Janet Rice (Victoria, Australian Greens) Share this | Link to this | Hansard source

I'm very pleased to rise today to support the passing of the Inspector-General of Aged Care Bill 2023. The bill's an integral step in following through on the recommendations of the Royal Commission into Aged Care Quality and Safety. The creation of an accountability mechanism is much needed to ensure the aged-care system is supporting and protecting older Australians.

The Greens fundamentally believe that the federal government needs to play a central role in the funding, regulation and support of high-quality aged-care services. We believe that Australia's aged-care system should be underpinned by transparency and accountability. And whilst we hope to see the government go further in these areas, we commend the establishment of an independent accountability mechanism to monitor aged-care services. We welcome the submissions provided to the inquiry through the Senate Community Affairs Legislation Committee's inquiry process and recognise the very useful input that was provided that informed the bill and its implementation. This process received unanimous support from the committee for the establishment of an independent inspector-general. However, there were organisations and community members who raised important concerns, recommending that the bill would benefit from a greater human rights' focus, a statutory framework for government responses and a role for the inspector-general in assessing individual complaints. A submission also made it clear that aged-care advocates are in favour of seeing the recommendations of the royal commission implemented swiftly.

We heard from the Older Persons' Advocacy Network, who said:

… OPAN strongly supports the critical role of the Inspector-General in calling out systemic issues and significant problems across the aged care system and making recommendations to Government for improvement.

OPAN continued:

We believe the Bill provides for significantly increased system accountability and transparency through reporting to Parliament and maintaining a strong focus on implementation of Royal Commission recommendations. We strongly support the Inspector-General of Aged Care having powers to deal with complaints about the Department of Health and Aged Care, the Aged Care Quality and Safety Commission, and the Aged Care Financing Authority.

Similarly, Aged and Disability Advocacy Australia said:

ADA supports the stated objectives of the legislation, particularly, to implement the identified recommendations of the Royal Commission into Aged Care Quality and Safety (the Royal Commission) which relate to the establishment and operation of the office of the Inspector-General, and the role of this office in ensuring accountability and transparency into the aged care system as well as bringing about positive systemic change.

They continued:

The described role of Inspector-General and stated responsibilities are supported by ADA, to facilitate these objectives. In particular, the need for independent oversight and monitoring is urgently required.

Additionally, and as set out in the Bill, the office must be equipped with necessary powers of review, monitoring and reporting. Appropriate information gathering authority will be necessary to obtain information relevant and necessary to the role being able to fulfil its mandate in accordance with the objective of the proposed legislation.

The Aged Care Rights Advocacy Service submitted:

ARAS appreciates the work undertaken to date by the former and current Australian Governments in the continuation of implementing the 148 recommendations made by the Royal Commission into Aged Care Quality and Safety. ARAS also welcomes the Inspector-General's role in providing oversight in the implementation of the recommendations, including the operationalisation and performance of the reforms with respect to their effectiveness in the delivery of safe and high-quality aged care services.

It is clear this is an area of urgent need for the sector. Without an appropriate independent accountability mechanism in place, many older people have suffered with inadequate care. The welcome and fundamental introduction of the inspector-general will provide an imperative function in monitoring and investigating an historically fraught system.

There is a lot of support for this bill. I'm hopeful to see further work to see the government support our call for the inspector-general to undertake greater scrutiny of the implementation of the royal commission recommendations, and the scope of need for systemic advocacy in the aged-care system needs to be matched with regular and thorough evaluation. I look forward to working with the government as well as advocates and community members to see future legislation that enhances the rights and protections of older Australians. Of course, there is far more work that needs to be done to enact all the recommendations of the royal commission and to ensure that older people have access to appropriate, affordable and diverse aged-care services. I'm confident we will be able to work together with the government to take a rights based approach to aged care that maintains and promotes dignity, independence and quality of life.

The Greens have made a number of recommendations regarding missing elements of this bill, and I am looking forward to continuing to advocate for a more fully empowered and functional accountability mechanism. I will also continue to advocate for a clear focus on the rights of older people in line with the recommendations of the royal commission. Older Australians are consistently left vulnerable by institutional betrayal and unaccountable structures. The royal commission highlighted the lack of responsibility and accountability challenging the rights of older people.

The exclusions of an individual complaints function and publication of regular updates are clear drawbacks of this legislation. I will be continuing to advocate to government to respond to all of the relevant recommendations of the royal commission. We need to see a high-quality, affordable aged-care system built on a rights foundation. This legislation, sadly, doesn't go far enough to embed a rights approach, but the Greens will continue to advocate for it. In particular, I look forward to a strong human rights basis in the new aged-care legislation.

In conclusion, I commend the government for the work that's been done to reflect the community's needs and to produce this bill. This reform is urgently needed and will be of crucial significance in the lives of countless older Australians, their families and their carers. I would like to thank Senator Marielle Smith for her work in chairing the committee's inquiry and engaging a variety of aged-care advocates and service providers to share their experiences and expertise. I'm pleased to be sharing the Greens' support for this legislation. It will improve people's lives. It's much needed and will have a major impact on older Australians. I can foreshadow that we will move an amendment during the Committee of the Whole stage of the bill, for which we are hoping for government support, reflecting our prioritisation of regular monitoring and evaluation, which is an issue we will continue to advocate for.

I also now want to foreshadow Senator Thorpe's second reading amendment. Senator Thorpe, who is unwell, has asked me to share what she wished to contribute to the debate on this aged-care legislation. Senator Thorpe says:

We are in an Aged Care crisis and our Elders suffer as a result of it.

Taking care of our Elders is an essential part of any society. Our Elders have cared for us when we needed it, and it is our responsibility to care for them as they need us in the later stages of life. Everyone deserves to age in dignity.

The Royal Commission has clearly outlined the problems prevalent in the Aged Care system currently and what needs to be done to reform it, including the establishment of the role of Inspector General of Aged Care as per recommendation 12 of the final report.

Senator Thorpe wants us to know that she is strongly in support of this establishment. She says:

The Governor General for Aged Care will be responsible for the oversight of the aged care system. The reform of that system i fully dependent on the new Aged Care Act, which we do not have in front of us yet.

