Anne Ruston (SA, Liberal Party, Minister for Families and Social Services) Share this | Link to this | Hansard source

I table a revised explanatory memorandum relating to the bill and move:

That this bill be now read a second time.

I seek leave to have the second reading speech incorporated in Hansard.

Leave granted.

The speech read as follows—

I am pleased to introduce the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020.

This bill amends the way that home care providers are paid Government subsidy such that home care providers will only be paid subsidy for care and services delivered to a home care recipient during a month, with Services Australia retaining the unspent Commonwealth subsidy for which a home care recipient is eligible to receive each month.

This builds on changes made by the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020 which amends the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 such that home care providers will not receive a payment in advance but in arrears.

Any unspent Commonwealth subsidy withheld as a result of this bill will be available for a provider to draw down on behalf of a home care recipient as care and services are provided in future. There is no change to a consumer's access to their full subsidy, and no change to the treatment of consumer contributions.

The bill introduces more contemporary business practices into home care subsidy payment arrangements and brings these arrangements into alignment with other Government programs.

Jenny McAllister (NSW, Australian Labor Party, Shadow Cabinet Secretary) Share this | Link to this | Hansard source

Labor will be supporting this bill. As outlined in the explanatory memorandum, the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020 amends the administration arrangements of paying home-care subsidy to approved providers. This is the next phase of amendments to the home-care payment arrangements. The first bill changed the payment of home-care subsidy to approved providers from being paid in advance to being paid in arrears.

Under this bill, home-care providers will only be paid subsidy for the care and services delivered to a home-care recipient during a month, with Services Australia retaining the unspent subsidy which a home-care recipient is eligible to receive each month. This changes the current arrangement so that the Commonwealth, rather than the approved service providers, will hold the unspent funds. The explanatory memorandum states these changes will provide for better transparency in the use of home-care funds.

The bill will introduce a mechanism whereby providers who elect to return unspent funds can start doing so within six months of the bill coming into effect. Providers who elect to return unspent funds will do this through a 100 per cent subsidy reduction until the unspent funds are exhausted. Any unspent Commonwealth subsidy withheld as a result of this bill will be available for a provider to draw down on behalf of a home-care recipient as care and services are provided in the future. There is no change to the consumers' access to their full subsidy and no change to the treatment of consumer contributions. In the lead-up to the introduction of this legislation, the Minister for Aged Care and Senior Australians sought the advice of ACFA. I understand the government is expecting to implement these changes by September 2021.

I do want to put on record Labor's concerns. Firstly, there has been a growing concern around the increasing amount of unspent home-care funds currently held by the approved provider. These unspent funds are a combination of the Commonwealth subsidy and consumer contributions. According to the Aged Care Financing Authority in its eighth report, released in July this year, unspent funds continue to increase significantly, with home-care providers holding $751 million at 30 June 2019, an increase of 39 per cent from the previous year, when $539 million was held at 30 June 2018. ACFA estimates that, based on the current rate at which unspent funds are increasing, these funds could be around $1 billion by 30 June 2020, although they may be even higher, due to some consumers putting their services on hold during the COVID-19 pandemic. According to aged-care accountants StewartBrown, the average unspent funds per client are approximately $7,000.

As with the first bill, there remains an increase in financial risk for some smaller service providers and those in regional, rural and remote areas that don't have adequate cash flows to deal with the payment changes and are unable to hold unspent funds. As suggested in the ACFA report, some service providers may have to revert to finding other financing arrangements, including loans and equity injections. Some service providers are concerned that, as a result of cashflow pressures arising from changes, they may be reluctant to take on new consumers during the transition phase. With the Royal Commission into Aged Care Quality and Safety to hand down its final report in February next year, more reform may be required for the home-care payment system.

