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

I rise to make a contribution to this matter of public importance debate. I articulated earlier in this place today how concerned we are about the failures in aged care in this country, particularly as it relates to the COVID crisis and the number of deaths that have occurred in aged care in this country and the fact that this government appears to see it as, 'Well, it's less than in Europe'—to justify it because it's less than what's happened in Europe and other countries and as if it is an inevitability. Well, it's not an inevitability. The fact is that we didn't have a plan. We had a lack of preparation. We haven't had enough money invested in aged care. We lack the workforce. We lack a surge workforce. We don't provide the hours of care that people need when they are in aged care. Those are just a few of the things that need to be addressed and that have led to the failures to adequately protect older Australians in residential aged care.

What I want to focus on here are the issues around our regulator. We don't think that the Aged Care Quality and Safety Commission is adequately supported or resourced, or has the appropriate regulatory powers to fully enforce standards in aged care. COVID-19 has further exposed the already significant problems in aged care and the significant problems with our existing regulatory framework—and, in fact, our approach to regulation. The Aged Care Quality and Safety Commission has been perfectly happy with assessing providers' readiness for COVID-19 through self-assessment tools and phone contacts. That is clearly inappropriate in the face of the potential impact of COVID on older Australians in aged care. They must have known about the significant problems we have in our aged-care sector in this country: the lack of staff, the fact that we are still arguing about whether we should have a nurse in the facility 24/7 and the fact that there is still conflict over provision of clinical care. They must have known that these problems were there.

I think it's incredibly telling how the commission has approached regulation in general. It is simply not appropriate to use self-assessment tools and phone contact to regulate in the face of this pandemic. The tick-box approach around assessing aged-care quality has been known to experts in the sector for years now. I've had constant complaints about it. People in the sector will openly tell you that quality assessors are not adequately equipped to do their jobs. They often don't have the capacity to observe outcomes and factors contributing to substandard quality care. In fact, in a submission to the aged-care royal commission in June, the CPSU said that nearly 60 per cent of assessors felt ill-equipped to identify gaps in care because they didn't have enough time on site to identify problems. The CPSU also noted that without additional staff to share the workload of monitoring aged-care assessments will continue to be rushed, while care is poor. One staff member told the union:

We often feel we are regulating with our hands tied behind our backs. We are not allowed to photographically record information, copy and take information, audio record key interviews. The Commission is a bit toothless in holding providers to account …

Another assessor said:

… there is no real penalty to failing the meet Standards. Just the inconvenience of additional visits from the Commission …

It is crystal clear that the Aged Care Quality and Safety Commission has failed to properly investigate facilities during the outbreak of COVID-19. I strongly believe that the decision to cease unannounced visits was the wrong decision. The regulator should have been there to make sure these facilities were up to scratch. The commission is underresourced and understaffed, not only to deal with this pandemic but also the fundamental problems in aged care. As at 31 August, Australian Defence Force personnel had visited a total of 252 aged-care facilities. In contrast, the Aged Care Quality and Safety Commission had conducted spot-checks and carried out 118 checks. This means the ADF are conducting more than double the amount of checks on our aged-care facilities. While that is a good thing, you would think the people with the expertise should be the ones in there. It is obvious that the commission doesn't have enough staff to inspect every single facility and undertake the spread of the work that needs to be done.

The minister told us at a COVID committee hearing in August that if the commission requires additional resources then the government will provide them. If that's the case, why isn't the minister providing the commission with significant extra resources and funding to bolster its workforce and let it do the regulation properly? Many stakeholders in the aged-care sector—including COTA, OPAN and the AMA—have been calling for a strengthening of the commission's functions and powers since it was established. The Greens have also been calling for this. In fact, we tried to amend legislation passed by the Senate last year to strengthen the commission's powers.

It is imperative that the government immediately look at how the commission can be strengthened and better resourced to support facilities throughout the pandemic and beyond COVID-19. This is yet another failure of this government in adequately ensuring that our regulator had the teeth, the powers, the funding and the resources to make sure that it could properly regulate this sector so the sector was in the best state possible as it faced this pandemic. It is unacceptable that this continue any longer.