Richard Colbeck (Tasmania, Liberal Party, Parliamentary Secretary to the Minister for Finance and Administration) Share this | Link to this | Hansard source

I present the government’s response to the report of the Senate Community Affairs References Committee on its inquiry into quality and equity in aged care and seek leave to have the document incorporated in Hansard.

Leave granted.

The document read as follows—

Australian Government Response to the Senate Community Affairs References Committee’s Report of the Inquiry into Aged Care – Quality and Equity in Aged Care

© Commonwealth of Australia 2007

This work is copyright. Apart from any use as permitted under the Copyright Act 1968 , no part may be reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to the Commonwealth Copyright Administration, Attorney-General’s Department, Robert Garran Offices, National Circuit, Barton ACT 2600 or posted at http://www.ag.gov.au/cca

ISBN: 1 74186 139 X

Publications Approval Number: 3947

© Commonwealth of Australia 2007

http://www.health.gov.au/Pyne

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Online ISBN: 1 74186 140 3

Publications Approval Number: 3947

FOREWORD

By the Minister for Ageing,

The Hon Christopher Pyne MP

I am pleased to present the Australian Government’s response to the Senate Community Affairs References Committee’s report Quality and equity in aged care.

The matters raised in the report are wide-ranging. Our overwhelmingly positive response to the report reflects the fact that most of the matters raised were under consideration by Government. Action has been taken consistent with our commitment to maintain Australia’s high quality and world class aged care system.

Overall, since the 2004-05 Budget the Australian Government has committed close to $2.1 billion in new initiatives that address the issues identified in the recommendations made by the Committee. This is in addition to the announcements made in the 2004-05 Budget including the $2.2 billion package of reforms in response to the Review of Pricing Arrangements in Residential Aged Care (the Hogan Review).

This year’s Budget continues the Australian Government’s strong commitment to supporting older Australians. It contains more than $1.7 billion for further improvements to our aged care system. This includes an extensive package of reforms, called Securing the future of aged care for Australians which was announced by the Prime Minister in February 2007.

Our record of unprecedented investment in aged care clearly demonstrates the Government’s commitment to provide for the best of care for Australians as they age. Total Australian Government expenditure on ageing and aged care activities will have grown from some $3.1 billion in 1995-96 to an estimated $10 billion in 2010-11—more than a three-fold increase.

The number of Australian Government subsidised aged care places also continues to increase. At 30 June 2006, there were 204,869 operational aged care places. This number exceeds the election commitment we made in 2001 to provide 200,000 operational aged care places by June 2006. In February 2007 we announced that we will lift the overall provision ratio to 113 places for every 1,000 people aged 70 years or over, including an increase in community care places from 20 to 25. This will yield 250,000 places by June 2011 of which 100,000 will have been added by the Australian Government since 1996.

Christopher Pyne

INTRODUCTION

On 23 June 2004, the Senate referred the following matters to the Senate Community Affairs References Committee (‘the Committee’) for inquiry and report by 30 September 2004:

(a)

the adequacy of current proposals, including those in the 2004 Budget, in overcoming aged care workforce shortages and training;

(b)

the performance and effectiveness of the Aged Care Standards and Accreditation Agency in:

(i)

assessing and monitoring care, health and safety,

(ii)

identifying best practice and providing information, education and training to aged care facilities, and

(iii)

implementing and monitoring accreditation in a manner which reduces the administrative and paperwork demands on staff;

(c)

the appropriateness of young people with disabilities being accommodated in residential aged care facilities and the extent to which residents with special needs, such as dementia, mental illness or specific conditions are met under current funding arrangements;

(d)

the adequacy of Home and Community Care programmes in meeting the current and projected needs of the elderly; and

(e)

the effectiveness of current arrangements for the transition of the elderly from acute hospital settings to aged care settings or back to the community.

On 1 December 2004 the Senate agreed to the Committee’s recommendation that the reference, not disposed of at the end of the 40th Parliament, be re-adopted with a reporting date of 23 June 2005.

The Committee received 243 public submissions and 10 confidential submissions. The Inquiry also drew extensively on evidence and analysis published in the Review of Pricing Arrangements in Residential Aged Care, Final Report (‘the Hogan Review’).

The Committee’s report, entitled Quality and equity in aged care, was tabled and released on the 23 June 2005. The report included 51 recommendations. In the majority of cases the recommendations focused on matters which the Australian Government was considering or on which action was being taken.

