Anne Urquhart (Tasmania, Australian Labor Party) Share this | Hansard source

tor URQUHART (—) (): I rise to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response) Bill 2022. I was told a story recently about the elderly mother of a friend who was moved into the secure ward of an aged-care facility and who had a fast-developing dementia. The family chose the facility because it had a good program of activities tailored to the needs of dementia sufferers. They stretched the family finances as far as they could to do this because they wanted their mother to have the best possible care. Like so many people in their position, they had to clean out and sell the family home—the only significant asset that their mother owned—to pay for that care.

Their mother's dementia first manifested in a loss of language. Over time she completely lost all her words. Communication of any kind became a constant struggle, except when the music therapist came to visit the aged-care home and played her guitar. Then she could sing: songs from the war years, songs from her childhood, songs ingrained in her memory many years earlier. That clearly gave her great pleasure. There is increasing scientific evidence that music seems to be robust and to withstand the effects of neurodegenerative decline and other acquired brain injuries. Neuropsychologist Catherine Loveday wrote back in 2016:

One key finding is that music is a particularly good cue for autobiographical memories—these are memories that reinforce our sense of identity and play a hugely significant role in how we connect socially and emotionally with those that are close to us. Tunes that we first encountered between early adolescence and our late 20s seem to be particularly evocative.

For this woman's family to discover that they could hear their mum's voice again and to see clearly how much joy the singing brought her was an incredible revelation.

But, soon after, the aged-care home had a massive round of cost cutting, and the contract with the music therapist was not renewed. And, with no-one to play the tunes and encourage her, their mother fell silent. Her physical needs continued to be met. She was cared for by a dedicated staff who did their absolute best to ensure that she was clean, she was fed and she was comfortable, but her voice was no longer heard.

On a new roster after the cost cutting, the staff were far too time poor to even put on a CD for her to listen to or to regularly take the dirty plates and cups out of her room after meals. Then, in what were clearly further savings measures, the menus were changed, and the meals presented to residents became far less appetising. Residents' dietary preferences went completely out the window. Despite all the notes and the records on the file of my friend's mother, she was regularly served meals of fish. She had always hated fish and, when she had a voice, had always made that very clear.

The night that my friend's mother passed away, there was a nurse on duty who could deliver the medication and particularly the pain relief that their mother needed. As my friend said, that was so important. I shudder to think what that night would have been like if that nurse had not been there. 'Surely there should be a nurse on every shift?' was the question.

That all happened over 10 years ago, but the warning signs were clearly there. Over that decade, the problems in our aged-care system continued to mount to the point of crisis. Over the last two years, the COVID-19 pandemic has served to emphasise and to highlight the weaknesses and flaws in the system and actually worsen the crisis, a crisis that is crying out to be addressed.

So this government, the Albanese Labor government, has taken on the task of restoring dignity, care, accountability and humanity to aged care, and it is because we must. The passage of this bill before us, the Aged Care and Other Legislation Amendment (Royal Commission Response) Bill 2022, is a critical step in reforming the aged-care sector. The urgency to do this is not simply based on people like me hearing stories from friends with parents in care, as devastatingly sad as they may be. A royal commission has formally heard the testimony and seen the evidence that reform is desperately needed. This is the evidence the Royal Commission into Aged Care Quality and Safety has enshrined in its reports.

The royal commission hearings presented mounting evidence of systemic flaws and inadequate care. The commissioners absolutely nailed it when they gave their interim report released in 2019 the title Neglect, just one word which summed up the terrible state of the system. The Australian people were shocked and at times horrified by the evidence the interim report presented. Neglectthat is what it presented. Then, when the final report entitled Care, Dignity and Respect was released in 2021, the royal commissioners called for a fundamental reform of the aged-care system. They said:

The extent of substandard care in Australia's aged care system reflects both poor quality on the part of some aged care providers and fundamental systemic flaws with the way the Australian aged care system is designed and governed. People receiving aged care deserve better. The Australian community is entitled to expect better.

And the Australian community is absolutely entitled to expect better. Well, this government has listened closely, and the bill before us starts us on the road to better. This reform can't come quickly enough. As the Minister for Aged Care, the Hon. Anika Wells MP, has said in the other place:

Too many parliaments, too many governments have shunned the hard work needed to support our aged-care system. … Over the last decade there have been 23 reports, inquiries, studies, committee reports and a royal commission telling us the same story.