Senator Thorpe continues:

I would like to underline the importance of recommendations 2 and 3 of the Royal Commission for the new Aged Care Act and therefore the work of the Inspector General. These recommendations outline the rights of older people seeking aged care and the key principles to underline the Aged Care Act respectively. They go to the heart of the reforms the Aged Care system needs to provide respectful, comprehensive and culturally safe care for our Elders to live in safety and comfort and lead self-determined lives connected to their loved ones. The system should always be guided by our Elders, their needs and wishes.

That was Senator Thorpe's contribution.

At the request of Senator Thorpe, I move:

At the end of the motion, add ", but the Senate calls on the Government to commit to ensuring the rights and principles outlined in recommendations 2 and 3 of the final report of the Royal Commission into Aged Care Quality and Safety underpin the development of the new Aged Care Act, and through the new Act, guide the Inspector-General of Aged Care's oversight of the aged care system".

Helen Polley (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Inspector-General of Aged Care Bill 2023 and the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023. The bills amend the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018 to ensure information can be shared with the inspector-general for the purpose of carrying out its functions. The bills also amend the National Anti-Corruption Commission Act 2022 to require that a person having already been investigated by the inspector-general can only be investigated by the commission where it is in the public interest to do so. Finally, the bills provide for the transitional arrangements to move from interim administrative arrangements within the department to the statutory inspector-general.

These bills are another historic moment in the Albanese Labor government's election commitment to bring transparency, accountability and quality back into the aged-care sector and every residential aged-care home across the country. We have continued on this path since taking office. It has been historic. The Albanese Labor government has been busy putting nurses 24/7 back into the aged-care sector and pushing for—and securing, I might add—a very important but historic 15 per cent pay rise for aged-care workers across the country. It must be noted that this pay rise, which everyone in aged care deserves, was opposed by the Liberals and Nationals, which is an absolute, utter disgrace. I would like to see those opposite work for a day in an aged-care home to see whether or not they think a pay rise for aged-care workers is necessary. Having walked in the shoes of aged-care workers on a number of occasions since being in this place, I can tell you that they certainly deserve that pay rise.

I also note the work of the minister, the Hon. Mark Butler, who, when we were last in government, actually built the foundations for reform to this sector, and what we saw from the Liberal-National government over the last almost decade was a government that failed to take responsibility, failed to build on that framework and failed to develop policy that was going to ensure that we had a very strong, skilled workforce and ensure that this sector was funded going forward. This is what delivering for the aged-care sector looks like, and we had to wait for an Albanese Labor government to be elected to deliver on that. I hope that those opposite have not forgotten—I know the Australian people have not forgotten—that it was Mr Scott Morrison who cut $1.2 billion from the aged-care sector and used it as an ATM. That's the record of the former Liberal-National government. This is the same former Prime Minister who called a royal commission into his own government's failings.

Those opposite had a very long time, almost 10 years, to fix the aged-care sector and they failed. It cannot be sugar-coated; they just didn't care. All they cared about was being in government for the sake of being in government. They were not actually focused on delivering better policy outcomes for their fellow Australians. During the Abbott government, there wasn't even a specific minister for aged care or a minister with 'aged care' in their title. That's what the former prime minister Tony Abbott thought of aged care and that important sector. Under Mr Turnbull and Mr Morrison there were four failed ministers who oversaw a sector in need of urgent reform. Can those opposite recite the names of those four failed aged-care ministers? I can. Who could forget former minister for aged care, Mr Greg Hunt; the former failed minister Richard Colbeck; the failed former minister Ken Wyatt; and, now, the illustrious, uneventful, unimaginative deputy opposition leader, Sussan Ley. They all failed, and why did they fail? It was because they didn't care. They didn't understand the sector and they didn't want to understand the issues because they had no capacity to bring the sector forward and ensure, as I said, that we had the skills and the workforce to take this sector forward.

Importantly, these bills establish an independent inspector-general of aged care who will impartially monitor and investigate the Commonwealth's administration and regulation of aged care. We are a transparent government, unlike the former Morrison government and the former Prime Minister's secretly held portfolios—secret from the public and secret from the ministers themselves; the former Prime Minister assumed those responsibilities, named himself a minister and didn't even bother to tell those ministers that he'd taken over their responsibilities. As a government, we want to ensure that the aged-care sector is equally transparent. It is so important. As recommended by the royal commission, the inspector-general will look at serious and ongoing problems associated with the design and operations of the aged-care sector and will specifically look at issues that are complex and interconnected and that have not been addressed adequately. This is really important work. The bill also provides the inspector-general with powers to monitor and report on the implementation of the recommendations of the royal commission, which is crucial. Remember that report? The title: Neglect. The onus of neglect firmly sits with those on the opposite side of this chamber. As a government, in the words of the Minister for Aged Care, the Hon. Anika Wells:

An inspector-general who will report their findings and recommendations to government, to parliament, and to the public, to instil greater accountability and transparency across the aged-care system, and, in turn, facilitate positive change for older Australians and their families.

That's something that should be welcomed by all.

We're an ageing population. We're a rich nation; therefore, we should have the best possible aged-care sector. But after nine years of neglect, it's now time for the adults to be in charge and change the culture of a sector in need of attention. Aged care plays an important role in the lives of our loved ones. It is a large, complex system that involves agencies and a range of programs and policies designed to care for and support Australians as we age. The inspector-general's functions can be broadly seen as monitoring, reviewing and reporting. An independent oversight means understanding what is going on across the aged-care system as a whole. The bill enables the inspector-general to use their information-gathering powers to monitor decisions, programs, operations and funding under the aged-care laws, to maintain a comprehensive understanding of what is occurring, what trends are emerging, what systematic issues are prevailing and what insights can be seen from a holistic point of view. The bill also sets out a broader framework for the inspector-general to investigate systemic issues through targeted reviews, to give assurances to the public and aged-care government bodies on the priorities of the inspector-general. The bill requires the inspector-general to publish a work plan each year. The review framework focuses on transparency and procedural fairness at its core.

