Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Hansard source

Can I just say that one of the things that the opposition has consistently said, throughout hearings and throughout the committee process, is that we believe this is a fundamental flaw in the whole system and in the bill, and we certainly understand what Senator Pocock is trying to do by moving this particular amendment, because there is no doubt whatsoever that the opposition absolutely supports the idea of equal access for individuals who need aged care, regardless of their income or wealth, and that includes ensuring that people with lower means continue to be able to support the aged-care services that they need, and, most particularly, that they need within their local community.

There is one thing that we heard time and time again during the inquiry, particularly when it related to areas in regional Australia. As an example, both of the nursing homes that gave evidence in Port Lincoln said that they were at capacity; there were many older people from Port Lincoln or surrounding districts who were currently in the Port Lincoln hospital; there was no capacity for them to be accommodated within the nursing homes in Port Lincoln, so these people were being forced to move hundreds of miles away from their community, their families and their loved ones, just to be able to get access to care.

The point I think Senator Pocock is trying to make here, and I'm sure he will correct me if I'm wrong, is that, currently, the accommodation supplement paid for by the government, the accommodation contribution made on behalf of an individual who is supported, if they receive the 25 per cent incentive payment because the home that they're in has more than 40 per cent of residents as supported residents, is $68 a day. If you then make a comparison to that, as Senator Pocock did, in terms of a higher value refundable accommodation deposit, the amount that the home would receive, as an example, from a daily accommodation payment would be $172 a day. The government is paying $68 a day; the home is charging, under commercial means, $172 a day, because that is what they are allowed to charge based on the MPIR. So, essentially, what we've got here at the moment is a situation where residential aged-care providers are covering the accommodation costs, or a significant proportion of the accommodation costs, for supported and partially supported residents, and, in doing so, are most likely charging higher costs to those people who aren't supported in those payments. So we have a massive discrepancy between what the supported accommodation payment is, even where it has received the 25 per cent increase or bonus that the minister was talking about, and the daily accommodation payment, the difference being, as I said, that the supported accommodation payment is $68 a day and the daily accommodation payment is $172 a day on the maximum current refundable accommodation deposit calculation, where the person is paying a daily accommodation payment.

One of the things that we were really pleased about was that the government accepted the recommendation of the opposition to move forward the accommodation review, because these pricing structures that currently are in place are completely and utterly unfair. We have three different means by which people are paying for their aged care. One is obviously supported by the government, and the other two are through a refundable accommodation deposit or through a daily accommodation payment which is based on the price of the accommodation deposit. We think that this review is absolutely essential to try to remedy this structural flaw. We believe that accommodation should have a room price and that room price should be consistent. You should not have three different prices—or, in the case of a ratio under 40 per cent, four different room prices—for exactly the same room. So we are very pleased that the government has listened to calls from the opposition. Once again, I give a shout-out to COTA for their very strong advocacy on behalf of some of the people they represent—those who are most vulnerable and particularly those who are suffering financial hardship—about the agreement to put more explicit hardship provisions into the bill.

Senator Pocock, while we're not in a position to support your amendment, I want to put on the record that we absolutely understand where this is coming from. We believe there is a bigger issue to resolve here than simply putting in another number or ratio. We think there is a far greater fundamental flaw in how accommodation is charged in the aged-care sector in Australia as we're standing here. So we would say we want to go to this review as quickly as possible to make sure that we have got the whole issue resolved, even though we absolutely support the intent of what you're trying to move here.

I'm keen to understand the changes that are being proposed at the moment that are in the rules. Currently, they're determined by location. Am I correct in assuming that in the future there will be no location requirements in terms of the ratios that you're talking about here, so it won't matter where you are but it will just be a blanket determination that, if the supported resident ratio of a particular home is over 40 per cent, you'll get $68 a day and, if it's under 40 per cent, it will be $52 a day? I'm not quite sure what the actual figure is, but is that correct? So it doesn't matter where you are—whether you're in the most remote part of Australia or the middle of a capital city? The 40 per cent rule is just a blanket one-size-fits-all, with no regard for the nuances of the vastly different statuses of those markets?