David Pocock (ACT, Independent) Share this | Hansard source

Thank you, Acting Deputy President. I rise to speak in support of the Aged Care Amendment (Implementing Care Reform) Bill 2022 and would like to start by echoing Senator Brockman's acknowledgment of nurses and what they have done for our communities across the country during the pandemic. They are some of the heroes of the pandemic. They have worked tirelessly, many to the point of burnout, and they continue to deal with massive workloads, burnout and low pay. This is a welcome first step to acknowledge that and start to put things in place to ensure that not only nurses are better supported but also people in aged care are better supported. I'd like to acknowledge the work of the ANMF and the registered nurses in the gallery today.

Much has been said about our aged-care system in this place since the aged-care royal commission, and rightly so. We've heard the stories of senior Australians being left to die without dignity in the very places that are meant to look after them. We've heard stories of pain, heartbreak and anguish. We may never know the full extent of the suffering that has taken place in aged-care facilities across the country over the past couple of decades, but we do know what the way forward needs to look like.

The aged-care royal commission gave us the blueprint for reform and laid out what is needed to ensure residents receive high-quality care in aged-care facilities. This bill achieves part of that vision. Principally, it enacts the requirements for all aged-care facilities to have a registered nurse on site and on duty 24 hours a day, seven days a week. This requirement would come into effect on 1 July 2023. This actually goes above and beyond what was recommended in the royal commission, but I know it is a commitment that has been welcomed widely by older Australians and advocates across the country. Simply, having a registered nurse available in every aged-care facility at all times will lead to better health outcomes for residents. It will ensure there is better monitoring of the health of aged-care residents. It is hoped that we will see fewer people transported to hospital for issues that would otherwise be prevented through early identification and intervention.

I want to echo what I've heard from aged-care advocates and those that work in aged care: one nurse should be the bare minimum. This bill does not put a cap on the number of nurses required in aged care; it sets a minimum standard of at least one nurse, 24 hours a day, seven days a week. There will be nothing preventing providers from employing more than one nurse, and I hope these decisions will be made based on the needs of residents over any other factor.

Throughout the inquiry, I heard concerns about how the exemption framework was established by this bill. On the bill's first reading in the House, it contained no safeguards for the granting of exemptions. It allowed the government, without limitation, to write and then enforce their own rules in exempting providers from the RN requirement. Technically, it would have been feasible for the government to exempt providers indefinitely from the requirement. I did not think that that was appropriate. I was pleased to work with the Minister for Health and Aged Care to move amendments to this bill that strengthened the safeguards.

This bill now contains some important provisions that limit the government's ability to provide exemptions, in line with what was intended by the royal commission. Any exemption must now be time limited and cannot exceed 12 months without review. The need for exemptions may differ markedly across the country. I acknowledge the challenges of regional and remote areas as highlighted by Senator Ruston, Senator Brockman and many others in this place.

Some providers may initially require more time to recruit the necessary workforce, and, in this instance, a longer exemption may be required. Some facilities may have a limited workforce, and, if one nurse were to become sick, an exemption may then be needed for a short period. Therefore, I think it's important that there is flexibility in the time limits provided, but none should exceed 12 months without looking at whether circumstances have changed for that facility. Importantly, the government will now also be required to consider the safety of aged-care residents in granting an exemption and whether alternative arrangements are in place to keep people safe and healthy during that period. Finally, all exemptions will need to be published in full view of residents, their families and aged-care watchdogs. This will provide another accountability mechanism to ensure the exemption power is not being overused.

Cumulatively, these changes ensure that the one-RN requirement cannot be watered down. If we're going to make this a minimum standard, then it should apply to every facility in the country. We should not be setting different standards based on postcodes. Those living in regional and remote areas should be entitled to the same standards of quality and safety in aged care as those living in the major cities. There is no doubt that, for some providers, recruiting and retaining an appropriate workforce to meet this requirement may be very difficult initially, but the exemption framework will assist with this.

This also speaks to a broader issue around the availability of skilled nurses across the health system and how we attract and—importantly and crucially—retain them. It seems to me that there's been an undervaluing of nurses for some time now, particularly in aged care. I've heard many stories of aged-care nurses moving to other places, like the NDIS, simply because they're being paid more and they have fewer patients to deal with. We're now realising what a precious resource nurses are and how much catch-up work we need to do to value them.

I implore the government to look at this holistically and consider how we are training, recruiting and retaining highly skilled nurses in all corners of our health and aged-care systems. I thank the minister once again for her collaboration on this bill. This is not the end of the road when it comes to reform, and I look forward to working with the government on continued reform that will improve the lives of people in aged care across Australia.