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

As senators will recall, I am speaking in continuance on the Aged Care Legislation Amendment (New Commissioner Functions) Bill 2019, which is phase 2 of transitioning powers and functions to the Aged Care Quality and Safety Commission and the commissioner. I was talking about the issues we need to be looking at, including a continuous quality improvement framework. As mentioned last year, the Australian Greens want to see a quality improvement framework being adopted to ensure that near misses are reported and work is done to continuously improve care for older Australians.

Last year I chaired the Senate Community Affairs References Committee inquiry into the effectiveness of the aged-care quality assessment and accreditation framework for protecting residents from abuse and poor practices and for ensuring proper clinical and medical care standards are maintained and practised. The committee recommended that the government work to expand the role of the commission to drive continuous improvement in quality and safety in aged care. Unfortunately, this bill has not touched the issue of continuous quality improvement, and we still have questions around the status of the framework. I will be asking about the status of the Serious Incident Response Scheme and the quality framework during the committee stage later this morning.

We have other concerns about the scope of the commissioner's complaints function. There is a significant lack of complaints and resolution of complaints about aged-care services being published. This is possibly driven by the reluctance of the secretary and the commissioner to use their respective powers to make information publicly available. It could also be due to the interpretation of the definition of 'protected information', as raised by COTA during the inquiry into the Aged Care Quality and Safety Commission Bill last year.

Today I will put forward an amendment that seeks to remedy this problem, by placing an obligation on the commissioner to publish information relating to complaints that have been made. The amendment requires the commissioner to publish a report at the end of each month on the number of complaints received about each approved provider or service provider, the number of complaints received about approved providers or service providers that were not resolved, and the type and number of actions taken by the commissioner to address the complaints. This amendment will lead to greater transparency and accountability regarding decision-making around aged care. Families want to know that their complaints are being heard, answered and responded to.

Aged-care advocates play an important role in supporting older people to address and exercise their rights and have their voice heard on the issues that are important to them. Under the current User Rights Principles, advocates and community visitors are granted access to enter aged-care facilities to assist older people. However, advocates still face a number of barriers to doing their job. For example, some advocates are still being refused entry and access into aged-care facilities. There are also issues around information being withheld from advocates where aged-care providers are blocking access to information. Advocates are reporting that it often takes time to resolve these issues with providers refusing entry. The commission is now responsible for enforcing provider responsibilities, including sanctions against providers refusing access to advocates. Today I will also be moving amendments that provide advocates with access to information relating to residential care, home care and flexible care.

The establishment of the new commission has made important steps towards a more holistic approach and better oversight of the aged-care sector as a whole. While some progress has been made, there is still significant work that needs to be done to ensure older people have access to safe and high-quality aged care. The royal commission's interim report made alarming observations about our current regulatory system in aged care. They said:

We have heard evidence which suggests that the regulatory regime that is intended to ensure safety and quality of services is unfit for purpose and does not adequately deter poor practices. Indeed, it often fails to detect them. When it does so, remedial action is frequently ineffective.

The regulatory regime appears to do little to encourage better practice beyond a minimum standard.

We believe we should be striving for an effective regulatory system that deters, detects and responds to actions that could cause older people harm. Regulation should be about enhancing health and wellbeing of people receiving care. Sadly, our broken aged-care system is not achieving these goals. While the royal commission has flagged its intent to recommend a fundamental overhaul of the aged-care system, including regulation, there are many changes that can be made to the regulatory system now so that older people do not have to wait for better care. We need action to ensure that we have a robust regulatory system that is fit for purpose and supports the kind of transformational change needed in our aged-care system.

I understand that the government is looking into the third phase of reforms relating to the commissioner's powers and functions. This presents a valuable opportunity to further strengthen the commissioner's set of powers and regulatory tools. In the meantime, I hope that the government will consider our proposed amendments that seek to strengthen the commissioner's powers and functions now. Older people deserve better quality care that is respectful and upholds their wellbeing, dignity and human rights, and we must do everything we can to ensure this happens as soon as possible.

There are many issues that still need to be addressed—restraints; the issues around viability of the sector; and rural and regional aged care, particularly rural and regional aged care for First Nations people. We do need to look at a total restructure of aged care. The Greens are aware that this will take time. But, because it will take time, we need to act now on the things that we know are wrong so that we can fix those while we develop a truly transformative approach to the way aged care is provided to older Australians.

As I indicated earlier, we will be supporting this bill, but I will be moving amendments, because I think the government hasn't gone far enough in this second phase of developing the role of the commission and the commissioner.