The inspector-general will report on more than just their reviews. The inspector-general may, at their discretion, report on the outcomes of their ongoing monitoring and reporting, publicly and to the parliament, on whether the aged-care sector is meeting the objectives of the aged-care legislation, where Australian government bodies are performing in a way that enables an effective aged-care system and whether they are driving excellence. The bill also empowers the inspector-general to report to the government, to the parliament and to the public about the progress of implementing recommendations of the royal commission. Progress reports from the inspector-general will occur annually to ensure that the aged-care reform that we desperately need remains a priority. It's a priority of this government, unlike those who held the reins and the government benches over almost 10 years. We want to see this change because we understand how important aged care is.

The aged-care sector—we've got to remember not everyone ends up in a residential home—is more than just residential care. It's providing in-home support as well for our senior Australians. This bill and future bills will put aged care at the top of the Albanese Labor government's agenda. Senior Australians are at the top of the Albanese government's agenda. Why? Because we understand. We've been listening to the sector, and we've been listening to members of the community. It makes sure that the royal commission isn't just another report without any tangible outcomes attached to it. We will ensure that the royal commission's report does not gather dust like the 27 reports that were brought down under the previous Liberal-National governments. On their watch, we had inquiry after inquiry talking about the failings of the aged-care sector. We had reports looking into the workforce and the challenges in attracting people to work and to care for older Australians. They fell on deaf ears. They gathered dust. We on this side understand the significant part that aged care plays in our communities and how important it is.

I have faith in our minister and I have faith in our government that we will change the culture of aged care in this country. I have faith that the minister, the Hon. Anika Wells, will deliver the outcomes for the Australians who so desperately rely on having a government who understands and who cares about their wellbeing and that we will help continue that transition of the aged-care sector, which was built when we were last in government, as I said, by Minister Butler. We actually owe this to the Australian people. We owe it to every Australian who is ageing to ensure that the standard of aged care, whether it is in residential care or it's help they're getting to stay in their own home. After all, most people want help to stay in their own home for as long as they can.

We also have to understand that those people who are now going into residential care are going in when their health has deteriorated. They need more care, so they need more specialist well-trained staff who are going to be able to give them the care that they need. I want to give a big shout-out to all the esteemed people like Professor June Andrews and other experts who talk about the care that is needed by older Australians and what is happening internationally. These are people that have studied and researched the issues in relation to ageing such as dementia and other degenerative diseases. This research is so important to our community, as it is to the international community.

As I said before, Australia is a rich country. We are a lucky country, but we can't trust those opposite to care for and look after older Australians. That is very clear, and that is why we have to stay in government. That's why we're doing the work that needs to be done now, and that is why we are delivering on the election commitments that we gave, that we as a government were going to bring transparency and accountability back into the aged-care sector. I know that through the Prime Minister, the responsible minister and my caucus colleagues we will bring back accountability, transparency and quality care to the heart of aged care because that is what older Australians deserve. They deserve respect. They deserve to have the care that they need when they need it, whether it is to stay in their home longer or it is in residential aged-care homes.

So much more should have been done by those opposite in the previous 10 years, but they failed because they didn't care. They weren't listening, they didn't care, it was all too hard. We now have a government under Anthony Albanese, Minister Anika Wells and Minister Mark Butler who care, as the caucus cares about older Australians. So we will deliver that transparency, that accountability, that respect and that dignity that every Australian deserves. It is just unfortunate that the only governments who ever deliver for older Australians with dignity and respect are Labor governments. That is why I am proud to be here as part of the Albanese Labor government who is delivering for older Australians. We're delivering good care and we're delivering accountability and transparency.

Matthew Canavan (Queensland, Liberal National Party) Share this | Link to this | Hansard source

If only what Senator Polley said were true. It would be fantastic if that were true and Senator Polley's conclusion actually accorded with the facts. I'll get to the facts in more detail in my contribution, but the facts are that we know of at least 30 aged-care homes that have shut over the first year of this government's time in office and shut because of a botched decision the government made to enforce a 24/7 nurse requirement in aged-care homes. As I said, I will get into more detail on that, given its important in the aged-care sector, but I did want to say to begin with that the coalition does support this bill, the Inspector-General of Aged Care Bill 2023, and the other piece of legislation within this package. We always support measures that are going to help ensure that there is greater oversight and the establishment of performance standards in the aged-care sector. Of course, this bill—an inspector-general of aged care—is a recommendation from the Royal Commission into Aged Care Quality and Safety. It was the former coalition government that established that royal commission, and we accepted their recommendations, including this one, recommendation 12. So we're proud to ensure the passage of this bill and see this established.

We do believe the creation of an inspector-general is important to ensure that the aged-care sector remains supported, and the core function of the inspector-general will be to improve the transparency and accountability across our aged-care system through monitoring, reviewing and publicly reporting on systemic issues. Obviously, we've seen some systemic issues come to light before, during and following the royal commission. While an inspector-general won't be able to stop all of those things happening, shining a greater light on these issues may help alleviate some of the harm that can occur or avoid their occurrence in the first place.

The bill enables the inspector-general to use their information-gathering powers to monitor decisions, programs, operations and funding under aged-care laws to maintain a compressive understanding of what is occurring, what trends are emerging, what systemic issues are prevailing and what insights can be made from a holistic view. We support creating this inspector-general's independent arm, independent from the Department of Health, other government bodies and regulators. It's important for that independence to be maintained to ensure appropriate safeguards.

I believe the government has appointed Mr Ian Yates as the Interim Inspector-General of Aged Care. He has long experience in the aged-care sector. I welcome, and I'm sure the coalition welcomes, that appointment.

I note that the Senate Standing Committees on Community Affairs has reported on this bill, and most submitters gave broad support to it, but there were some concerns noted—that the inspector-general should regularly consult with the aged-care sector and older people, particularly on the development of annual work plans. The opposition agrees this is critical to the role of the inspector-general to ensure that he or she understands the issues on the ground, not just those that come out of Canberra.

There is a lot to support here, and I do hope this makes a difference in the aged-care sector, but there are some pressing concerns in the aged-care sector right now, especially one's that have been brought to me by my community of Central Queensland. My office was contacted just a few weeks ago, in the parliamentary winter recess, by some victims of a botched policy process from this government that has unnecessarily seen the closure of an aged-care home in Central Queensland.

