Kimberley Kitching (Victoria, Australian Labor Party, Shadow Assistant Minister for Government Accountability) Share this | Link to this | Hansard source

While it's Senator Keneally on the list, I will be speaking. Labor will be supporting the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. The purpose of the bill is to change the payment of home-care subsidy to approved providers from being paid in advance to being paid in arrears. The shadow minister first spoke on this legislation in the other place back in March this year. Although Labor supports this bill, we do have concerns we wish to put on the record. To see any impact to service providers will be unacceptable. To see any impact to the services older Australians receive will be unacceptable. To see any upward impact on home-care fees and charges to older Australians will be unacceptable.

The change from advance to arrears payments was due to commence in June 2020. There is an increase in financial risk for some smaller service providers who do not have adequate cash flow to deal with the changes. Those home-care providers currently losing money will face significant difficulties changing payment arrangements. Some service providers said that, as a result of cash-flow pressures arising from changes, they may be reluctant to take on new consumers during the transition phase. Service providers are concerned that, if the payment arrangements increase administrative costs, then costs would be passed on too.

The Liberal government is renowned for piecemeal reform. It is almost four years since the government introduced its Increasing Choice in Home Care reforms. Almost four years on and the question is: what has been achieved for Australians choosing to receive aged-care services in their home? These reforms have done nothing to address growing waiting lists. There are still more than 100,000 older Australians waiting for their approved home-care package. Over the past two years there have consistently been more than 100,000 older Australians waiting for the care they so desperately need. This is a national shame. Sadly, more than 30,000 older Australians over three years died waiting for their approved home-care package. Over 32,000 Australians entered residential aged-care prematurely over the past two years because they could not access approved home-care packages. Wait times have blown out, but older Australians waiting for their high-level package are waiting almost three years to get the care that they have been approved for. The median waiting time for older Australians going into residential aged care has grown under the Liberals and Nationals from just over a month to a five-month wait.

The Productivity Commission's report on government services released this year revealed older Australians waiting for high-level home-care packages are waiting almost three years for approved care. The report revealed that older Australians are waiting longer to enter residential aged care. The government has made improvements to the transparency of home-care fees; however, home-care recipients are still raising concerns about the rising cost of administrative and daily care.

Then there is the Royal Commission into Aged Care Quality and Safety's interim report, handed down over a year ago. The report, titled Neglect, put forward a recommendation that required urgent action to address home care. The government's response was woefully inadequate. More than 100,000 older Australians were waiting for their home-care package, and the Morrison government's response was 10,000 home-care packages. In the budget, the government announced 23,000 home-care packages, but only 2,000 are level 4, the highest level of care. The actual number waiting for their approved level 4 package is 15,873. This is not acceptable. How can any Australian trust the Morrison government when it comes to aged care?

The aged-care system under this government is broken. We know that the Prime Minister when he was Treasurer cut $1.7 billion from the aged-care budget. This has had an impact across residential aged care. These cuts have had a significant impact. Funding has only been announced when the Morrison government has been under political pressure. The question is: why didn't the Morrison government put funding into the aged-care system before COVID-19? The interesting thing is that the amount of funding the Prime Minister cut from the aged-care budget almost matches the funding that he had to put back in because of the deadly COVID-19 outbreaks.

Let's have a look at how a lack of funding has impacted older Australians, their families and carers. We already know about the $1.7 billion cut from the aged-care budget. I've already mentioned the 100,000 older Australians waiting in the never-ending queue for a package. There has been inaction on hundreds of recommendations from more than a dozen reviews, reports and inquiries. Complaints about aged care doubled to almost 8,000 in just one year. The Morrison government has failed to fully implement even one aged-care recommendation from a landmark report to stop elder abuse released in 2017. The Morrison government delivered just 38 emergency food packages to older Australians isolating because of COVID-19. On top of all of this, there is the failed Minister for Aged Care and Senior Australians. He has lost the confidence of the Australian people and the parliament. We know the Morrison government did not have a plan for COVID-19, and this has been stated in the royal commission's special report into COVID-19. We know the Morrison government was not prepared for COVID-19 in aged care. Tragically, almost 700 older Australians died in residential aged care across Australia. Despite the early warnings, the Morrison government didn't do enough. There was difficulty for aged-care workers to access PPE, inadequate infection control training, no surge workforce strategy and no idea of how many aged-care workers were working across multiple sites, and reports were not made public quickly enough.