This leads me to the Morrison government's lack of serious reform across the home-care system. We know that the Morrison government has turned its back on older Australians who are waiting for care and support in their own homes. If the Morrison government really cared, it would have done more for older Australians. This month marks the fourth anniversary of the government's reforms of increasing choice in home care. Almost four years on, the question is: what has been achieved for older Australians who are choosing to receive aged-care services in their own homes? Well, there's not much to show for it, is there? These reforms have done nothing to address the growing waitlist for home-care packages. Consistently there have been 100,000 older Australians waiting for their approved home-care package over the past two years. More than 100,000 older Australians are on a never-ending waitlist. Sadly, more than 30,000 older Australians died over three years while still waiting for their approved home-care package. More than 32,000 older Australians over a two-year period entered residential aged care prematurely because they could not access their approved home-care package. Waitlist times have blown out. Older Australians waiting for their higher-level package are waiting almost three years to get the care they have been approved for.

The government has made improvements to the transparency of home-care fees. However, we are still getting reports from people all over the country about rising costs. People are concerned about administrative fees, exit fees and other fees that they're being charged, and that is limiting the amount of care and the hours that people are able to receive. The former minister said that he would have a look at the fees and that he was going to do something about this but, again, there doesn't seem to have been any action from the government on that. We do need to hear from the government about whether or not it is going to do something about these fees and the concerns that I'm sure are being communicated to all of the people on the other side in their electorate offices as well. If we're getting them from all over the country, the government must be too.

Then there is the royal commission's interim report, which was handed down in October 2019. In that report, tellingly titled Neglect, the commission put forward three recommendations that required urgent action. They recommended that the Morrison government urgently fix the home-care package waitlist, which was described as 'cruel', 'unfair' and 'discriminatory'. Has that waitlist been fixed? No, it has not. The government's response to the interim report was woefully inadequate: a meagre 10,000 packages when the waitlist at that time was 119,000 persons long. That is 119,000 older Australians without the care and support that they were approved for. And this was a mere drop in the ocean when you consider how chronic this never-ending waitlist is and the impact it has on older Australians, their families, their carers and their loved ones.

But this is the hallmark of this Prime Minister. It's the hallmark of the Morrison government: drip-feeding home-care packages on an ad hoc basis, the majority of which are not the higher-level packages that tens of thousands of older Australians have been approved for, are entitled to and continue to wait for. The Morrison government has no plan to deal with the growing waitlist, no plan to deal with future demand and no plan to help the older Australians who need care right now. This government needs to do better.

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

I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020. This bill builds on the changes that were passed at the end of 2020 around the way home-care subsidies are paid to providers. It will ensure that providers are only paid home-care subsidies for the services they actually provide to the consumer, instead of receiving the full subsidy each month regardless of services delivered. This bill also makes changes to unspent funds from September this year. The Commonwealth will now retain unspent funds on behalf of the home-care recipients instead of approved providers. Providers will also be able to return unspent funds to the Commonwealth within six months of this bill coming into effect.

Unspent funds have been an ongoing issue in aged care. The current pool of unspent funds sits at around $900 million. Unspent funds provide older Australians with flexibility to pay for future care needs or budget for unforeseen events. However, there have been serious problems in allowing providers to hold onto this money. Some providers have been using these funds as part of their working capital and making money from interest earned, sometimes even allowing the money to be held by a third party. This practice doesn't encourage openness and transparency in the way consumers' funds are being used.

The Australian Greens support this bill because it introduces a new level of transparency to the way home-care subsidies are paid to providers. However, I would like to raise some serious concerns we have with the implementation of the new payment arrangements and other matters. During the consultation phase of this bill, some providers raised concerns about the costs that would be incurred implementing these changes. The Australian Greens share the concerns raised by COTA that these changes must not adversely impact on the outcomes for older people and their families. I will be seeking assurances from the minister that this bill will not result in providers passing on additional fees and charges to home-care recipients and indicate that I will be seeking a short—hopefully—Committee of the Whole to address some of these issues.