The Australian Government’s response to the Review of Pricing Arrangements in Residential Aged Care in the 2004-05 Budget provided a $2.2 billion package, Investing in Australia’s Aged Care: More Places, Better Care. The large majority of the reforms included in this package, many of which address issues identified by the Inquiry, are now in place. The outstanding matters have required complex and rigorous development and testing over time including the new funding model and related information technology systems. The Government has announced that the new Aged Care Funding Instrument (ACFI), which has been developed with extensive involvement of many residential care providers, will be in place on 20 March 2008. The ACFI will be supported by the implementation of eBusiness and an updated payments system for aged care subsidies which are being developed by Medicare Australia.

Beginning with the enactment of the Aged Care Act 1997, the Australian Government has pursued a reform agenda to ensure that older Australians can access a world class, high quality and affordable aged care system that is responsive to their needs and preferences.

Since the $2.2 billion package in the 2004-05 Budget the Australian Government has continued to closely monitor the effectiveness of the aged care system. Where necessary, new reforms have been introduced and reforms in progress built on through strengthened arrangements or additional funding.

This year’s Budget continues the Australian Government’s strong commitment to supporting older Australians. It contains more than $1.7 billion in new funding for further improvements to our aged care system. This includes an extensive package of reforms, called Securing the future of aged care for Australians which was announced by the Prime Minister in February 2007.

The package allocates $1.1 billion to increase Government payments for residents of aged care homes including an additional $92.2 million in the Budget taking the total funding in the package to $1.6 billion. Of this funding, $884 million will support initiatives related to matters identified by the Inquiry.

In addition, funding for new aged care initiatives in the Budget totals a further $255.4 million. Overall, including resident contributions, funding for residential care will increase by $1.3 billion over the next four years, on top of increases for indexation and the increased places already factored into Budget estimates.

Overall, since the 2004-05 Budget the Australian Government has committed close to $2.1 billion in new initiatives that address the issues identified in the recommendations made by the Committee. In relation to a number of the new initiatives funding has been augmented by additional resources from the states and territories through the Council of Australian Governments or other avenues. Details of the initiatives are provided in the responses to the recommendations.

Consequently, the Government considers that the large majority of the recommendations made by the Committee are being addressed.

The Government does not agree with four recommendations. Each of these is inconsistent with current whole-of-government policies on such matters as workplace relations and programme indexation.

The Government’s responses to the recommendations made by the Committee are set out below. They clearly demonstrate the Government’s willingness to invest in reform and the development of care for older Australians.

RESPONSE TO EACH RECOMMENDATION

Aged care workforce

Recommendation 1

The Committee welcomes the Commonwealth’s allocation of 400 extra nursing places at universities in the 2004-05 Budget. However, the Committee recommends that the Commonwealth further increase the number of undergraduate nursing places at Australian universities to 1000 as recommended by the Hogan Review.

In addition to the 440 aged care nursing places funded in the 2004-05 Budget and Additional Estimates, a further 1,036 general nursing places have been allocated to universities across Australia in 2006 for commencement in 2007. Universities are able to bid for new places for aged care nursing. Aged care nursing is regularly identified by the Department of Employment and Workplace Relations and state and territory health ministers as a skill in demand which informs the allocation of new places. Universities are also able to redistribute places from general nursing or other disciplines toward aged care nursing to meet student and employer demand.

Funding of $4.1 million for up to 410 more post-graduate nursing scholarships over four years was committed by the Australian Government in its final response to Hogan Review announced on 11 February 2007. The scholarships are part of a $32 million package of support designed to encourage more and better qualified people to work in community care and complement the Aged Care Nursing Scholarship Program which provides up to 250 scholarships each year.

Commonwealth Grant Scheme funding to assist nursing clinical training has increased this year from around $690 to $1,045 per nursing unit of study (2007 prices) to enable eligible higher education providers to expand and improve their clinical training arrangements. In addition, as part of the 2007-08 Budget, funding for nursing units of study will increase by an additional 1 per cent from 2008. These initiatives will enable higher education providers to expand and improve their nurse teaching and clinical training arrangements.

The 2007-08 Budget also provided $211 million over four years to increase university flexibility. A part of this measure was a relaxation on the caps on university places (both Commonwealth supported and full fee) which may lead to further increases in the number of nursing places offered at universities across the country.

Recommendation 2

That the Commonwealth work with aged care providers to ensure that their shared responsibility to assist enrolled nurses to complete medication management training meets the target as recommended by the Hogan Review.