The Labor Party has an eight-step plan. It's clear, though, that the Morrison government has no plan for aged care. The Leader of the Australian Labor Party outlined eight steps the Morrison government could take now to address the issues in aged care. These include (1) minimum staffing levels in residential aged care; (2) reduce the home-care package waiting list so more people can stay in their homes for longer; (3) ensure transparency and accountability of funding to support high-quality care; (4) independent measurement and public reporting, as recommended by the royal commission this week; (5) ensure every residential aged-care facility has adequate personal protective equipment; (6) better training for staff, including on infection control; (7) a better surge workforce strategy; and (8) provide additional resources so that the aged-care royal commission can inquire specifically into COVID-19 across the sector while not impacting or delaying the handing down of the final report.

We know that Australians are angry about this. They are upset. We know they don't trust the Morrison government or the current minister for aged care, Senator Colbeck. They don't trust the Morrison government to act on the royal commission's final report. Labor will continue to hold the Morrison government to account, not only here in the parliament but also publicly. Older Australians, their families and their carers deserve better.

Rachel Siewert (WA, Australian Greens) Share this | Link to this | Hansard source

I rise tonight to contribute to the debate on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020, which introduces the first phase of changes to the way home-care subsidy payments are made to home-care providers. This bill changes the payment of home-care subsidies to providers from being made in advance to being made in arrears, and it's part of a package approach here. It takes a first step in addressing issues around the $750 million in unspent funds currently being held by home-care providers. Unspent funds are problematic because they are used by providers as part of their working capital to generate interest or held in trust by a third party. This phase of changes is set to commence from February 2021.

Our understanding is that the majority of providers won't need to make changes to their payment systems to accommodate these changes. The government has stated that home-care providers who have concerns about the impact of these changes on their financial viability will be eligible for transition support funding and business advisory supports. The Australian Greens will be following this very closely to ensure that providers who are financially vulnerable and operate in thin markets get the support they need to adjust to these changes. We are particularly concerned about those providers in thin markets. Obviously, that is rural, regional and remote providers. We're particularly concerned to make sure that they aren't significantly impacted by these changes.

We do support this approach because, as I said earlier, there are concerns about the large amount of money that is being held in advance payments by providers. We don't want to see providers failing because of poor transition processes. Those that have poor processes may be affected by this and will need to improve their processes, but we don't want to see providers unduly affected by these measures, despite the fact that we do support the basic idea of moving to a different form of payment.

We'll also be watching closely to ensure that changes from both phases—phase 1 and the next phase—do not adversely impact the outcomes for older people and their families. Of course that's absolutely critical. By changing the way that providers receive home-care subsidies, this bill will introduce accountability and transparency to home-care funding—something that's desperately needed. In exactly the same way, we need transparency and accountability improved for residential care as well. This is critical in ensuring that the aged-care system better services and supports the needs of older Australians and that Australians know how the money we are investing in home care and residential care is being spent to support older Australians.

It would be remiss of me not to point out the fact that we still need additional home-care packages. There's absolutely no doubt that the waiting list is still far too long. People have to wait far too long to get the right level of care that they need. Today I'm calling on the government to act immediately to address this issue in home care. As recommended by counsel assisting the royal commission, we need to clear the home-care package waiting list by December next year. Older Australians who need support at home should have universal access based on need, not based on capped places or funding. It is critical that we address these issues to ensure that older Australians can access the care they need when they need it, where they need it and where they want it. If they want to stay at home and receive care at home, they need to be able to access the level of care they need, not go onto a lower package and wait until they can access a higher level of care.

Having said that, the Greens do support this bill. We will, as I articulated, be watching very carefully to ensure that those providers that are financially vulnerable, particularly those in thin market areas, are not adversely affected by these changes and that, most particularly, older Australians get a better deal out of this process. They cannot be worse off. We expect to see them in a much better position. We will be supporting this bill, but we'll be watching the transition process very carefully.

Richard Colbeck (Tasmania, Liberal Party, Minister for Aged Care and Senior Australians) Share this | Link to this | Hansard source

I thank colleagues for their contributions on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. This bill amends the way that home-care providers are paid the government subsidy, to address stakeholder concerns regarding unspent funds and to align home-care arrangements with other government programs, such as the National Disability Insurance Scheme. This bill will amend the legislation such that an approved provider of home care will not receive payment in advance but will be paid the monthly subsidy for a home-care recipient on lodgement of a claim with Services Australia after the end of each month.

The government has introduced a second bill, which will amend the legislation such that home-care providers will only be paid subsidy for services rendered to a care recipient during a month, with Services Australia retaining the unspent subsidy for which a care recipient is eligible in each month. This unspent subsidy will be available for a provider to drawdown on behalf of a care recipient as services are provided in future. Again, I thank members for their contribution to the bill. I commend the bill to the Senate.

Question agreed to.

Bill read a second time.