It is a story of neglect and of government ignoring aged-care concerns. They represent many, many missed opportunities. The previous speaker, Senator Hughes, spoke about how we had picked up the previous government's bill, but Neglect, those 23 reports, those inquiries and those studies were all on the previous government's watch. We must not miss this opportunity, and there is a lot of work to do before we get to effect meaningful change.

This bill begins that work. It amends aged-care law and other legislation to implement a series of urgent funding, quality and safety measures, several of which were recommended by the Royal Commission into Aged Care Quality and Safety. Schedule 1 of the bill relates to the new Australian National Aged Care Classification, AN-ACC, the model for calculating aged-care subsidies that was endorsed by the royal commission. Schedule 2 of the bill is a new measure that will facilitate the publication of star ratings. Schedule 3 introduces a code of conduct for the aged-care sector, as recommended by the royal commission. Schedule 4 of the bill extends the Serious Incident Response Scheme to home care and flexible care. Schedule 5 of this bill strengthens the governance of approved providers. Schedule 6 facilitates increased information-sharing. Schedule 7 of the bill will increase government oversight of how refundable accommodation deposits and bonds are used. Schedule 8 of the bill expands the functions of a renamed Independent Health and Aged Care Pricing Authority.

Schedule 9 of the bill will enable the implementation of an interim solution with respect to the requirement to obtain informed consent for the use of restrictive practices. Schedule 9 to the bill also provides a limited immunity from civil or criminal liability that may arise in relation to the use of a restrictive practice, where someone follows all of the requirements under Commonwealth law in relation to the use of a restrictive practice. This provision does not provide a broad immunity to negligence in respect of the use of a restrictive practice.

The bill replaces the outdated Aged Care Funding Instrument with a new model for calculating aged-care subsidies, called the Australian National Aged Care Classification model, which has been developed in consultation with the aged-care sector and consumer groups. Since April 2021, residential aged-care recipients have been progressively assessed and classified under the AN-ACC, and funding under the new model will commence this year, on 1 October.

Importantly, the bill includes several measures that will provide additional protections directly to older Australians—protections which cannot be delayed any longer. The Serious Incident Response Scheme, SIRS, will be expanded to establish obligations for approved providers of home care and flexible care in a community setting to report on and respond to incidents and take action to prevent incidents from recurring. A new code of conduct will set high standards of behaviour for aged-care workers, approved providers and governing persons of approved providers to ensure they are delivering aged care in a way that is safe, competent and respectful. Improved information-sharing between care and support sector regulators will enable proactive monitoring of cross-sector risks and will better protect consumers and participants from harm. An interim solution for the provision of consent to the use of restrictive practices will also be established while state and territory consent arrangements are reconsidered.

The bill also includes a series of measures that provide greater transparency and accountability of providers. Star ratings will be published for all residential aged-care services on My Aged Care by the end of 2022. Star ratings will enable senior Australians and their families and carers to make informed decisions about their aged care. From 1 December 2022, approved providers and their governing bodies will be required to meet new responsibilities that will improve governance. Approved providers will be required to notify the Aged Care Quality and Safety Commission of changes to key personnel, and the current disqualified-individual arrangements will be replaced with a broader suitability test. Amendments will also be made to increase financial and prudential oversight in respect of refundable accommodation deposits and bonds. The functions of a renamed Independent Health and Aged Care Pricing Authority will be expanded to include the provision of advice on healthcare and aged-care pricing and costing. This bill makes a series of important changes that will improve the health, safety and wellbeing of older Australians and will assist older Australians and their families to understand the quality of care and the operations of providers. As I said, there is a long road of reform, and there is much more to do.

The husband of a local aged-care worker regularly calls my office in Davenport. He's incredibly worried about his wife, who is on the brink of burnout. Every week, she is pressured to work a lot of extra shifts, often on her days off. She often arrives at work to find there aren't enough other staff to work with her to safely provide the care that is needed in a timely fashion. She loves her job. She loves caring for vulnerable older Australians but is seriously considering leaving the industry. It is a story that I'm sure all of us have heard, and I hear it constantly from workers in the aged-care sector. Coupled with that is an intense concern about the family finances, as they struggle every week to make ends meet on her low wage. There are thousands of families and thousands of workers in this country in this same situation, and that should not be the case.

Above all, we must ensure that the voices of those in aged care are heard, and those are the residents and the people working in the aged-care system. Our elders deserve dignity and respect in their later years, and, when their voices fall silent, we must do everything we can to support them to sing again. I commend this bill to the members of this chamber, and I hope that all the members in this chamber will join us on the road to reform the aged-care sector.