Tony Sheldon (NSW, Australian Labor Party) Share this | Hansard source

The heartbreaking losses of life in aged-care facilities during the COVID-19 pandemic were a flashing red light for the health and safety of older Australians. According to the reporting in the Sydney Morning Herald, '"Chaos", confusion and 19 deaths: how COVID-19 took hold inside Newmarch House' published on 25 July 2022, 19 residents died at the Newmarch House aged-care centre in New South Wales. Anglicare CEO Grant Millard later said 'he regretted not selling all residents to hospital'. In according to reporting from The Age on St Basil's Homes on 18 December 2022, 45 residents, as many of us are now aware, died at a Melbourne nursing home from COVID-19—another five died from neglect. These are 50 older Australians and their families who deserved better. What is incredible is that this aged-care centre, St Basil's Homes, received $2.4 million in JobKeeper payments from the Morrison government in 2022, despite slashing their staff from 40 full-time staff and 100 part-time staff before the deaths to just three full-time staff and 87 part-time staff afterwards. The conditions of care was appalling.

It was clear from these deadly outbreaks that the previous legislation didn't have enough teeth for the regulators to make sure that aged-care centres were properly staffed, were taking their obligations seriously and were keeping their residents safe. The former government was handed the final report of the Royal Commission into Aged Care Quality and Safety in February 2021. The Liberals and the Nationals decided it was not an urgent priority to legislate the 148 recommendations. The sheer volume and breadth of recommendations is reflective of how bad things were allowed to get and it also demonstrates how urgently the reforms in this bill, the Aged Care Bill 2024, are required.

This government has been getting on with the job of enacting many of the recommendations to create a simplified, rights based framework legislation to regulate the aged-care system. The royal commission recommended that a new aged-care act be enacted focusing on protecting and promoting the rights of older people. The statement of rights within the bill will place a duty of care on providers to ensure that restrictive practices are only used as a last resort, that an individual has the right to be free from all forms of violence and degrading or inhumane treatment and that providers do not cause adverse effects to the health and safety of individuals to whom they are providing services. These are fundamental, critical pieces that are at the heart of this new bill. The government committed to putting older people back at the centre of the aged-care system, and these new rights will do just that.

The Albanese government's aged-care reforms are important, and to deliver them we need a sustainable funding system. The funding changes proposed by the bill are based on the recommendations of the Aged Care Taskforce for a system that is fair and equitable. The taskforce received feedback through 180 submissions, 11 roundtables, 12 in-person forums and targeted consultation with the department. While the Commonwealth will continue to be the main funder of aged care, the bill proposes a refined means-tested user-pays system for co-contributions to everyday living and independent support. The new means testing will be based on income and assets but with greater nuance and four new levels of thresholds, including different means-testing methods based on whether someone is in a home or community setting or in residential aged care. Aged-care users will pay no contribution to clinical care costs. These services will be fully funded by the Commonwealth. And there will be a $130,000 lifetime cap on the non-clinical care contributions or cessation of contributions after four years. Co-contributions are an important step to making the aged-care system sustainable now and for the future generations who will require aged-care services.

Chapters 3 and 4 of this bill set out the registration process, eligibility requirements and obligations on providers in order to deliver funded aged-care services. Under the bill, the Aged Care Quality and Safety Commission will have the power to monitor, investigate, search and seize documents that are necessary to ensure compliance with the act. The commissioner may issue a required action notice to a registered provider, and a civil penalty can be imposed if a provider is not complying with the notice. The commissioner may also issue a compliance notice for any breach of the new act, which carries a civil penalty if the provider does not comply.

In a strengthening of the previous aged-care act, a compliance notice may refer to the provider's significant failure or systematic pattern of conduct, which can lead to its managers or owners being liable for a civil penalty. In serious cases the commissioner may vary or revoke a condition of the provider's registration or impose a new condition if the commissioner believes there is an immediate and severe risk to the safety, health or wellbeing of aged-care users. Lastly the commissioner may issue a banning order which excludes an individual and organisational entities from working in the aged-care sector. Because we know there is a hesitancy to complain about the quality of care, individuals who make disclosures about contraventions will be protected from victimisation and will not be subject to criminal, civil or administrative liability. That's an important whistleblower protection.

The bill also creates the complaints commissioner and the quality and safety commissioner, who will have distinct regulatory powers consistent with those of other Commonwealth regulators. That will mean that older people, workers and others will have clear pathways to raise concerns about the quality of aged-care services.

For the first time, digital platform providers in the aged-care sector will be subject to compliance obligations. Recent reforms to the NDIS require mandatory registration for all digital platform providers, and that is a good thing. However, I'm aware of the concerns that some of these stringent requirements for others won't be required in the new Aged Care Act.

Transparency requirements for digital platforms are so important because of disgraceful businesses like Mable who have crept into the aged-care sector. Mable is owned by a multinational venture capital company and is making money hand over fist by underpaying its workforce, which it has classified as contractors. The Health and Community Services Union told the Inquiry into the Victorian On-Demand Workforce:

… Mable's minimum rate is … below the legal minimum wage in the sector which is $26.22 per hour for level one casual home care workers.