This bill also introduces administrative changes to software and business systems for both providers and the government. Some stakeholders raised some concerns—and I don't blame them—about the capacity of Services Australia to implement the required changes to their systems to allow for a smooth transition. I would like to take this opportunity to again urge the government to continue its discussions with providers and put in place a robust transition plan. These changes should not result in any disruptions to the delivery of home care. I don't want to see any older Australians left disadvantaged by these changes.

As providers have traditionally held onto unspent funds, some are concerned about how these changes will impact their financial viability. This is especially concerning for providers who are operating in thin markets who might find it difficult to adjust to the new systems and arrangements. I understand providers will be eligible for transition support funding and business advisory supports if needed. The Australian Greens will be monitoring this process closely. We do not want to see aged-care providers failing because of poor support during this transition phase.

This bill takes a small step towards improving transparency and accountability in aged care, but there is still a lot of work to do in this space. I'm convinced that a fundamental lack of transparency, especially around funding, has contributed to some of the abuse and neglect we see in aged care. There is currently no requirement for providers to publicly report on how government funding is being used. This means that we don't have access to public information on the number and skills mix of staff; staffing qualifications and training; and the amount of money spent on direct and indirect care, including medication and food. Without improved transparency and accountability across the aged-care sector, we will never see the level of reform and change we so desperately need.

I have a range of questions that I want to put to the minister during the Committee of the Whole stage. Some of these questions regard the issue of protected information under division 86 of the Aged Care Act. For years stakeholders and constituents have raised concerns about the definition of protected information under the act. COTA believes that the broad definition of protected information means that very little information about complaints or decisions is published. Access to information about family members in aged-care facilities or information about complaints is often denied on the basis that it is interpreted as protected information under the relevant acts. This detracts from the community's confidence in the complaints system.

One constituent who contacted my office made appeals right up to the High Court but never got to the bottom of the understaffing issues in the aged-care facility that his mum was living in. The department, the commission and the courts have all denied this constituent access to information on the basis that it is considered 'protected information' under the act. People should be able to access information easily about the experiences of their family members in aged-care facilities. This is an extraordinarily concerning matter, and I will be asking questions about it, as I articulated.

Fundamentally, one of the key issues here is how we look after older Australians and how older Australians are treated in aged care, whether it be home care or residential aged care. But we also need to think about the journey before somebody is in the aged-care system and when they are applying for an aged-care package. At the moment, it is my belief that we are seeing more people having to apply for residential aged care because we are not managing the journey into home-care support properly. We have ad hoc systems across the country where information is not provided to the older person or to their family. Services are not connected, and we need to be thinking about that very, very clearly. At the moment people are having more incidents, more falls, more lack of attention, and there is a lack of understanding of people's journey into aged care. It is not being thoroughly addressed by hospital services, by GP clinics or by anybody that comes into contact with an older person. Sometimes it's the luck of the draw, depending on who an older person gets as their contact person or their support person when they have an incident. That has to stop in this country. We need to make sure that we are providing the sorts of services that support older Australians in their home, if that's where they want to stay, or in residential care. We need services that provide support to family members, information flow and transparency about how decisions are being made, what decisions are being made and how money is being spent.

Finally, I would like to foreshadow a second reading amendment, which I have circulated, that notes that this bill does nothing to address the urgent need for additional home-care packages. Every year 19,000 people who are approved by government for home care are forced into residential aged care before they receive a package. We need the government to act immediately to ensure that home-care package waiting lists are cleared by 31 December 2021, that people already receiving aged-care packages are actually receiving the aged-care package that meets their needs and that people aren't forced to take a lower package because they can't get access to aged-care package levels 3 and 4. You shouldn't have people having to second-guess the system because they know that they'll have to wait a long time to get an aged-care package that actually meets their needs. What you're getting at the moment, which the government said they wanted to avoid, is people staying on CHSP rather than going onto an aged-care package level 1, 2, 3 or 4 because they are actually getting better support and less hassle from the CHSP compared to going into the aged-care system. People don't know when to actually get an ACAT assessment done because the system does not meet people's needs. I speak from personal experience here, so I have some knowledge of the troubles that people are having while trying to get joined-up services in the system. We have to do better in this country.

