Kerrynne Liddle (SA, Liberal Party, Shadow Minister for Child Protection and the Prevention of Family Violence) Share this | Hansard source

Aged care is a critically important health service sector. It delivers pivotal services to older Australians. The sector assesses, protects and cares for our elderly as they adapt and realign their lives as they age. My home state of South Australia has the highest proportion of older people on mainland Australia, with more than 630,000 people over 50; that is 37 per cent of the population. In South Australia the majority of over-65s live independently at home. Only one in four people aged 55 and over live in care accommodation. There are 531 retirement villages with 26,000 residents. Aged care is important to every Australian as we all hope to age well and comfortably, and in SA there are many more of this cohort who should. The coalition believes that the establishment of an Inspector-General of Aged Care is important. This role would ensure the aged-care sector remains supported. The coalition will back this legislation to permanently establish the Inspector-General of Aged Care and associated statutory office.

The establishment of an inspector-general implements recommendation 12 of the aged-care royal commission, which was supported by the coalition. To implement the recommendations of the aged-care royal commission, the former coalition government provided more than $19.1 billion to support the aged-care sector. It is appropriate that the Inspector-General of Aged Care monitors and investigates the Commonwealth's administration and regulation of the aged-care system. It is also important that the findings and the recommendations of the inspector-general are tabled in this parliament, providing greater accountability, transparency and understanding of the work that occurs across the aged-care system. Accountability and transparency will assist in leading to the achievement of better outcomes and will assist in identifying those who need greater focus on what they're doing. Accountability and transparency is important in every sector but particularly in the aged-care sector, where people are often fragile and more vulnerable.

As the royal commission found, Aboriginal and Torres Strait Islander people do not access aged care at a rate commensurate with their level of need. A combination of factors creates barriers to Aboriginal and Torres Strait Islander people's access to the aged-care system—from social and economic disadvantage to a lack of culturally safe care and discrimination. Lack of access to aged-care services is further compounded by Aboriginal and Torres Strait Islander people's additional vulnerabilities from higher rates of disability, co-morbidities, homelessness and dementia. To feel secure and obtain culturally safe services, many, although not all, Aboriginal and Torres Strait Islander people prefer to receive services from Aboriginal and Torres Strait Islander people and from Aboriginal and Torres Strait Islander organisations. What is needed is Aboriginal and Torres Strait Islander people employed in the sector at greater levels and across the sector and others with high levels of cultural competency. The position of Inspector-General of Aged Care will provide the resources to cast a light on some of the most pressing challenges for the aged-care sector and in particular the services targeting Aboriginal and Torres Strait Islander peoples.

I acknowledge it is Aged Care Employee Day today and the work these carers do. Last week I met people working in the sector at the launch of the National Aboriginal and Torres Strait Islander Ageing and Aged Care Council here at Parliament House. It was good to talk to them about the aged-care sector. I congratulate the organisation for their advocacy for improvements in the ageing and aged-care sector because we know, of all the people eligible to access aged-care services, only 16 per cent of Indigenous people do so. I believe it is vitally important that elderly Indigenous people are afforded the same levels of care as other people. This really should be non-negotiable, with no excuses. Providers of aged-care services for Indigenous people must be held to the same level of scrutiny and accountability as mainstream services.

Workforce shortages are putting serious pressure on Australia's entire healthcare system, and aged care is not immune to these workforce challenges. It is clear that this crisis is impacting on the viability of aged-care homes across our country, especially in regional areas. As Senator Ruston outlined in this place earlier today, the latest quarterly report from StewartBrown outlines the shortage in directly employed nurses and that it is increasing the demand for agency nurses, which is costing aged-care providers significantly more. Agency staff now cost providers $17.04 per bed per day. That's an increase of $9.86 per bed per day compared to the same period in 2022.