The Australian Government has responded to Professor Hogan’s recommendations by supporting the full cost of 5,250 additional certificates of attainment in medication management over four years from 2004-05. Providers are expected to share responsibility in ensuring more enrolled nurses complete medication management training.

Recommendation 3

That the Commonwealth implement a strategy which allocates an appropriate number of undergraduate nursing places on the basis that recruitment for those places occurs from the current residential and community care workforce in both rural and urban settings proportionally.

For all universities receiving the new aged care nursing places that commenced in 2005, a clause has been included in their Commonwealth Grant Scheme Funding Agreement which requires the aged care places to be allocated with a preference for applicants with experience working in the aged care industry and that the course must respond to the needs of students who continue to work in the aged care industry. Of the 440 extra places allocated to aged care nursing from 2005, 195 were allocated to campuses in the capital cities and 245 to regional campuses.

Recommendation 4

That the Commonwealth investigate the effectiveness of incentives for staff to work in aged care settings in rural and remote areas.

The Australian Government provides a viability supplement for small residential aged care facilities and those in rural and remote locations in recognition of the difficulties faced by such services in attracting and retaining staff. In the 2004-05 Budget, the Government increased this viability supplement by $14.8 million over 4 years. In the 2006-07 Budget, $19.4 million over 4 years was provided to extend a viability supplement to providers of Community Aged Care Packages, Extended Aged Care at Home (EACH) and EACH Dementia programmes.

A new initiative to support staff to deliver services in remote and very remote aged care services was announced in the Australian Government’s final response to the Hogan Review. As part of this initiative, practical support will be available for providers delivering care to difficult-to-service populations through access to skilled aged care professionals who are able to tailor assistance to the needs of the particular service/provider including longer term training and developmental support.

The 2007-08 Budget includes funding of $8.5 million over four years to provide 120 Indigenous Australians with the opportunity to gain continuing jobs working in community care in place of positions previously subsidised through the Community Development Employment Projects (CDEP) program. This includes 30 positions in remote areas under the National Respite for Carers program and 90 in regional and urban areas in the Home and Community Care (HACC) program. The conversion of CDEP positions into continuing jobs will contribute to the development of a stable and skilled workforce in rural and remote areas.

The wages and other employment conditions offered by aged care employers in rural and remote areas are matters between the employers and their employees subject to relevant legislation including the Workplace Relations Act 1996, as amended by the Workplace Relations (Work Choices) Act 2005. This legislation provides flexibility for parties to negotiate conditions (including incentives) of employment in a workplace agreement.

Recommendation 5

That the Commonwealth, as a matter of priority, expand the National Aged Care Workforce Strategy to encompass the full aged care workforce, including medical and allied health professionals, and all areas of the aged care sector, in particular the community care sector.

The National Aged Care Workforce Strategy developed by the industry through the Aged Care Workforce Committee acknowledges that further work will be needed to cover the full aged care workforce. The Committee is overseeing the implementation of the Strategy.

In keeping with the strategy, the Australian Government will repeat the Census and Survey of the residential aged care workforce in 2007 and is providing additional funding for a concurrent community care workforce census and survey. These initiatives will broaden understanding of the aged care workforce and will assist the Aged Care Workforce Committee with any further development of the National Aged Care Workforce Strategy.

Recommendation 6

That the Department of Health and Ageing and the Department of Education, Science and Training, as part of the National Aged Care Workforce Strategy, ensure the inclusion of quality aged care curricula in undergraduate nursing.

The Australian Government encourages and supports the adoption by universities of an aged care core component in undergraduate nursing curricula through such measures as the allocation of aged care nursing places. Universities are self-accrediting institutions that decide the courses they will offer and the curriculum for those courses. Industry bodies can seek to work with individual universities (or other higher education providers) to develop courses that meet their needs.

Recommendation 7

That the Commonwealth consider implementing mechanisms to ensure that the conditional adjustment payment aimed at restoring wage parity for nurses, personal carers and other staff in the aged care workforce is used to meet this aim.

The Government does not agree with this recommendation. The aim of the conditional adjustment payment (CAP) is not ‘to restore wage parity’. Wages and other employment conditions are matters between employees and employers subject to relevant legislation including the Workplace Relations Act 1996, as amended by the Workplace Relations (Work Choices) Act 2005.

The Australian Government has made clear the purposes of the CAP and stipulated the conditions that providers must meet to receive the CAP. To remain eligible for the CAP, approved providers must encourage staff to undertake training, prepare audited financial reports and participate in a periodic workforce census. The payment is provided on top of the annually-indexed subsidy, to assist aged care homes to continue to provide high quality care to residents, including paying more competitive wages to nurses and other staff.