I'll be asking the minister some questions around this bill and around the funding that's currently available for these packages, because older Australians' home-care needs are not being met. That is very clear. While people are passing away before they can get the care they need, while they are sitting on packages that don't meet their needs, while they are not getting access to accountability and transparency—and we know that because we have a royal commission on right now—we cannot claim that this system is meeting the needs of older Australians and their families, carers and support people. We need change; we need it urgently. This bill is part of that step, but there's a lot more that needs to be done in this country so we can, first, assure older Australians that they have a system that will meet their needs and provide the care that they need and, second, reassure families that their loved ones are getting the appropriate level of care when they need it and where they want it.

Sue Lines (WA, Deputy-President) Share this | Link to this | Hansard source

Thank you, Senator Siewert. Do you want to formally move that second reading amendment?

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

I move my second reading amendment as circulated in the chamber:

At the end of the motion, add ", but the Senate:

(a) notes that this Bill does nothing to address the urgent need for additional Level 3 and 4 Home Care Packages; and

(b) calls on the Government to act immediately to ensure the Home Care Package waiting list is cleared by 31 December 2021".

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

I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020. Along with my Labor colleagues, I ask that this bill be referred to the Selection of Bills Committee for further scrutiny. Under the changes contained within this bill, home-care providers will only be paid for care and services delivered to a home-care recipient during a month, while Services Australia will retain the unspent money that a home-care recipient is eligible to receive each month. In other words, rather than service providers holding on to unspent subsidies, the Commonwealth government will.

Labor understands the rationale of this change. Currently, many aged-care providers are holding on to large and growing pools of unspent subsidy money, and these measures provide a degree of probity for these balances. Aged-care accountants StewartBrown estimate that the amount of unspent subsidies could already exceed $1 billion. Yet, while the sums of money grow, the government continually fails to provide enough funded places. There are more than 100,000 older Australians waiting for care.

Like most legislation that this government proposes, this bill is another wasted opportunity. The government has missed a chance to act on the tragic shortcomings in our aged-care system. According to the Report on government services 2021, in 2019-20 there were around 840,000 older Australians on the Commonwealth Home Support Program, which is the entry-level support package for those living independently in their own homes. These recipients receive basic services, like domestic assistance, personal care, social support, and allied health and respite services. There were a further 172,000 clients of home-care packages. These are more intensive packages for people who require additional care in their homes, such as help with showering or clinical care. That is over a million Australians taking advantage of home-care services, but these most advanced home-care services are not adequate for the needs of older Australians. More than a third of older people who are living in households and in need of assistance reported that their needs were not being fully met—one-third. This increases to 42 per cent for those with a profound or severe disability. With these sorts of numbers, it's clear we are failing our older Australians. The recipients of these packages are in their late 80s or maybe their 90s, with chronic or terminal illnesses, and they are waiting up to three years to receive the services that they need to function.

The ABC reported just recently, in September last year, a story about Evelyn Micallef:

Evelyn Micallef is 93, has dementia and can no longer walk.

Her daughter Ann Innis and Ann's husband Steve use a hoist to get her out of bed and into a wheelchair every day.

They feed, dress and take care of her.

Despite the relentless work, they do not want to send her to a nursing home—

particularly due to the threat of COVID. The article continues:

Evelyn gets by on a low-level homecare package worth $15,000 a year.

She was approved for the highest package available, worth $50,000 a year, in May last year, but like more than 100,000 older Australians, she's still waiting for the Federal Government to fund it.

In the meantime, her home-care provider charges as much as $550 a month just for administration. A third of her $15,000 package is gone before her family have used the money on the simplest things, like a carer to help Evelyn shower.

