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

I rise today to make a contribution to the Age Care Legislation Amendment (Financial Transparency) Bill 2020. This bill addresses significant shortcomings in our current aged-care system by requiring aged-care providers to publicly report on financial information, including spending on food, medical products, accommodation, salaries, wages, administration and staff training.

You wouldn't think this was too much to ask, given that we pay about $21 billion a year for provision of aged care. It should be common sense that this is the sort of transparency that's expected for that expenditure of resources on some of the most vulnerable members of our community. By requiring providers to report such information, we would have a much better understanding of how well facilities are resourced and what they're doing with that funding. Is it going where it should be going? We would get a better understanding of any possible gaps in care, quality and safety.

For example: just what are residential aged-care facilities spending on clinical care? We know from the recent pandemic that they have significantly let down residents and their families across the country, but particularly in certain states—like in Victoria, where what the deficiency in aged care has meant for residents is there for all to see. If they were practising better infection control right from the start we wouldn't have been in the situation we found ourselves in in aged care in Victoria.

In 2019-20 the Commonwealth spent, as I said, around $21 billion on all types of aged care, yet there are no requirements for providers to disclose how much money is actually spent on care. Our aged-care system fundamentally lacks transparency in communication, reporting and accountability. One of the major systemic failings of the aged-care system is the lack of transparency and accountability about how providers disclose the way they use government funding to deliver services. This is a regulatory failure that I'm sure has contributed to providers getting away with providing inadequate care to older Australians, and it galls me to have to have to sit here and listen to the excuses from government about why we don't need this and how good our aged-care system is when we've got a royal commission into it, for crying out loud! We've got a royal commission because of inadequate care in this country—account after account after account of the failure of the system. Ants in wounds, for crying out loud! We haven't gone far from the kerosene baths episode.

We still have not banned physical and chemical restraints. They still don't have to get permission when they use those restraints. I'm still getting complaints from constituents, saying that they've that found their loved ones had been physically and chemically restrained. We have to ask: how can older people and their families make informed decisions about aged-care services if they can't understand how much a facility spends on items such as food, staffing costs and other critical care elements? I think we would all agree that residents and their families have a right to know what the facility spends on basic care needs such as food, medicines, medical products, continence aids, management wages, staff wages, staff numbers and categories.

We have had a debate for so long in this country about minimum staffing levels. We still haven't got there. We still don't require a nurse to be on duty 24/7 for crying out loud! Nor are our staff in residential aged-care facilities getting paid enough; hence, they have to work across multiple facilities. Of course, we realise what that means, don't we? Counsel assisting the Royal Commission into Aged Care Quality and Safety recommended the need for more stringent financial reporting requirements. They recommended:

104.1. From 1 July 2023, the Australian Aged Care Commission should be empowered under statute to require approved providers to submit regular financial reporting.

104.2. The frequency and form of the reports should be prescribed by the Commission.

I think that needs to be done well before 2023.

This bill also raises bigger questions about the role of for-profit aged-care providers. The devastation that ripped through aged-care facilities in Victoria put for-profit facilities in the spotlight. We saw some terrible examples of for-profit providers failing to meet basic standards of infection control procedures and clinical care, and having to be rescued by the government. No-one should be making such huge profits from the provision of essential services to Australians.

In the meantime, this bill would introduce a new level of transparency and accountability when it comes to reporting how aged-care funding is spent by providers. We hear the excuse: 'We've got a royal commission coming; we shouldn't be doing stuff that pre-empts the royal commission.' This place is going to debate two bills on aged care in the next two weeks, so we can make changes before the royal commission reports—in fact, we need to be making changes The government acknowledges that themselves with the bill being around the different funding and the way we're going to go to a reimbursed approach instead of up-front funding for home care, and also with piloting and doing the comparison process for the funding instrument. Both of these bills will go through here because they're sensible, as is requiring a greater level of transparency from our aged-care sector. They have got away with not doing the right thing for far too long. I do agree with Senator Henderson: there are some very good providers in this country; but there are some very bad providers in this country too, as has been well displayed over this year.

We need reform, we need it urgently. We've already seen the two interim reports from the royal commission. We have seen the counsel assisting's comment to the royal commission. The final report, that very substantial piece of work, is due in February next year. We've known for a long time that we need to have transparency. We know we need a better understanding of how money is spent. We need to be paying the staff in aged care better, and we've known that for a very, very long time. It's time for some better transparency. We support this bill.