Gerard Hayes, the New South Wales secretary of the Health Services Union, was quoted in the Financial Review on 26 July 2023 as saying that 'aged care should be a direct employment relationship' and that for companies like Mable:

… there should be total responsibility and accountability for employers for delivering a service, not just for a group that introduces people and takes a cut.

Professor Paula McDonald from the Queensland University of Technology Business School told the Senate Select Committee on Job Security in 2021:

They—

Mable workers—

don't get paid for the time in which to travel between their stints of two- or three-hour work. They don't get paid to go and meet a prospective employer to find out whether that arrangement is suitable.

During the royal commission, senior counsel assisting Peter Gray QC argued—and this is important—'Without regulation, there is no compulsion for platforms like Mable to follow best practice.' Mable denies these arguments and says, 'Rather, Mable facilitates ongoing relationships of mutual choice.' Well, I find it hard to believe that older Australians are making a choice for their carers to not receive superannuation, workers compensation and training and for Mable not to be accountable for the quality of care that it provides.

On 26 August this year, the government's laws to allow the Fair Work Commission to make minimum standards orders for a range of gig workers came into effect. We haven't yet seen an application to cover workers on Mable, but we saw that there is an inherent problem with bargaining power in the gig sector, and we acted. What did the Liberals and Nationals do in response to the threat posed by Mable? They gave $7.2 million to provide surge workforce in aged-care homes during the pandemic—in itself, logical. But they provided it to services like Mable's service, whose quality was so subpar that Anglicare, which owned a facility in Penrith where Mable provided workers, told the royal commission, 'It quickly became apparent that the staff Mable could provide did not have the skills and qualifications that were needed.' So, under the watch of those opposite, Australian taxpayers paid Mable $7.2 million to prop up a workforce that was underpaid and exploited and didn't meet minimum training standards.

I strongly support this bill and congratulate the minister, Anika Wells, on the incredible amount of work that has been done in this portfolio over this term. The minister has said that the legislation 'will allow us all to take the next steps with confidence and to venture into a new age of excellence' and that 'there is more to do with aged care and our mission continues.' I support the ambition for future tranches of reform in aged care. I would like to see a strengthening of the transparency requirements that are placed on digital platform operators, particularly in the home-care sector. More work should be done to hold digital platforms to the same standard as registered providers, including requirements to demonstrate to the commission that they are compliant with the strengthened Aged Care Quality Standards and Code of Conduct for Aged Care; to be subject to regular ongoing audits or compliance monitoring by the commission; and to comply with the Serious Incident Response Scheme and report directly to the commission in line with requirements under the scheme.

I've heard concerns that the Support at Home program, encouraged by the bill, could mean that unscrupulous providers will rush to take advantage of the additional $4.3 billion investment and increased availability of services. It is important that registered providers be required to ensure that their workers have minimum qualifications, but the fact the digital platforms do not need to meet those minimum qualifications could result in a race to the bottom on service quality.

As part of the next stage of reforms, we should continue to consider recommendation 87 of the royal commission, which calls for the preferencing of direct employment of workers as a requirement for ongoing approval to deliver services. These are the sorts of reforms that unions and industry will be pushing for, and I'll continue to be part of that conversation.

One of the hallmarks of the Albanese government's approach has been to recognise the value of all aged-care workers, which is clear with our $15 billion investment in pay rises, and to make sure we maintain and uphold people within this industry. Personal care workers will be eligible for an additional 13 per cent wage rise, on top of the 15 per cent awarded in 2023, which has amounted to wage increases of up to 28.5 per cent over the past 12 months for some workers.

Jocelyn Hofman, a registered nurse in an aged-care home in Western Sydney, welcomed the wage increases and said that she has never received a pay rise like this during her 37 years in the profession. Linda Hardman, who has been an assistant in nursing in an aged-care home for over 20 years, said:

I's a very complex job. It's very physical and it can be very mentally straining at times, because you have to really be adaptable. Every shift is different, because sometimes someone might have a stroke or they could have a fall.

Linda also said:

Because of the cost of living at the moment, when I do get the [wage] increase, it is going to improve my quality of life.

Aged-care residents getting a better deal is also a priority for this government, and we can see that there's now a registered nurse on site in aged care 99 per cent of the time across Australia. Under this government, older Australians are already receiving an additional 3.9 million minutes of care every day, which has contributed to a statistically significant decrease in the proportion of residents who experience polypharmacy, antipsychotic medication use, falls that result in major injury, use of physical restraints and unplanned weight loss. The addition of the Dollars to Care program to the star-rating profiles holds providers accountable for how they spend their budget, including how much they spend on care, cleaning, accommodation and food.

Our vision is for an aged-care system that upholds the rights of older Australians and helps them to live active, self-determined and very meaningful lives. We went to the 2022 election promising to lift the standards of aged care in Australia, and we're delivering it through this bill.