The interim report of the Royal Commission into Aged Care Quality and Safety said this:

The Australian Department of Health, which oversees this system, has no mechanism to follow up with people who are on waiting lists to give them updates, including about whether they have progressed up the waiting list or how long it will be before a Package is available.

According to this interim report, the direct results of these shocking waits include 'declining function, inappropriate hospitalisation, carer burnout and premature institutionalisation because necessary services are not provided'. In the past three years, more than 30,000 have died waiting for their home-care packages to be approved on this government's watch. That is more than the number of additional places the government has recently announced. This government obviously has not prioritised older Australians, and older Australians have had to pay the ultimate price. In January 2020, the Productivity Commission released the median wait time for home-care packages. It had blown out in the last year by more than two months. Some older Australians are entering residential care or even emergency departments instead of receiving their approved home-care package.

The aged-care system is broken and, as the royal commission has noted, it suffers from neglect. Of course, that's why the title of the report is Neglectneglect by this government. This government gets complaints relating to aged care, and of course nothing happens. This is a government that has been in power now for eight years. The aged-care watchdog failed to issue a single fine or warning, despite receiving more than 2,000 complaints from April to June of 2020, of which 340 were directly related to COVID-19 infection control. From 2,000 complaints, not a single regulatory action appears to have been taken.

According to expert evidence provided to the royal commission into aged care by the CEO of Presbyterian Aged Care NSW & ACT, Mr Paul Sadler, unspent money accrues for one of four reasons:

a. A contingency amount negotiated between the consumer and provider.

b. The consumer deliberately planning for a large expense, such as an equipment purchase or period of respite care …

c. The consumer's needs have been accurately assessed, but they exercise their choice to refuse particular services …

d. Because their assessed level of HCP is higher than their actual service needs.

We can easily see pressure from the provider being a reason, as well as a desire among home-care clients to have their funding for a rainy day. Allowing the Commonwealth rather than the aged-care provider to maintain control of the money has support in the sector, but there are serious and unanswered questions about how the many aged-care providers on thin margins, including in rural or regional areas, can manage without the reserve of funding. The government again fails regional Australia.

In the wake of the pandemic that has deeply shaken the aged-care sector, is now the best time to upturn the entire funding model of aged-care providers? The better question to ask is whether 2021, a year when COVID-19 has deeply rattled the aged-care sector, is the best time to upturn funding models that aged-care providers rely on. The best way to manage these questions is to refer this bill to the Selection of Bills Committee for further consideration.

Home care is a devastatingly underfunded sector. The demographics have been clear for many, many years. Demand for aged-care services is only going to rise. Reform in the sector is a good thing, but if reform puts aged-care providers on the path to unviability, we must determine what we can do to soften this bill's impact on marginal providers. We must provide more general aged-care providers to be certain that they do not need to take shortcuts whilst providing their critical care.

Today the ABC told another story about aged care. An article by Michael Atkin told the story of Christine Radke and her 95-year-old father, Herbert:

Herbert has dementia and physical ailments, which means Ms Radke needs to assist him with every part of daily life from getting out of bed to going to the toilet.

…   …   …

Ms Radke is trying to keep her father out of residential aged care, but managing each day is a challenge.

She said her father felt guilty about how much help he needed because he lived independently until recently.

…   …   …

They receive some help through a limited, federally funded home care package worth about $16,000 a year, which for Herbert means a support worker showers him three times a week.

But in June, Herbert was assessed as needing the highest home care package available, known as Level 4, which would provide another $36,000 in funding.

The Radkes don't know how long they'll have to wait before more Federal Government funding is made available to them—only to expect it will be at least another six to nine months—

that is, if they're lucky. The article continues:

Ms Radke is trying to cherish the time she has left with her father, but looking after him is challenging.

Older Australians shouldn't have to spend their final years feeling like an imposition on their children. Older Australians deserve much better than this, and it's time for this government to do much better.