In 2007-08, the value of the CAP will rise by 1.75 per cent to 7 per cent. Consistent with the Government’s commitment, the CAP will be reviewed in 2007-08.

The Accreditation Agency, accreditation standards and complaints resolution

Recommendation 8

That the Agency ensure that the training of quality assessors delivers consistency in Agency assessments of aged care facilities.

The Aged Care Standards and Accreditation Agency (the Agency) has implemented a multi-faceted quality assurance programme as part of its aim to ensure that assessments are accurate. This programme includes:

• creation of new positions in its offices of Principal Assessor and Assessment Manager whose roles include ensuring audits are carried out effectively in accordance with the Agency policy and procedures;
• inclusion of observers on samples of audits and support contact visits to assess conformance with Agency processes;
• updating training for assessors; and
• providing revised guidelines for assessment in the publication Results and processes in relation to the Expected Outcomes of the Accreditation Standards.

Agency assessors must complete an approved training course and be registered with RABQSA International. Eligibility to continue as an assessor is also reviewed annually

Recommendation 9

That the Agency publish data on the accuracy of assessors’ decisions in conducting assessments against Agency benchmarks and that this data be provided in the Agency’s annual report and on its website.

Agency assessors do not make the decisions concerning compliance with expected outcomes or whether a service is granted accreditation. These decisions are made by senior Agency delegates based on a wide range of information including assessors’ reports. Assessors monitor the processes and practices that services have in place to meet the Accreditation Standards and complete a report which is provided to the Agency and the service’s approved provider. This report, together with any submission by the approved provider to the Agency, information obtained from the Department of Health and Ageing and other information provided to the Agency is considered in making the accreditation decision. The Agency also has quality assurance processes in place including observers on audits, support contacts, and reviews of assessors’ reports.

Recommendation 10

That the Agency further develop and improve information provided to residents and their families about the accreditation process, including those from CALD backgrounds and Indigenous people, and more actively involve residents and their families in the accreditation process.

The Agency has developed consumer guides and an audio visual presentation on DVD to better explain accreditation and to assist people in making decisions about residential aged care.

These products are also aimed at providing aged care residents with information about the quality they should expect, the accreditation process and what it means for them.

During an accreditation audit a minimum of 10 per cent of residents and/or their relatives are interviewed and their comments taken into account when the assessment is being conducted.

In order to assist residents and their families understand and be involved in accreditation, the Agency obtains information from aged care homes about any particular cultural services and language issues. This also assists in deciding the formation of an assessment team including, as appropriate, multi-lingual assessors and an interpreter. Similarly, the Agency uses assessors with either Indigenous backgrounds or knowledge of Indigenous culture where there is a predominance of Indigenous residents.

The Community Partners Program also assists people from culturally and linguistically diverse communities to have informed expectations about community and residential aged care services. New funding of $13.2 million over five years from 2006-07 for the Community Partners Program will double the number of projects funded. This will expand the development of information and education approaches, such as the use of ethnic media to provide information on aged care, the development of peer support networks, and the provision of assistance to aged care providers so that they can offer culturally appropriate care.

The new funding is in addition to the $10.2 million the Government has already committed to continuing the Community Partners Program over the next four years.

Recommendation 11

That the Agency develop a rating system that allows residents and their families to make informed comparisons between different aged care facilities. The Committee notes that work is being done on a web-based prototype; however it considers that the rating system should not be limited to a ‘star rating’ but should include easily understood descriptions of a range of attributes, such as type and range of services provided; physical features of homes; staffing arrangements; costs of care; and current accreditation status.

In 2005, the Department of Health and Ageing commissioned an independent study by the Centre for Evidence Based Aged Care at LaTrobe University. This study suggested that there are challenges in developing such information so that it is both reliable and useful to consumers.

The Australian Government Department of Health and Ageing also developed the Aged Care Australia web site (www.agedcareaustralia.gov.au) in response to the Hogan Review recommendations. The web site provides people with a single point of reliable and easy to understand information about aged care, carer support and other relevant health information.

Web site visitors are able to view important information about each Australian Government-funded aged care home, including accreditation and certification details, type of services offered and activities available to residents.

People can also access information about the quality of accommodation by viewing photographs, floor plans of sample rooms and details of recreational areas, including descriptions of garden areas.