Mount Morgan is a proud town. It's got a venerable history as a town. It was once home to the biggest goldmine in the world. But, like many mining towns, once the mine goes, it's tough for the residents there. But they're hardy people, and still 2½ thousand people live at Mount Morgan. It's lucky enough to have an aged-care home—or does, for now, have an aged-care home. That's good for it. While it's relatively close to Rockhampton, it's still a 30- or 40-minute drive to the major town of Rockhampton. Those in an aged-care home—and their loved ones—quite often will have mobility issues, which makes moving even a 30- or 40-minute drive away a really big deal. These people contacted my office because, in the last month, the provider of aged-care services at Mount Morgan Carinity announced that they plan to close the aged-care home probably by Christmas this year because they simply can't comply with the new government's ill thought through measures to require a registered nurse to be on site 24 hours a day seven days a week.

Let's put into context what this requirement means for a town like Mount Morgan. As I say, it has 2½ thousand people. They've got a small aged-care home; it's not large. The government is saying they need to have a registered nurse 24 hours a day seven days a week. Obviously, they'll only work eight-hour shifts or thereabouts, so immediately they will need three full-time registered nurses on their books. They won't work seven days a week though. They want to have weekends. There will also be holidays and absenteeism. I'm told by Carinity and others in this space that, to meet this requirement, they'd need to have five registered nurses on their books or thereabouts, even for a small aged-care home like the one at Mount Morgan. You're not going to get five registered nurses in Mount Morgan. It's not going to happen. It doesn't matter how long you wait. It doesn't matter what we do in skills development or all these things. It's 2½ thousand people. You are not going to get five registered nurses in Mount Morgan. It's just not going to happen. So the government's plan is to not have aged-care homes in towns of about 2½ thousand people. That is the absolute consequence of their policy. It's not a debate. It's not a matter of judgement. It's just not going to happen.

All the residents that have contacted me love the aged-care facilities, they love the people they work with, they love being close to their relatives, but now they're going to have no aged-care home. I can understand the government's attempt to lift standards across the country. I'm not quibbling with that in the major cities, where getting a registered nurse to be there 24/7 should be possible. But for these small towns, why can't there be some flexibility? Why can't there be a little common sense applied so that people in small country towns aren't separated unnecessarily from their loved ones?

I want to relay one story here that's been passed onto me. Not everyone that's contacted me wants their stories made public, I understand that, but I thank Ms Sealy for agreeing to have her story made public. Marlene Sealy is a long-term resident of Mount Morgan. She's 80 years old. Her husband, Fred, is 83 years old and he has dementia. He's been in the aged-care home for the last few years at Mount Morgan. Marlene lives just down the road from this centre. Mount Morgan is a small town. She normally visits her husband, Fred, six times a week. She can walk there. That, obviously, is lovely for Fred and Marlene to keep up their relationship as a long-term married couple.

Now, the Mount Morgan facility is closing. As I said, it will probably close by Christmas. To give Carinity credit, it says it will stay open for as long as it needs to for residents to find alternative arrangements, but almost certainly, this means that Fred will have to go to Rockhampton, which is, as I say, a 35 or 40-minute drive away. Marlene doesn't have a driver's licence. There's, obviously, very limited public transport. In fact, it will take Marlene an hour-and-a-half to two hours each way to get a bus to Gracemere and change. It's multiple buses for an 80-year-old lady. She obviously won't be able to do that six times a week. So because of the government's policy—they will get up here and spruik, and say how wonderful it is—we've separated a long-term married couple, Marlene and Fred Sealy, who will make their last time on this planet terrible and horrible and miserable. That's what you've done. You could fix it overnight. I've written to the Minister for Aged Care asking her for some common sense. You could fix it, just give them an exemption. We know of apparently 30 across the country that have shut because of this requirement, so far. Give those aged-care homes in these country towns an exemption; it's not that hard.

There are exemptions. The government senators might come back with their own exemptions. Let's go through those. It's ridiculous. They're not really exemptions; they're Claytons exemptions. These exemptions are only available to providers with fewer than 30 beds in certain Monash modified areas. I think Mount Morgan would qualify for this, but that doesn't matter because the exemption can only go for a year. They can only get exempt from the requirement until July next year, for one year. There are not going to be five registered nurses in Mount Morgan in a year's time. There won't be in five years or 10 years time or15 years time. It's not going to happen.

Can somebody over there please explain to me how the people of Mount Morgan could somehow, magically, attract five registered nurses to their town? It's not going to happen. So why don't you give them an exemption for the long-term? Maybe the inspector-general could be given extra powers to give extra monitoring of these sites in country towns that have an exemption, to make sure standards are okay, that maybe they have a registered nurse there at least every 24 hours, not all 24 hours—something. I'm flexible. Why doesn't the government and the minister get their hands dirty and go to the country towns and work out a way forward for them, instead of this Pontius Pilate approach, where we wash our hands, 'It's got nothing to do with us. Marlene and Fred Sealy: who cares?' Sorry Marlene and Fred, you're just unfortunate perverse consequences of this ham-fisted and botched approach. Just give them a bloody exemption. How hard is it? I've written to the minister asking for that. We'll wait and see.

But it gets worse. Apparently, those places that have an exemption have to report every 30 minutes that a registered nurse is not on site—I was told that, and someone can correct me if this wrong. They have to report to the regulator every 30 minutes! I believe Mount Morgan has an exemption for now because it's past the date, and it doesn't have a registered nurse 24/7, and these requirements came into effect in July this year. Mount Morgan is a small aged-care home in a country town. They don't have a lot of staff and they've got other things to do, but apparently the government wants them to call up every 30 minutes to say: 'We don't have a registered nurse.' And in 30 minutes time they call up and say: 'We still don't have a registered nurse.' In 30 minutes time, again: 'We still don't have a registered nurse.' What is this bureaucratic madness?

Shouldn't we be focusing on the patients and the people so they're happy? No-one has called me to complain about what's happening in Mount Morgan. There are systemic issues and there are problems, but it doesn't seem like Mount Morgan is one of them. Why are we imposing these ridiculous constraints on small aged-care homes? The only thing requiring the country aged-care homes to do this every 30 minutes will mean is poorer patient outcomes, because while they're making the call or worrying if they've called or will call in the next 30 minutes they're not focusing on their patients in the aged-care home. It is absolutely crazy.

