Slade Brockman (WA, Liberal Party) Share this | Hansard source

Apologies to the chamber for not being here at my appointed speaking slot. Shocking. Shocking. I too rise to speak on the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023.

Whilst the coalition will be supporting this bill, we do wish to raise a few issues that are of concern in this sector. I suspect it will shock nobody to hear that my concerns are particularly about the impact on regional Australia of some of the changes made by the Labor government. In travelling throughout regional Australia over the last little more than a year since Labor has been in power, I have seen a great deal of concern about some of the changes that are impacting on the sector and impacting its long-term viability and its ability to service particularly smaller regional communities. I will get to some of the detail of that.

But right across the sector we have seen a concern with the increasing regulation that is being required of aged-care providers, not just in ensuring a high quality of care but in micromanaging the detail of shift lengths, in having to monitor 30-minute increments of nurses being present when they don't meet the 24/7 standard, especially for facilities, as I have said, in regional areas, where the level of administrative support is simply not as great as it is for the large chains, which are predominantly based in urban centres.

Regional aged-care facilities are often community supplied, community run. They are often heavily reliant on volunteers to do things like serve meals and to do some activities with those who reside in those facilities. The level of administrative support, as I have said, is simply not there in the same way it is for the larger chains in the cities. Understanding that while still understanding the preference for people to stay in communities they have potentially been born into, have grown up in, have their families in, rather than having to move away to larger centres, be they larger regional centres such as Bunbury, Albany, Geraldton. To move to the city is obviously something that is greatly distressing for people, particularly at a time of life when stress of that sort is the last thing they need.

I will not name facilities because, obviously, this is a very confronting issue for small communities and for those small facilities in country towns. But there is a degree of uncertainty, a degree of a worriedness about how they are going to cope into the future with the constantly increasing demands upon that part of the sector, which I think is something that all governments do need to confront. Sometimes we are effectively saying that smaller facilities in regions will never be able to meet some of these requirements. Is it then better to say that facility should not be allowed to operate under a different arrangement or should be forced to close down? That is a very difficult decision and a very confronting decision for those smaller community based facilities.

But just to give a couple of examples—not all of these are going to be in the regions—there was a hostel facility not far from where I live in Perth, a lodge facility that was closing down. There was a range of reasons why it was closing down. It was an older facility, it was hard to meet standards and it was hard to maintain compliance with the new requirements. But I think I am correct in saying that, almost universally, the residents of that facility would have preferred it to keep going. There is no accusation that there was any mistreatment. There was no accusation that anything negative or bad had happened within that facility; it just hadn't kept up with the standards. It was an older facility, it was a lodge type facility and it didn't meet modern requirements.

I think we do have to have a conversation about that situation—where there is actually no accusation or imputation that there is anything negative happening—and about whether we should allow residents to actually stay in those facilities if that is what they want. Maybe we should give people the option as well to leave, but maybe we should actually look to see if there are ways of preserving facilities like that. Maybe that's a more cost-effective way for governments and a better way for those patrons, because, let's face it, when you're in that stage of life, the disruption caused by having to move accommodation can be quite significant. I think we actually have to take that into account.

In Perth, a larger provider was looking to close three residential facilities, basically because, in the wake of the royal commission, they were considered to be too old and too small to be able to be brought up to spec and then to also be economically viable with the new 24/7 RN requirements. Obviously having those requirements for smaller facilities is, by definition, going to be more difficult. These were residential facilities in urban areas, and they were under similar pressure to that which regional facilities are facing.

There was an article in the Geraldton Guardian just a few weeks ago about the number of elderly people who were forced to stay in the hospital in Geraldton due to the lack of aged-care beds in that community. I think at one point they had a higher number of 'temporary' aged-care residents in the Geraldton Regional Hospital than in any hospital in Western Australia. One in six beds were being occupied by patients because they were in the queue for an aged-care placement and not because they were in need of hospital care. Again, that is a concerning statistic and one that is not necessarily going to be fixed by making the requirements on regional aged-care facilities more onerous. It is something that I think we need to have a mature and sensible conversation about.

Obviously all Australians want and expect our older Australians to be well supported and cared for in our community, including in residential aged-care homes. We remain committed to supporting the health, safety and wellbeing of older Australians, and we understand the important role that aged-care providers, care workers and nurses play in ensuring this support is provided in residential aged-care settings. This is reflected in the two pieces of legislation in the package. The Inspector-General of Aged Care Bill 2023 seeks to permanently establish an Inspector-General of Aged Care and the relevant statutory office. The Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023 seeks to transition the temporary arrangement for the interim inspector-general to permanent arrangements.

Establishing the inspector-general and relevant statutory office was recommendation 12 of the Royal Commission into Aged Care Quality and Safety. We believe that the establishment of the Inspector-General of Aged Care is important to ensure that the aged-care sector remains supported, and we will support this legislation to permanently establish the Inspector-General of Aged Care and associated statutory office. The core function of the inspector-general will be to improve transparency and accountability across our aged-care system, through monitoring, reviewing and publicly reporting on systemic issues. I hope this will instil a greater accountability, a greater level of transparency and more understanding of the work that occurs across the aged-care sector.

I'll pause there briefly to say that it's very important that that information is reflected not just for urban based centres—which obviously are the vast majority of aged-care homes and aged-care facilities across Australia—but it is also reflected, and not in a negative way, for the very important work that is being done in the community sector in rural and regional Australia, to make sure that those ageing-in-place places, which give the ability for people to remain in their communities, continue to exist.

I also wish to acknowledge Mr Ian Yates, who is the interim Inspector-General of Aged Care. He has had 20 years experience as the chief executive of the Council on the Ageing Australia. Mr Yates has also been chair of Aged Care Council of Elders and has served as a member of the National Aged Care Advisory Council, the Aged Care Quality and Safety Advisory Council and the Aged Care Financing Authority.

Just before I run out of time, I do wish to touch again on this issue of 24/7 nurses and workforce shortage because it is just so important to the regions. During the election campaign the Prime Minister promised that every aged-care home would have a nurse on site at all times by July this year. Now, one year later, under this Labor government's watch, aged-care homes are closing down due to this election commitment. The date of 1 July was dreaded by aged-care providers across the country as Labor's expedited 24/7 registered nurses requirement hit the sector amid severe workforce shortages. To the best of our knowledge, so far more than 30 homes have, tragically, closed down because they could not see a way to meet the government's legislated requirements. This has meant that residents—often dedicated community members who wanted to live close to families, often in rural and regional or outer metropolitan areas—have had to find somewhere else to live. I think this is a great shame.

We're now a month on from when this expedited policy came into effect and we know that it wasn't just the rushed 24/7 policy that forced homes to close; sadly, the punitive exemption criteria have had the same effect. The exemption criteria offered exemptions only to providers with fewer than 30 beds in Modified Monash Model 5, 6 and 7 locations. People managing these facilities in regional Australia look to the future. They know how hard it is in regional Australia to get, in particular, RNs. They see that the only way they will probably be able to secure them is by robbing their local hospital or robbing their local GP's practice, if they're lucky enough to have an RN. So it really did put a massive question mark over those facilities and the sheer level of perseverance that is required, and that continues to ratchet up. This means that those facilities are constantly under greater and greater pressure.

I think it's a conversation that we need to have. We need to talk more about how we can continue to deliver aged-care facilities in smaller communities and in rural and regional communities and about how we allow those communities to make some of their own decisions about what those aged-care facilities may look like, without necessarily having a prescriptive Canberra model being imposed upon them. It's not an easy discussion—I understand that—but I think it is a discussion that the sector and all sides and all parties in this place need to have.