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

I'm happy to support the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020, like the No. 1 bill before it. This bill came about following questions I asked in a number of past Senate estimates about the handling of unspent home-care funds once someone passes away or goes into residential care. When I first raised this issue, it turned out the department had very little oversight of these funds. There was absolutely no auditing. The department pretty much relied on an honour system to ensure that these funds were paid back to the Commonwealth. According to the latest report from the Aged Care Financing Authority, the amount of unspent funds held by providers soared by 40 per cent to $751 million last financial year, and it was predicted to top $1 billion by June this year. This is a huge amount of money needlessly paid out and sitting in others' bank accounts.

This bill changes the administrative arrangements for paying home-care subsidy to approved providers of home care. Home-care providers will only be paid for the care and services delivered to a home-care recipient during each month, with Services Australia retaining any unspent subsidy the home-care recipient is eligible to receive each month. The bill will also introduce a mechanism whereby providers who elect to return unspent funds that are held by them start to do so within six months of the bill coming into effect. The efficiencies and better transparency created by this bill and the earlier legislation already passed will mean much less waste, which must translate to more aged-care packages.

At the moment there is a massive shortfall in packages, especially for the most acute level of assistance. This is despite an announcement of 23,000 additional places in the budget over the next year, on top of the 6,105 places announced last July and an additional 10,000 places that were recently announced in the MYEFO. Whilst the 39,000 places are very much welcome, there are still more than 60,000 senior Australians needing care and assistance who are on the waitlist for a home-care package—more than 60,000. The drip-feed of packages must stop and it must be replaced with a comprehensive plan to deal with the waitlist and provide places for packages that people actually are approved for.

Figures released by the Department of Health in September showed that, in the last two years, 28,000 people died whilst on the waitlist. This is absolutely appalling. The consequences of the long waitlist for home care are traumatic and often come with dire outcomes. Many elderly Australians wait up to two years for their home-care package following assessment. Often, by this time, their condition has deteriorated and, in many cases, families can no longer care for them or they can no longer care for themselves. Often they're forced to go into residential care. Every year a staggering 19,000 people who were approved for home care are forced into residential aged care before they receive a package.

Our senior Australians should have the right to receive care and assistance in their own homes if that is their preference. Our senior Australians deserve respectful, affordable, accessible and safe aged-care options that are offered in a timely manner. So, whilst I support this bill and the efforts by government to more efficiently allocate the limited funding available to home-care providers for our senior Australians, much more needs to be done to fix the home-care system. Prime Minister Morrison recently said, 'The health and wellbeing of older Australians is an absolute priority.' I agree, and all of us here should hold him to those words when the Royal Commission into Aged Care Quality and Safety hands down its final report next month.

Deborah O'Neill (NSW, Australian Labor Party) Share this | Link to this | Hansard source

I rise to make a short contribution on behalf of people in New South Wales, in particular those in the retirement capital of the state, in the seat that I live in, the seat of Robertson, and, adjacent to that, the seat of Dobell. So many people who have lived a great life in the city have worked and made a profound contribution to the country by their endeavours and efforts. They've run businesses and they've worked in factories. They've done everything you can imagine, and they seek retirement on the Central Coast. They believe, when they move to the Central Coast, some of the rhetoric of this government—that the government claims it will be there for them. But, sadly, all too often on the Central Coast, we are finding more and more people who fit the descriptions that have been so aptly put before the chamber by Senator McAllister, Senator Siewert, Senator Sheldon and Senator Griff.