So what's the Albanese government's plan to address this? This increase is clearly not sustainable for the aged-care providers who are trying to comply with government regulations. It is the reason why the coalition has been calling out for a whole-of-care-sector workforce plan. One-size-fits-all, that type of model, rarely, if ever, works. A city-centric model rarely, if ever, works. Whatever the model, it should allow sector operators to be flexible and innovative in how they deliver quality care to their communities, but that is not about being under the minimal standard. Instead of penalising, this government should look to incentivising providers to use new technologies like telehealth, and support the sector to value and upskill carers to perhaps become enrolled nurses, enrolled nurses to maybe become registered nurses and therefore remain and contribute to this very important sector.

During the election campaign, the Prime Minister promised that every aged-care home would have a nurse on site at all times by July 2023. As a result of this requirement being demanded a year earlier than recommended by the royal commission, under the Albanese Labor government's watch, aged-care homes are closing down. July 1 was a date that was dreaded by aged-care providers across the country, as Labor's 24/7 registered nurses requirement hit the sector amidst a glaring obvious already existing workforce crisis.

As a consequence, elderly people have been forced to move away from their families and communities, all because Labor isn't flexible about staffing requirements during a workforce crisis. I have heard that in regional areas and directly from those in nursing homes. To the best of my knowledge, so far more than 30 homes around the country have tragically closed down, as they were not able to meet the government's legislated requirements. However, this government won't tell us. There is now transparency, and they are hiding the impact and the facts from the public.

It is more than a month since this fast-track policy came into effect, and we know that it isn't just the rushed 24/7 registered nurse policy that has forced aged-care homes to close but there has been an extremely limited exemption criteria. For providers to become exempt from this requirement to have a registered nurse on site 24/7, they must report every 30 minutes or more that an RN was not on-site and/or not on duty and the reason an RN was not on-site and/or not on duty—seriously, every 30 minutes. Who thought of that one? Seriously, did the minister not think to seek clarity, ask what that actually looks like for a provider, for a resident? This additional burden on a sector that is caring for some of the most vulnerable people is crippling and closing some small regional, rural and remote providers. It is now time for the Prime Minister to step in so more aged-care homes do not close. It is for that reason that the coalition will move an amendment to encourage the inspector-general to immediately review the impacts of the government's expedited policy and to provide advice on how the sector could be better supported through the current workforce shortages.

Of course the coalition supports older Australians receiving the best care possible, but bringing forward the royal commission's time lines and imposing rigid constraints on the sector is reckless, damaging and hurtful. We heard Senator Canavan giving some examples earlier. The opposition supports the independence of the inspector-general and endorses the separation of the inspector-general from the Department of Health and Aged Care and the other government bodies responsible for administering and regulating aged care. This is an important safeguard that guarantees the impartiality required to monitor, investigate and report on systemic issues across the aged-care system.

Finally, I note the number of submissions during the consultation period of this legislation that are supportive of the establishment of the inspector-general but that also mentioned additional matters relating to the implementation of royal commission recommendations. The royal commission recommended that the governance of the aged-care system be subject to ongoing scrutiny and that is why it is so important the inspector-general is empowered to review these government agencies to oversee their performance and their decisions. When I travel to aged-care facilities right across the country, I'm consistently told about the complexity of the current aged-care system, especially around the complaints mechanism. The coalition is pleased to see that within the explanatory memorandum of the legislation that the inspector-general will also focus their attention on reviewing existing complaint mechanisms. The inspector-general will also consider how complaints, both from consumers and providers, are currently handled and will provide recommendations to ensure systems are continually improving and operating fairly and effectively. But it shouldn't just rely on people making complaints; it should also rely on assessments to identify if there are any issues.

Noting the significant proportion of royal commission recommendations that were due to be implemented within five years, the coalition considers it prudent that the inspector-general provides interim reports on the status of implementation of the recommendations. This should occur annually and be tabled in parliament up until the five-year comprehensive report into the implementation of the recommendations is finalised. The coalition will support an amendment to this effect, as we believe it is important the Department of Health and Aged Care and the government are held accountable for the changes they make through an independent body. The coalition implores the government to start listening to the sector and stop imposing regulation that is forcing aged-care homes to close and having a negative impact on the families that love the residents who live in them. Older Australians deserve better; they deserve our respect and the right to age with dignity in their communities, surrounded by the love and care of their families.