The Aged Care Home Finder also allows a comparison of up to five aged-care homes, based on how they meet the particular needs of a potential resident. People can tailor their comparison of different homes by selecting desired features such as, proximity to a specific town or suburb and type of care offered. Users of the Aged Care Home Finder are also able to view maps that show the home’s proximity to local facilities.

Another feature of the website is the Community Care Service Finder which assists people who need support in their own home to locate care services available in their area. This search tool provides information on providers who offer services such as assessment services, including Aged Care Assessment Teams and assessors for Home and Community Care. Details of the services offered by each provider, contact information and operating hours are included.

Recommendation 12

That the Agency ensure that all facilities be subject to a minimum of one annual random or targeted spot check and at least one site visit with notification over its accredited period.

From 1 July 2006 around 5,200 visits will be made by the Agency each year to residential aged care homes. This will include about 3,000 unannounced visits, compared to 563 unannounced visits conducted in 2004-05. Every home will receive at least one unannounced visit every year and the average number of overall visits will increase to 1.75 visits per home per year. These extra unannounced visits will provide aged care residents, their families and the public with greater confidence that the high standards of care required by the government are being met on a consistent basis.

These visits will be in addition to accreditation site audits, support contact visits and review audits. As a result the Agency will be visiting homes at a greater frequency than ever before.

Recommendation 13

That the Agency, in consultation with the aged care sector and consumers, develop a benchmark of care which ensures that the level and skills mix of staffing at each residential aged care facility is sufficient to deliver the care required considering the needs of the residents. The benchmark of care that is developed needs to be flexible so as to accommodate the changing needs of residents.

The Government does not agree with this recommendation. Under the Accreditation Standards, all approved providers are responsible for ensuring that they have appropriately skilled and qualified staff sufficient to ensure that services are delivered in accordance with the standards to meet the care needs of all residents in their home. The Government notes that the Accreditation Standards are consistent with the Workplace Relations Amendment (Work Choices) Act 2005.

Recommendation 14

That the Commonwealth, in consultation with industry stakeholders and consumers, review the Accreditation Standards to define in more precise terms each of the Expected Outcomes and that this review:

• address the health and personal care needs of residents, especially nutrition and oral and dental care; and
• include specific consideration of the cultural aspects of care provision, including the specific needs of CALD and Indigenous residents.

The Australian Government has undertaken an evaluation of the impact of accreditation on quality of life and care of residents in aged care, including identifying options for the measurement of quality improvement into the future. Wide stakeholder consultations were undertaken during the evaluation. All of the project’s iterative stages are currently being integrated into a final comprehensive evaluation. Any consideration of changes to the Accreditation Standards would benefit from waiting until the outcomes of that evaluation are available.

Recommendation 15

That the Agency make greater use of interpreters during accreditation visits to aged care facilities, especially those facilities that cater for specific or predominant numbers of CALD or Indigenous residents; and that assessors be trained in cultural competency as part of their formal training courses.

The Agency obtains information from homes in their accreditation applications about any particular cultural services and language issues to assist in deciding the formation of an assessment team including, as appropriate, multi-lingual assessors and an interpreter. Similarly, the Agency uses assessors with either Indigenous backgrounds or knowledge of Indigenous culture where there is a predominance of Indigenous residents.

Recommendation 16

That the Commonwealth review the operations of the Aged Care Complaints Resolution Scheme to ensure that the Scheme:

• is accessible and responsive to complainants;
• provides for a relaxation of the strict eligibility criteria for accepting complaints;
• registers all complaints as a complaint, with the complaints being categorised by their degree of severity, such as moderate level of complaint, complaints where mediation is required or where more significant levels of intervention are require

Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Ageing, Disabilities and Carers) Share this | Link to this | Hansard source

by leave—I move:

That the Senate take note of the response.

The government statement tabled today is in response to a report which was tabled in this place on 23 June 2005. It has taken this government two years and three months to respond to a report that you would expect the Senate to receive within three months. It is normal to expect a government response three months after the tabling of a report, but we have had to wait two years and three months to receive this document.

I was very pleased to be the chair of that inquiry into aged care by the Senate Community Affairs References Committee. I acknowledge Senator Allison’s involvement in developing the terms of reference, particularly on the issues affecting young people in nursing homes. To take two years and three months to respond to what was an excellent but not huge report is appalling. This government document is one of hollow self-congratulation. It intentionally misunderstands some of the recommendations.