This is a horror story that we've been listening to in the chamber this afternoon—a horror story in which the government pats itself on the back when it leaks out a few more home-care packages. That's what we see constantly; that is the pattern of behaviour of this government. There is a big claim and a rhetorical flourish of the kind Senator Griff alluded to in his closing comments: 'We care about Australians in their aged-care stage. We care about the contributions. We'll be there for you.' That's what the Prime Minister says, and that's what the minister for aged care says as well. But, when they're needed and when they're wanted, they are absolutely missing in action to the extent that—and I want to restate these figures—28,000 people died on the waiting list. Imagine the scale of that: 28,000 funerals, with all the grief, all the sorrow, all the despair and all the broken-heartedness of people who believed Mr Morrison and his government and thought that they would get what they needed because that's what they were promised by a government that simply lies through its teeth to the Australian people day in and day out. Twenty-eight thousand people died waiting for a home-care package. That is a great shame and a great stain on the social compact that people believe they have with the government that they've paid taxes to for all of their working life. What do you think that's like for those families who had that degree of trust? This situation has been exacerbated—it's gotten completely out of control under the Liberal-National governance of the last eight years.

In regional Australia, this situation is even worse than it is in the cities. I've spoken about the fantastic place where I live in the seat of Robertson. I have meetings regularly with the service providers in aged care. They are heartbroken. It's not just the banks of these smaller providers that are teetering on the brink in regional Australia. For the people who've invested their lives in working in aged care, who felt a calling to that profession, who in many cases give as an expression of their faith, it's not just a business to them. They have a deep sense of care for aged Australians. They are finding that they cannot provide the care that aged Australians need. They are finding that people who really wanted to stay in their community and in their own home are being forced into formal aged-care settings that they never wanted to be a part of. And it's because they are waiting and waiting and waiting, day in and day out, for the money they should receive to have home care.

Senator Griff correctly quoted the figures: 19,000 people who were approved for home care couldn't get anything from this government and were forced into aged care. I don't know about everybody in this chamber or about the people who might be listening to this, but conversations about how you're going to look after your mum, dad, aunt, uncle or somebody that you care for in the community or that you're a guardian for—those conversations are carefully undertaken. Promises are made: 'Mum I'll make sure that you're looked after. I'll do my best.' In the back of their minds is a trust in the government, in this Liberal-National government, that when the time comes if they need a hand they're going to be able to get it. But this government has failed to deliver. Right now, as I'm standing here in the chamber, there are still 100,000 Australians who need and want a home-care package. This government will spin the story that they've put this legislation in the chamber and they're doing great work in aged care. It's not great work and it's not meeting the needs of Australians; it's disingenuous. What we're seeing here is just another punctuation mark in an ongoing litany of failures with regard to aged care.

How bad is this government? How bad is their treatment of older Australians? It's so bad that the aged-care commissioner put out an interim report entitled Neglect. Neglect—that is the signature of this government written all over the aged-care sector. Neglect at every turn. So this piece of legislation today—another little bit of window dressing to tinker at the edges—once again reveals the cynical attitude that this government has to Australians and the abuse of trust of older Australians, particularly older Australians who believe this government is there for them. Well, 28,000 of them got buried while they were waiting. I bet they regret voting for this government many, many, many times. If you care about the people you love who are ageing, you cannot afford to vote for this government ever again because their track record is a wreck. You only have to look back over these eight years to see the steady decline of actual investment in systems and care for aged people.

I will report that the minister who is so responsible for aged care, sitting over there, Minister Colbeck, dared to look up at me and mouth that he doesn't believe a word I'm saying. That is the kind of hypocrisy that we see from this government—a failure to accept the fact that thousands and thousands of older Australians are dying on your watch because you can't raise a finger—

Kimberley Kitching (Victoria, Australian Labor Party, Deputy Manager of Opposition Business in the Senate) Share this | Link to this | Hansard source

Senator O'Neill, through the chair—

Deborah O'Neill (NSW, Australian Labor Party) Share this | Link to this | Hansard source

I appreciate that. The fact is that thousands and thousands of Australians are dying on the watch of this government. If you care about your family—if you have an older Australian, a mum or dad, that you care about in your family and you're banking on this government to give you a bit of help or support if they become unwell, have a stroke, develop dementia or need someone to come in and give them a bit of a hand to have a shower, I'm sorry to tell you it won't be there. If by some miracle the government should deign to give you acceptance of your request and provide you with a little bit of care, be pretty confident that if, say, your mum has a sudden health crisis and is assessed as needing a high level of care—level 4 is a high level—this government will think it's okay to give you a level 1 package. It actually thinks that that's okay. I don't want to trivialise this, but this lunacy is like if you went to a shoe shop and asked for a size 7 and they gave you a 2. It doesn't fit. That is how ill fitting this government's policy around aged care is.