I'd be very interested to know if any of the government senators have some talking points on this. I don't know if we'll get to the in committee stage on this, but if so I might ask questions about what advice they've had on the exemptions that have been put in place. Did they do any modelling or give any consideration to these smaller aged-care homes? Is there going to be a review of what's going on? Was there a regulatory impact statement done on this? What's been the evaluation? It seems to me to have terrible consequences, and this is not an area I've traditionally been heavily involved in. I'm happy to be corrected. I might be wrong about a number of things. I'm going off what I've been told and the limited research I've done since being contacted about this.

I'm going to keep fighting for Marlene and Fred because it is just not bloody right in our country for people to be treated this way. There is clearly a way the government can meet its election commitment—and I don't begrudge that for the major cities—while providing reasonable and commonsense exemptions to smaller aged-care homes where people are happy, where they're near their families and where they are part of a community. The other thing to say here is that these smaller aged-care homes are part of the community and part of what makes towns like Mount Morgan great. Everybody knows everybody, they know who works there and they chip in and help out. Apparently we instead want everybody to have to move to a soulless corporate major city where they don't know everybody and spend the last few years of their life in complete, abject loneliness.

I don't understand how anyone can defend this. Why don't you just fix it? It's not that hard. I don't know why Minister Wells doesn't just get her hands dirty. I'm not sure if she's travelled to any of these country towns. She's welcome to Mount Morgan any time to come and see what's happening. I know Marlene has said she's more than happy to speak to the minister, and I passed on her details to her. I hope something can be done about this, because it's about real people's lives and, as I say, there's an easy fix for it.

At the end of my remarks, at the request of Senator Ruston I seek leave to move the opposition's second reading amendment on sheet 2052.

Claire Chandler (Tasmania, Liberal Party, Shadow Assistant Minister for Foreign Affairs) Share this | Link to this | Hansard source

Senator Canavan, we already have a second reading amendment before the chair, so you will have to move it after that question has been determined. You can foreshadow it, which I think you have.

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

I rise to speak on the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023. The Albanese government hasn't wasted any opportunity to act on the systematic issues in the aged-care system that we inherited from the previous government.

I must commend Minister Anika Wells, the industry and the unions—including the Health Services Union, the United Workers Union and the Nursing and Midwifery Federation—for their work in reforming this country's aged-care system to make it work better for those needing care and showing respect to the workforce. This includes responding to the recommendations of the Royal Commission into Aged Care Quality and Safety, which those opposite dragged their feet over while older Australians were being treated abhorrently and aged-care workers were being treated like second-class citizens.

In our first year in government, we've embarked on more than 100 reform policies and projects in aged care. That's more than 100 reform projects in just 12 months. That includes legislating having registered nurses in aged-care homes 24/7; funding a 15 per cent pay increase for aged-care workers; introducing a star rating system so residents and families can make informed decisions about their choice of care; and increasing the amount of time of care each aged-care resident receives. Together, these measures will meaningfully improve conditions for both aged-care workers and older Australians receiving care, most importantly.

This is despite the Liberals' and Nationals' attempts to slow the progress made by our government. We've been able to make lifechanging changes to the system for workers and older Australians, but there is still more to do. This bill allows for the appointment of an independent Inspector-General of Aged Care, which will drive accountability and transparency across the system. Accountability and transparency in aged care are key pillars of the promises we made to the Australian people, and this legislation is about holding ourselves to the same high standards we're asking of the sector. The inspector-general will be responsible for monitoring the administration and regulation of the aged-care sector as well as monitoring, reviewing and reporting to the minister, parliament and public the progress of implementing the recommendations of the royal commission report.

Accountability and transparency in aged care would be concepts those opposite are unfamiliar with. They sat on the report of the royal commission for 18 months and took the title, Neglect, a little too literally. They presided over a worsening crisis in aged care which not only impacted older Australians but allowed for a race to the bottom of working conditions for those working in the sector. Through the Select Committee on Job Security, I heard from workers in aged care across the country about the systemic issues in aged care, including understaffing of facilities and workers pushed to their absolute breaking points. Tracey Colbert, an aged-care worker from Melbourne, described the strain placed on staff in the sector this way:

Also, they took the ENs—

enrolled nurses—

out of our sector. So then the carers had to do the role of an EN, doing medications. When a carer is doing medications, it takes that carer off the floor.

She went on to say:

Therefore, the other person has to do the work of two people, while this person is doing medications. That could take half an hour to an hour, depending on how many residents you've got. In my area, we have 43 residents with only six carers.

It's hard to understand why anyone—aged-care providers, government, workers or residents—would find this to be an acceptable norm within the system.

While workers are being stretched as thin as humanly possible, they're simultaneously being subjected to insecure working arrangements within the sector. Through the job security committee, we heard so many witnesses express their anxieties about their work and cost-of-living pressures. Sheree Clarke, an aged-care nurse from Queensland, shared this:

For me, personally, that insecure work has led to insecure housing. Because I've only got a 16-hour contract, I can't sign a lease. My anxiety levels wouldn't allow me to go to a higher rent, so I found myself living in a caravan park.

We've seen this shoddy business model spread like wildfire across the sector, where aged-care workers are hired as part-time contractors with few if any guaranteed hours. That means their employer can move their shifts and their hours up and down at a whim, including cutting shifts for workers if they speak out on any issues, including quality of care. Keeping everybody desperate for hours puts people on call 24 hours a day, seven days a week, and you never get real time off. It means they are essentially casuals, only they don't get the 25 per cent loading.

As the HSU national secretary, Lloyd Williams, put it:

… the situation we have is that … employers offer employees low part-time hours and then expect workers to be on demand for additional hours. If you are subject to low part-time hours, you are desperate, then, for additional hours. I don't think the relationship becomes one of a voluntary nature, because of the financial circumstances that that worker is placed in.