The report was divided into a range of areas. Time will not allow me to deal with all of them but, hopefully, I will get to the most important ones. Almost three years ago, when I became the shadow minister for ageing, the big issue people would talk to me about when I went to aged-care facilities was funding, particularly capital raising. The most significant issue now facing aged care, both residential and community—and this government knows it—is attracting and retaining a quality workforce to care for some of the most vulnerable people in our society.

The response from the government to the seven recommendations that the committee made in our report is, to be frank, ridiculous. The first recommendation that our committee made was to do with the number of nurses that we have in aged care—in particular, residential aged care. In the life of this government, the number of registered and enrolled nurses who now work in our aged-care facilities in Australia has reduced. At the same time, the number of people who live in residential aged care in Australia has increased by almost 25,000. So we have fewer qualified nurses caring for some of the most vulnerable people in our society.

The recommendation of our committee was to follow the recommendation of Professor Warren Hogan, which was to increase the number of undergraduate nursing places at Australian universities to 1,000. The response is offensive. It talks about the 440 aged-care nurses funded in the 2004-05 budget. That is acknowledged in the recommendation. The response then goes on to talk about the normal number of undergraduate places that are there every year—year in, year out. The recommendation was clear. We want an extra thousand at least to deal with the problem that we have in finding nurses to work right across the health sector but particularly in aged care.

In 2004 this government received a report that said that we are 19,000 nurses short in this country. I note, though, that the government in its response was too embarrassed to talk about the 500 enrolled nurses who, the Prime Minister announced last week, are now going to be trained in hospitals rather than in the well-organised and well-run TAFE system. We know, and Catholic Health Australia knows, that those 500 enrolled nurses that the government has promised to be trained in TAFE will never end up in aged care, because the pathway is not there. I commend Francis Sullivan from Catholic Health Australia for raising the issue, as did I, because we know that that announcement will not result in any new nurses, either enrolled or full nurses, who work in aged care.

Recommendation 5 of the committee report said that as, a matter of priority, we need to expand the National Aged Care Workforce Strategy to encompass the full aged-care workforce, including medical and allied health professionals across all of the aged-care sector, including the community care sector. There is a little bit of honesty in the response to this recommendation. The government acknowledge that further work needs to occur to cover the full aged-care workforce. What have they been doing?

We have known of the problem of workforce in aged care, but the government are still acknowledging that we need to do further work. The next paragraph of the response does tell you what has been happening: they have taken a census. They have counted the number of people who are working in aged care. I am sorry, but we actually need more than counting people who work in aged care. We would like to know how we are going to train, pay and therefore keep people in aged-care services so that we can actually run the facilities that we have.

The second section that the report goes to is a section on accreditation. The first recommendation talks about the need for delivering consistency in assessment of aged-care facilities. The second recommendation goes to the question of the accuracy of assessors’ decisions and, further, is about the access to the process of accreditation by both residents and their families. Once again, the government has intentionally misunderstood the first two recommendations. The issues have not been addressed by this government. Every time there is a problem in aged care and an issue is raised, particularly in the media, the question of consistency of assessment is raised.

We need to have confidence as a community in a system that delivers a fair analysis of the quality of care that is being provided. It is my clear and strong view that we have in fact eroded that confidence in the accreditation process in aged care, particularly over the last 18 months. Aged-care providers have no confidence in the assessment system. The more they find out about it, the more families have limited confidence in the process of accreditation and quality assurance. Unfortunately, we are now getting to the point where I do not think parliamentarians have confidence in the process either. When we lose confidence in the process, I am afraid it is time for a review.

Also in that section, the committee recommended that the agency develop a ratings system that would allow residents and families to make informed comparisons between different aged-care facilities. This followed on from a recommendation of Professor Hogan, who recommended that there be a star rating so that people could make some decision about the facility before either entering it themselves or placing a loved one there. Personally, I do not agree with Professor Hogan’s star rating. It is not a motel that we are talking about. We are talking about a place where a person is going to live and receive care.

Once again, the government intentionally misunderstood the recommendation. The recommendation says that we want to give people information so they can make an informed judgement on where they might want to go. The government then went to great lengths to talk about how they have developed a website. And the website is quite good. Whoever developed it did a quite good job. But it does not allow you to make any comparison about the quality of care that is being provided at the facility—the level of staffing. It does not tell you what charges will be levelled on any resident. It does tell you where it is, and that is useful. We acknowledge that; that is okay. But, once again intentionally, the government has not addressed the guts of the question. (Time expired)

Question agreed to.