure that our older Australians in aged care will be better cared for. This bill gives effect to the government's announcement in the 2018-19 budget to establish the new commission from 1 January next year, as part of providing for better quality of care for consumers of aged-care services in Australia. At this point, I would like to pick up on a comment that Senator Bilyk made. She said that at the moment the current framework isn't working. I'd remind Senator Bilyk—perhaps she can think back to that time—that the current framework was part of the Rudd so-called health reforms. Remember those reforms that gave us 13 new agencies and a total blowout of bureaucrats? This was one of the agencies that was set up, which was lauded as part of this package that I spoke about before—the Living Longer Living Better package, which was supposed to ensure that this quality in our aged-care services would be maintained. Perhaps I can remind Senator Bilyk: it may not be working, but you set it up and so you do bear some responsibility for the issues that have arisen.

The introduction of this commission is also a direct response to the findings and recommendations of the review of the national aged-care regulatory process, which was undertaken by Kate Carnell and Ron Paterson. This commission will bring together the functions of the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner, and further work will be undertaken next year to bring the aged-care regulatory functions of the Department of Health into the commission from 1 January 2020. I have to say at this point, this will rectify some of the major errors that were made by those opposite when they set up these huge bureaucracies. In the end, these bureaucracies were falling over each other and overlapping responsibilities and all we ended up getting were more bureaucrats rather than more effective and efficient services.

This reform is part of a two-year agenda to strengthen and enhance aged-care regulation to protect and ensure the quality of care provided to our older Australians. And of course our older Australians, our consumers in this space, are at the very heart of our reforms. The objectives of the commission are to protect and enhance the safety, health, wellbeing and quality of life of aged-care consumers; to promote confidence and trust in the provision of aged care; and to promote engagement with aged-care consumers about the quality of care and services.

The commissioner will take on the functions which are currently performed by the complaints commissioner and the chief executive officer of the quality agency, with specific functions also set out that relate to engaging with aged-care consumers in the developing and promotion of best practice models for the engagement of providers; and seeking and receiving clinical advice in relation to the functions of the commissioner, which is envisaged to occur through the engagement of a chief clinical adviser. An expert clinical panel will be established to support the role of the chief clinical advisor. The commissioner will be supported by advice from the Aged Care Quality and Safety Advisory Council. The council will be made up of members with significant expertise in the relevant fields, and they will be empowered to provide the commissioner and the government with advice concerning the functions of the commissioner.

The Aged Care Quality and Safety Commission (Consequential Amendments and Transitional Provisions) Bill 2018 provides for the administrative matters required to transfer the functions and operations of the existing bodies into the new commission. Importantly, this bill provides for the continuation of the appointment of the members of the existing council as members of the new Aged Care Quality and Safety Advisory Council, and will enable the new council to commence operations immediately. It will provide stability and experience in the advice being provided to the commission and to the government. This forms part of the broader aged-care reform agenda announced in 2018-19, which includes further reforms to improve aged-care regulation and to provide greater transparency of the quality in aged care, which will continue to be implemented in the coming months and years.

I conclude with comments in relation to the royal commission. I think the royal commission is important because it will afford people the opportunity to put forward their stories. As I said, the overwhelming majority of aged-care facilities maintain very high standards. We have very dedicated aged-care workers, very dedicated nurses and personal carers that work in this space, and I've had the privilege to meet many of them, particularly at the time when I was the shadow minister in this space. But regrettably, there are instances where standards have fallen—