When we thought work conditions in the sector had hit rock bottom, up stepped the gig economy to drive standards down even further—gig platforms like Mable which pay their contractors below award wages, wages that would be illegal to pay to an employee. Mable has a business model built on paying workers below minimum wage while not providing employee benefits like leave or super or workers compensation. The previous government allowed for this to occur and then actually endorsed it. Instead of addressing the systemic issues in the sector or working through implementing the recommendations of the royal commission, they awarded Mable $7.2 million to provide surge staff in aged-care homes during the COVID-19 pandemic—which turned out to be such a disaster that it became a case study of the royal commission.

Even employer groups have spoken out about the dangers of having platforms like Mable infiltrate the aged-care space. Charles Cameron, from the Recruitment, Consulting and Staffing Association, told the job security inquiry:

We're very concerned that vulnerable clients, or representatives of disabled or elderly clients, will not have the time to properly analyse or, indeed, understand that, when you source an individual through these platforms as an independent contractor, you're not engaging somebody even on a labour hire basis; you're simply being matched and introduced to them. We think that presents a large number of problems …

I think it's fair to say that the community expects a high level of care for older Australians. The rise of Mable and other platforms is doing the exact opposite and sending care standards through the floor.

I want to commend the Health Services Union for being at the forefront of the fight against gig workers and the gig economy being exploited. The Health Services Union national president, Gerard Hayes, said of the rise of the gig economy: 'It is fraught with danger.' He has been proven right by the royal commission.

The royal commission rightly said that direct employment, not gig work, should be the workforce model in the sector. As Lauren Hutchins, from the Health Services Union, has said:

If you look at some of these platforms, they are a combination of Tinder and Uber. You put your profile out there and people … then make a decision based on the information that is provided. What you don't see is that those workers themselves often don't have access to workers compensation. They certainly don't have access to any form of leave. The arrangements in terms of their pay are often pretty dodgy …

This is why the workplace reforms the government will introduce later this year are so important. We cannot leave the welfare of our most vulnerable Australians in aged care or on the NDIS to the mercy of gig platforms.

The introduction of this bill affirms and reinforces the Albanese Labor government's commitment to improving the standard of aged care in our country. This is about supporting aged-care workers in secure, well-paid and fair work to improve the standard of care for older Australians—something that was absolutely not a priority of those opposite. This bill is another step in restoring trust in the aged-care system, and I commend the government and the minister for their action in this space.

Kerrynne Liddle (SA, Liberal Party, Shadow Minister for Child Protection and the Prevention of Family Violence) Share this | Link to this | Hansard source

Aged care is a critically important health service sector. It delivers pivotal services to older Australians. The sector assesses, protects and cares for our elderly as they adapt and realign their lives as they age. My home state of South Australia has the highest proportion of older people on mainland Australia, with more than 630,000 people over 50; that is 37 per cent of the population. In South Australia the majority of over-65s live independently at home. Only one in four people aged 55 and over live in care accommodation. There are 531 retirement villages with 26,000 residents. Aged care is important to every Australian as we all hope to age well and comfortably, and in SA there are many more of this cohort who should. The coalition believes that the establishment of an Inspector-General of Aged Care is important. This role would ensure the aged-care sector remains supported. The coalition will back this legislation to permanently establish the Inspector-General of Aged Care and associated statutory office.

The establishment of an inspector-general implements recommendation 12 of the aged-care royal commission, which was supported by the coalition. To implement the recommendations of the aged-care royal commission, the former coalition government provided more than $19.1 billion to support the aged-care sector. It is appropriate that the Inspector-General of Aged Care monitors and investigates the Commonwealth's administration and regulation of the aged-care system. It is also important that the findings and the recommendations of the inspector-general are tabled in this parliament, providing greater accountability, transparency and understanding of the work that occurs across the aged-care system. Accountability and transparency will assist in leading to the achievement of better outcomes and will assist in identifying those who need greater focus on what they're doing. Accountability and transparency is important in every sector but particularly in the aged-care sector, where people are often fragile and more vulnerable.

As the royal commission found, Aboriginal and Torres Strait Islander people do not access aged care at a rate commensurate with their level of need. A combination of factors creates barriers to Aboriginal and Torres Strait Islander people's access to the aged-care system—from social and economic disadvantage to a lack of culturally safe care and discrimination. Lack of access to aged-care services is further compounded by Aboriginal and Torres Strait Islander people's additional vulnerabilities from higher rates of disability, co-morbidities, homelessness and dementia. To feel secure and obtain culturally safe services, many, although not all, Aboriginal and Torres Strait Islander people prefer to receive services from Aboriginal and Torres Strait Islander people and from Aboriginal and Torres Strait Islander organisations. What is needed is Aboriginal and Torres Strait Islander people employed in the sector at greater levels and across the sector and others with high levels of cultural competency. The position of Inspector-General of Aged Care will provide the resources to cast a light on some of the most pressing challenges for the aged-care sector and in particular the services targeting Aboriginal and Torres Strait Islander peoples.

I acknowledge it is Aged Care Employee Day today and the work these carers do. Last week I met people working in the sector at the launch of the National Aboriginal and Torres Strait Islander Ageing and Aged Care Council here at Parliament House. It was good to talk to them about the aged-care sector. I congratulate the organisation for their advocacy for improvements in the ageing and aged-care sector because we know, of all the people eligible to access aged-care services, only 16 per cent of Indigenous people do so. I believe it is vitally important that elderly Indigenous people are afforded the same levels of care as other people. This really should be non-negotiable, with no excuses. Providers of aged-care services for Indigenous people must be held to the same level of scrutiny and accountability as mainstream services.

Workforce shortages are putting serious pressure on Australia's entire healthcare system, and aged care is not immune to these workforce challenges. It is clear that this crisis is impacting on the viability of aged-care homes across our country, especially in regional areas. As Senator Ruston outlined in this place earlier today, the latest quarterly report from StewartBrown outlines the shortage in directly employed nurses and that it is increasing the demand for agency nurses, which is costing aged-care providers significantly more. Agency staff now cost providers $17.04 per bed per day. That's an increase of $9.86 per bed per day compared to the same period in 2022.

