Malarndirri McCarthy (NT, Australian Labor Party, Assistant Minister for Indigenous Australians) Share this | Hansard source

I rise to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response) Bill 2022 and take this opportunity to commend Minister Wells for bringing this to the Senate and to the House, showing not only the priority that we place on all of our election commitments, which we will be pushing forward over this term of the parliamentary cycle, but also the priority we place on our elders. We talk about our children as being vulnerable and we know we must look after them, but we also have to look after our elders. Certainly in the First Nations way of life our elders are critical. We saw throughout the pandemic the fear that most Australians felt but, in particular, elderly Australians—and who still feel it today, because the pandemic is not over. We are living with this pandemic, and it is our elders who are incredibly vulnerable.

I recently visited Nhulunbuy, in north-east Arnhem Land, and had the opportunity to work with some of the Yolngu elders there and seek their advice and their wisdom as to what we need to do in terms of our aged care and caring for our elders. It was wonderful to be able to spend some time with Carers NT and to see the launch of the Djaka'mi facility in eastern Arnhem Land. In the Yolgnu language 'Djaka'mi' means to care, and it's certainly a fitting name for this initiative. The work of Carers NT at Djaka'mi supports both NDIS disability participants and aged-care clients to be supported on country in Nhulunbuy. They employ local people who bring their language, culture and connection. It also provides an opportunity for respite for the elders in a place that's safe, and their families and carers know that they can take some time and leave their loved ones with people that they trust.

Many elderly Territorians have died hundreds of kilometres away from their community, away from their homelands, their country and their families. I say this from a very realistic point of view due to the geography of places like the Northern Territory and indeed places across northern Australia and Western Australia where we are such a great big country. First Nations people largely want to live connected closely to their country, and sometimes those hospital services, those aged care services and indeed most government services are not as close as we would think they could be in places like Darwin and Alice Springs. So most people travel where they have to for the care that they require.

Good, dignified aged care depends on listening to elderly Australians and what they want no matter where they are in the country, and this facility is what good, dignified care looks like. It changes lives. If we can see great care provided in a remote part of the Northern Territory like Nhulunbuy with this particular service, we can and should see it done elsewhere.

And, as Assistant Minister for Indigenous Health, I will just highlight that the Royal Commission into Aged Care Quality and Safety recommended that the government:

… ensure that the new aged care system makes specific and adequate provision for the diverse and changing needs of Aboriginal and Torres Strait Islander people …

I'm incredibly pleased to highlight here to the Senate that the Australian government is investing $106 million in providing face-to-face support for older First Nations people and $115 million in building culturally safe aged-care facilities. I met with elders in north-east Arnhem Land and with Djaka'mi, which is a not-for-profit community-based organisation dedicated to improving the lives of family carers living in that part of the country.

We know that, through this particular bill, the Albanese Labor government's commitment crosses a broad cross-section, in terms of seeing the aged-care sector across Australia improve quite dramatically, and I just want to go through some of those points. One of the things that I know has really, really raised the hopes of many families is the fact that we want to increase the average minimum care time per resident per day and introduce a mandate that requires all residential aged-care facilities to have a registered nurse onsite 24 hours a day, seven days a week. This will deliver on the government's election commitment to put more nurses back into nursing homes, giving carers—the loved ones who care for their loved ones and their elders—more time to care. From July 2023 our government is mandating the requirement for a registered nurse to be onsite at all times. This commitment directly responds to recommendation 86.5 of the royal commission and will be delivered one year earlier than was recommended.

Aged care is everyone's business. This piece of legislation promises much of what we took to the election, and we know that that critical need is one that we recognise has been ignored and neglected for way too long. This was evident in the Out of sight, out of mind report that we saw in the previous term. The new Australian National Aged Care Classification, AN-ACC, funding model will replace the outdated Aged Care Funding Instrument in October, offering more equitable funding that is better matched to providers' costs in delivering the care residents need. Aged-care providers shouldn't be expected to walk alone, and our government is committed to supporting them appropriately. The star rating system will see the Department of Health and Aged Care publish a comparison rating for all residential aged-care services. This will support older Australians, their loved ones and their representatives in being able to compare services and able to make more informed choices about their aged care, and that's important. Why should we think that, as you grow older, you have less choice and less ability to make decisions about the kind of care you want? We recognise that this is pivotal to the dignity and care not only of our elders but also to the families who look after them and the general carers who are part of that network.

Reforms will also see the extension of the Serious Incident Response Scheme to all in-home care providers, meaning increased protection for older Australians from preventable incidents, abuse and neglect. I, like many of you here, and certainly many Australians, was horrified by the heartbreaking stories of abuse and neglect coming out of aged-care settings. For too long there were no mandatory incident-reporting requirements for providers of home care or flexible care delivered in a home and community setting. This meant that there was no oversight of allegations of abuse and neglect of older Australians receiving care in their own homes. And how tragic is that: to be in your own home and to experience that neglect and abuse, and be able to do nothing about it? This change is absolutely overdue, and it's critical we denounce abuse and neglect and not simply leave it out of sight and out of mind.

I'm also pleased to see the introduction of a new code of conduct for approved providers, their workforce and governing persons, setting minimum standards of behaviour to ensure older Australians receive care in a safe, competent and respectful manner. New provider governance and reporting arrangements due to begin at the end of this year will improve transparency and mean greater accountability on providers to better focus on the needs of older Australians receiving care. First steps will also be taken towards harmonising regulation of care and to support providers across the aged-care, disability support and veterans' care sectors by improving information-sharing between the bodies that regulate these sectors.

I not only commend Minister Wells I also commend Minister Butler and the Prime Minister for their swift action to work on fixing this system. The status quo of neglect over the past decade simply has not been good enough. I also commend all of those elderly Australians, their carers and the workers who provided their stories, and conveyed the reality of aged care in this country to the royal commission. These changes, among many others, will build on our promise to deliver security, dignity, quality and humanity in care for every older Australian across the aged-care system.

In my portfolio area, as Assistant Minister for Indigenous Health, I'm also very conscious, as we talk about the aged-care sector—and I know that previous speakers have spoken about First Nations organisations and the Aboriginal health sector—to point out that one of the priority areas which I will focus on as well captures the aged-care sector: those patients who are on renal dialysis. We have a significant number of the First Nations population receiving dialysis, many of whom—but not all, some of them are quite young—are in the aged-care sector, with extra needs and requiring support.

I can speak from experience in the Northern Territory, where families leave their community to go to renal dialysis in Alice Springs, Tennant Creek, Katherine or Darwin. Some of them receive that care on country or at home, and that, combined with the need to have a reliable and supportive aged-care nursing home nearby is also absolutely essential for those clients in particular. That's because renal disease is one of the greatest diseases that impacts on First Nations people in our regional and remote areas of Australia in particular. Highlighted by those geographical distances is the need for access to a clean and reliable water supply for the dialysis machines and also the ability to have resources on country, should people want to stay there for their care.

These are questions that I ask as I travel around Australia, talking about health, First Nations health and access, as we look at this from the perspective of what kind of care our elders require. So I'm enormously pleased that our government has brought this bill forward. I will certainly be following very closely the significant policy announcements that we've made in relation to aged care and in the health sector generally. I commend the bill to the Senate.