So I urge Australians: don't accept the ridiculous rhetoric of this self-aggrandising government that pats itself on the back day in and day out and that spent $1 billion telling you how good it is. If it had spent that on aged care, maybe some of the 28,000 people who got buried while they were waiting for a package might still be here.

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

The Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 2) Bill 2020 amends the way that home-care providers are paid subsidies to address stakeholder concerns regarding unspent funds and to align home-care arrangements with other government programs such as the National Disability Insurance Scheme, NDIS.

The measures in the bill improve financial accountability and allow for better transparency over the actual use of funds for home-care service delivery. The bill will amend the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 such that home-care providers will only be paid subsidies for care and services rendered to a home-care recipient during a month, with Services Australia retaining the unspent subsidy that a home-care recipient is eligible to receive each month. This unspent subsidy will be available for providers to draw down on behalf of a home-care recipient as care and services are provided in the future. There is no change to a consumer's access to their full subsidy.

This builds on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020 that amends the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 such that providers of home care will not receive a payment in advance but in arrears. I thank senators for their contribution to the debate and commend the bill to the Senate.

Jenny McAllister (NSW, Australian Labor Party, Shadow Cabinet Secretary) Share this | Link to this | Hansard source

by leave—I seek to amend Greens amendment on sheet 1189, deleting the final four words 'by 31 December 2021' and replacing them with 'as a matter of urgency'.

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

Of course it's up to the chamber as to whether they accept the amendment, but as mover of the amendment I will accept that. I'm hoping 'as a matter of urgency' means that's before 31 December this year, but, as the mover of the amendment, I say the Greens will accept that amendment.

Kimberley Kitching (Victoria, Australian Labor Party, Deputy Manager of Opposition Business in the Senate) Share this | Link to this | Hansard source

I will clarify. Subsection (b) will read:

(b) calls on the Government to act immediately to ensure the Home Care Package waiting list is cleared as a matter of urgency.

So the question is that the second reading amendment, as amended, moved by Senator Siewert and contained on Sheet 1189, be agreed to.

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

I acknowledge the amendment from Senator Siewert and the intent of the amendment from the opposition. We are in a circumstance right now where we are just some weeks from the final report of the royal commission. Clearly, the government will seriously consider the report of the royal commission, and I note that Senator Siewert's second reading amendment is based on counsel assisting's draft recommendations to the royal commissioners. We don't yet know what the royal commission's final report will say. We are expecting that there will be some expectation of further reform and urgency with respect to the management of home-care waiting lists. I want to put on the record the fact that the government continues to invest, as has been noted during the debate. There will be an additional 39,105 packages allocated within the system this financial year, reaching somewhere like 195,000—

Kimberley Kitching (Victoria, Australian Labor Party, Deputy Manager of Opposition Business in the Senate) Share this | Link to this | Hansard source

Minister, I am aware the question hasn't been put. In effect, in terms of procedure, you're speaking to something that hasn't been put yet. I suggest that maybe this might be raised in committee.

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

I thought it had been put.

Kimberley Kitching (Victoria, Australian Labor Party, Deputy Manager of Opposition Business in the Senate) Share this | Link to this | Hansard source

I put the question. The question is that the second reading amendment, as amended, moved by Senator Siewert and contained on sheet 1189, be agreed to.

Question agreed to.

The question is that the motion for the second reading, as amended, be agreed to.

Original question, as amended, agreed to.

Bill read a second time.