So what's the Albanese government's plan to address this? This increase is clearly not sustainable for the aged-care providers who are trying to comply with government regulations. It is the reason why the coalition has been calling out for a whole-of-care-sector workforce plan. One-size-fits-all, that type of model, rarely, if ever, works. A city-centric model rarely, if ever, works. Whatever the model, it should allow sector operators to be flexible and innovative in how they deliver quality care to their communities, but that is not about being under the minimal standard. Instead of penalising, this government should look to incentivising providers to use new technologies like telehealth, and support the sector to value and upskill carers to perhaps become enrolled nurses, enrolled nurses to maybe become registered nurses and therefore remain and contribute to this very important sector.

During the election campaign, the Prime Minister promised that every aged-care home would have a nurse on site at all times by July 2023. As a result of this requirement being demanded a year earlier than recommended by the royal commission, under the Albanese Labor government's watch, aged-care homes are closing down. July 1 was a date that was dreaded by aged-care providers across the country, as Labor's 24/7 registered nurses requirement hit the sector amidst a glaring obvious already existing workforce crisis.

As a consequence, elderly people have been forced to move away from their families and communities, all because Labor isn't flexible about staffing requirements during a workforce crisis. I have heard that in regional areas and directly from those in nursing homes. To the best of my knowledge, so far more than 30 homes around the country have tragically closed down, as they were not able to meet the government's legislated requirements. However, this government won't tell us. There is now transparency, and they are hiding the impact and the facts from the public.

It is more than a month since this fast-track policy came into effect, and we know that it isn't just the rushed 24/7 registered nurse policy that has forced aged-care homes to close but there has been an extremely limited exemption criteria. For providers to become exempt from this requirement to have a registered nurse on site 24/7, they must report every 30 minutes or more that an RN was not on-site and/or not on duty and the reason an RN was not on-site and/or not on duty—seriously, every 30 minutes. Who thought of that one? Seriously, did the minister not think to seek clarity, ask what that actually looks like for a provider, for a resident? This additional burden on a sector that is caring for some of the most vulnerable people is crippling and closing some small regional, rural and remote providers. It is now time for the Prime Minister to step in so more aged-care homes do not close. It is for that reason that the coalition will move an amendment to encourage the inspector-general to immediately review the impacts of the government's expedited policy and to provide advice on how the sector could be better supported through the current workforce shortages.

Of course the coalition supports older Australians receiving the best care possible, but bringing forward the royal commission's time lines and imposing rigid constraints on the sector is reckless, damaging and hurtful. We heard Senator Canavan giving some examples earlier. The opposition supports the independence of the inspector-general and endorses the separation of the inspector-general from the Department of Health and Aged Care and the other government bodies responsible for administering and regulating aged care. This is an important safeguard that guarantees the impartiality required to monitor, investigate and report on systemic issues across the aged-care system.

Finally, I note the number of submissions during the consultation period of this legislation that are supportive of the establishment of the inspector-general but that also mentioned additional matters relating to the implementation of royal commission recommendations. The royal commission recommended that the governance of the aged-care system be subject to ongoing scrutiny and that is why it is so important the inspector-general is empowered to review these government agencies to oversee their performance and their decisions. When I travel to aged-care facilities right across the country, I'm consistently told about the complexity of the current aged-care system, especially around the complaints mechanism. The coalition is pleased to see that within the explanatory memorandum of the legislation that the inspector-general will also focus their attention on reviewing existing complaint mechanisms. The inspector-general will also consider how complaints, both from consumers and providers, are currently handled and will provide recommendations to ensure systems are continually improving and operating fairly and effectively. But it shouldn't just rely on people making complaints; it should also rely on assessments to identify if there are any issues.

Noting the significant proportion of royal commission recommendations that were due to be implemented within five years, the coalition considers it prudent that the inspector-general provides interim reports on the status of implementation of the recommendations. This should occur annually and be tabled in parliament up until the five-year comprehensive report into the implementation of the recommendations is finalised. The coalition will support an amendment to this effect, as we believe it is important the Department of Health and Aged Care and the government are held accountable for the changes they make through an independent body. The coalition implores the government to start listening to the sector and stop imposing regulation that is forcing aged-care homes to close and having a negative impact on the families that love the residents who live in them. Older Australians deserve better; they deserve our respect and the right to age with dignity in their communities, surrounded by the love and care of their families.

Fatima Payman (WA, Australian Labor Party) Share this | Link to this | Hansard source

I rise to support the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023. This bill is another step in our journey to fix aged care, something we are absolutely committed to for the wellbeing of our older Australians and the workers who care for them. This bill makes consequential and provisional amendments to Commonwealth laws to support the establishment of the Inspector-General of Aged Care. It ensures information can be shared with the inspector-general for the purpose of carrying out its functions. This bill also amends the National Anti-Corruption Commission Act 2022 to require that, where a person is being investigated by the inspector-general, they can only be investigated by the commission if it is in the public interest. Finally, this bill ensures arrangements for the departmental interim administration.

As a Labor senator, I am really proud of this bill and of this government for acting—for taking action after years of neglect. We are committed to getting this right. We are dedicated to this work, because we know that it's the right thing to do. I want to acknowledge the years of campaigning from union members across the country on this issue. You were not listened to by the previous government, but we are listening now, and we hear you loud and clear. You deserve to be recognised for the important work you do, and the industry needs to be fixed so that older Australians receive the care they deserve as well. I'm proud to stand in solidarity with United Workers Union members, in this instance and on every day they fight for their workplace rights.

I would like to extend a warm, happy Aged Care Employee Day: thank you. Thank you for your dedication to care for our elderly and your compassion to push through the tough times. I want you to know that the Albanese Labor government recognises your commitment to our vulnerable Australians. Thank you.

Linda Reynolds (WA, Liberal Party) Share this | Link to this | Hansard source

I rise to speak in support of this Inspector-General of Aged Care legislation and the role of the Inspector-General of Aged Care. The coalition, when in government, embraced this recommendation and pledged to create an Inspector-General of Aged Care. This was done with the explicit intention of offering independent oversight over our aged-care system to ensure transparency, accountability and confidence for all.

