Stirling Griff (SA, Centre Alliance) Share this | Link to this | Hansard source

I move:

That this bill be now read a second time.

I seek leave to table an explanatory memorandum relating to the bill.

Leave granted.

I table an explanatory memorandum and seek leave to have the second reading speech incorporated in Hansard.

Leave granted.

The speech read as follows—

This Bill enacts modest but significantly beneficial provisions that will drive ongoing quality improvements for aged care residents and help consumers make informed choices.

This Bill amends the Aged Care Act 1997 to require Commonwealth-subsidised residential aged care providers to report on the number of falls and the number of medication errors suffered by residents each quarter, and for the Secretary to make this information public.

The Bill also amends the Aged Care Act to require approved providers to post any sanctions made against them on their website.

Sanctions against approved providers can mean there is an immediate or severe risk to the health, safety or wellbeing of residents, and it is self-evident that we need to make it simpler for families and care recipients to know about them when they arise. Providing this information on a provider's website, as well as the My Aged Care portal, will make this information easier to access for residents and families.

By also mandating disclosure of two key quality indicators - falls and medication errors - the Bill will help drive improvements at both a provider and a systemic level, to ensure fewer accidents and sentinel events in aged care facilities.

Residents in aged care facilities experience nearly five times more falls than people of the same age who live in their own home. Injury from falls is an ever-present hazard in an aged care facility, given the frailty and poor mobility of many aged care residents. However it is important we benchmark and monitor the prevalence of falls, as excessive rates can indicate negligence, issues with the safety, planning and layout of a facility, or inadequate staffing leading to residents getting around without sufficient assistance.

Research shows medication errors can indicate poor staffing ratios, in particular a lack of nursing staff, and insufficient or inappropriate staff training and procedures.

We can view reporting of these clinical indicators as the "canary in the coalmine" – high numbers would alert authorities and families that something is amiss with the type and level of care offered at a facility. This would be expected to trigger scrutiny and a suitable response to address the causes of these avoidable injuries.

A 2016 systematic review of medication errors in aged care residents, published in the Journal of the American Geriatrics Society, found medical errors leading to hospitalisation and death were common and involved 16–27 per cent of residents (across five studies included in the review).

In the United States, significant reform followed the 1999 report by the Institute of Medicine: To Err Is Human: Building a Safer Health System. At the crux of the report was a push for mandatory reporting of medical errors on the basis that reporting errors is fundamental to preventing them.

We understand from evidence given by the Department of Health during Additional Estimates in February that the Aged Care Minister has already indicated he would like to make falls and medication errors part of National Aged Care Quality Indicator Program (QI Program).

The program recently became mandatory for all approved providers and requires all approved providers to collect and provide clinical quality indicator data to the Department of Health on three indicators - unplanned weight loss among residents, the use of physical restraints, and pressure injuries.

The introduction of the program followed a 2011 report by the Productivity Commission, Caring for Older Australians, that recommended qualitative and quantitative indicators be published at the service provider level as a means of improving provider accountability and informing consumer choice. It nominated prevalence of falls as one prospective indicator, alongside pressure ulcers, pain management, nutrition and hydration. At the time, the Productivity Commission noted that standards of care were more focussed on meeting minimum standards rather than on continuous quality improvement.

This Bill contains measures that complement the now-mandatory QI Program and other recent reforms, and which evidence shows are important in driving transparency and improvements in aged care.

We are currently at a cross-roads in aged care. Following the revelations of the neglect and abuse that occurred at Oakden nursing home in South Australia, governments have scrambled to understand and fix the systemic problems that allowed the failures and scandalous conditions at Oakden's Makk and McLeay wards to persist for so many years.

It has caused state and federal governments to go back to basics and re-evaluate current regulatory bodies, systems and procedures. Time will tell how effective various measures will be in driving improvements.

Without question, that work is nowhere near complete, and the current Royal Commission into Aged Care Quality and Safety will no doubt lead to further significant reform.

The danger is in sitting on our hands until the Royal Commission delivers its final report in 2020, and failing to progress solutions and systems we know will work.

People in aged care facilities don't have the luxury of time.

The Aged Care Minister took three years to make the QI Program mandatory, after it was successfully piloted in 2015 and 2016 and then continued on a voluntary basis. We do not see the point in delaying further progress, especially given the Minister's support for mandatory disclosure of falls and medication errors, and given the fact approved providers are now required to engage in a continuous reporting scheme for three important indicators.

The amendments contained in this Bill are relatively modest, but the benefits to aged care residents are clear, and there is no need to delay until the Royal Commission hands down its final report in April 2020 to know that the provisions are welcome and necessary.

I seek leave to continue my remarks later.

Leave granted; debate adjourned.