The inspector-general will also have the ability to oversee the implementation of policies announced by the Labor government. Like so many other policy areas, this government makes promises in aged care that they can't keep. They break promises. Again, this was one of those really sloppy areas of policy development by this government. Let's not forget that during the election campaign the Prime Minister promised that every aged-care home would have a nurse on site at all times by July this year. Now, anybody who has worked in government or in fact anybody who is in this chamber would have known that was impossible to meet for a number of reasons, least of all that we don't have enough registered nurses in this nation. We would certainly be taking registered nurse away from where they are already a scarce resource, particularly in hospitals.

Now, one year later, under the Albanese Labor government's watch, aged-care homes are closing down because of this election commitment. It's one thing to make promises you know you can't keep. It's another to have the hubris and the stubborn will to not change a policy that is doing great harm. If you talked to any aged-care provider you'd know that 1 July this year was a date they were dreading because so many of them have not been able to meet Labor's expedited 24/7 registered nurses requirement. This has hit the sector as it has a very large shortage of suitable workforce, particularly, as Senator Liddle said, in rural and regional areas.

Tragically, as a result of this government's—I'm not quite sure whether it's just incompetence or whether they just simply do not care, but so far we know of at least 30 aged-care facilities that have closed down as they were not able to meet the government's legislative requirement. Again, is it incompetence or is it the fact that those opposite would rather have aged-care facilities close, particularly smaller facilities in rural and regional areas, rather than admit they were wrong? I suspect it is probably an unhealthy combination of both.

That means that residents who were dedicated community members, who lived close to their families, have been forced to move out of their home simply because this government wouldn't be remotely flexible about staffing requirements during a workforce crisis. Now we are a month on from when this expedited policy came into effect. We now know it wasn't just the rushed 24/7 policy that has forced aged-care homes to close, but the punitive exemption criteria sadly have had the same effect. Again, those opposite just don't care.

The minister's prescriptive exemption criteria only offered an exemption to providers with less than 30 beds in modified Monash model 5, 6 and 7 locations. For providers to become exempt from the requirement to have an RN on site 24/7, they must report every period of 30 minutes or more that an RN was not on site and/or not on duty and the reason—every 30 minutes. Anybody who has ever visited, been to or consulted with smaller residential aged-care facilities knows that they are already almost crippled with administrative burden in terms of time and cost. This is simply ridiculous. Again, it seems designed to have done what it is now doing—that is, closing small community regional aged-care centres.

In the last month we've seen providers like the Carinity Summit Cottages in Mount Morgan and Petrie Gardens in Tiaro close, saying very clearly that this reporting requirement has placed such a high administrative burden on providers they simply cannot do it. That is something that should have been blindingly obvious to the government. It's actually quite shocking that this minister is comfortable with watching homes shut down, not just because of her rushed legislative requirements but because of the niche exemption criteria she has determined. Again, hubris and a complete lack of care. If anybody opposite actually went and visited any of these facilities and talked to the operators and the residents, they would see that they're crying out for help and not more restrictions. It is now time for the Prime Minister and the minister to step in, admit they were wrong and actually ensure that more aged-care homes do not close. On this side, we remain absolutely committed to ensuring older Australians receive the care they need and the care they deserve. Australians cannot afford to see more aged-care providers shut their doors, particularly when and where they're needed the most.

I'd like to remind those in this chamber about the coalition's record in government. Those opposite are very quick to point out on pretty much everything that apparently it's almost like year 0 every time they come into government, 'Everything was stuffed. Nothing happened.' They've come in to fix things. I'll tell you what, it is absolutely not the truth in most policy areas, and it is certainly not the case in this area. In government, it was actually the coalition who called the Royal Commission into Aged Care Quality and Safety to ensure our oldest and our most vulnerable Australians received the care, support and also the respect of their dignity and that we recognise appropriately the contributions they have made to our society. The final report of the royal commission that those on this side of the chamber commissioned makes 148 recommendations following 23 public hearings over 99 days, 641 witnesses and over 10,000 public submissions. The recommendations are the product of wise and compassionate scrutiny of Australia's aged-care system. The coalition's 2022-23 budget delivered just over half a billion dollars in funding for aged-care reform, which built on previous funding that we delivered, contained in the 2021-22 budget and also that year's MYEFO. This brought the coalition's total investment in response to the final report to more $19 billion. We delivered a once-in-a-generation reform of aged care and provided respect, care and dignity to our senior Australians. Our 2022-23 budget responded to 10 recommendations of the royal commission specifically and built on our existing five pillars for aged-care reform.

We delivered a record investment across the aged-care system over the forward estimates, from $13.3 billion in 2012-13 under Labor—when Labor was last in government, it was $13.3 billion—to $30.1 billion in 2022-23. We actually grew the aged-care budget in our time in government by 126 per cent. We on this side of the chamber called the royal commission, and we did a lot of reform, including an 126 per cent increase in the aged-care budget. By 2025-26, funding in aged care, in our forward estimates when we were government, was growing to an estimated $34.7 billion per year. Also in government, we remained committed to providing our older Australians with support to live in their own homes for longer. This is why the coalition increased new home-care packages from 60,308 under Labor ,when they were last in government, by 357 per cent. It went from just over 60,000 to 275,597 new home-care packages. We didn't just talk about it. We delivered the care that people wanted to stay in their homes for much longer.

To support our aged-care workers, we provided an aged-care workforce bonus of up to $800 for eligible aged-care workers. We did that on 1 February of 2022, which cost $210 million. Additionally, approximately 265,000 workers benefited from the age-care workforce retention bonus, and this was the fourth workforce bonus that the coalition government had delivered, which was valued at over $600 million. But we also listened to the experience of the Australians who gave evidence to the Royal Commission into Aged Care Quality and Safety, and we took wideranging and decisive action to implement those recommendations.

Our response included a five-year implementation plan, which, as I said, was underpinned by five pillars. And those five pillars that we introduced when in government included home care, providing those Australians who choose to live in their home with support. The second was residential aged-care services and sustainability to improve and simplify residential aged-care services and access. The third was residential aged-care quality and safety, improving residential aged care and safety in all facilities. The fourth was we implemented a wide range of measures to support growing and better skilled aged-care workforce. The fifth was we implemented comprehensive measures for governance, to provide new legislation and stronger governance of the sector and of individual aged-care facilities.

It is absolutely imperative now that the Albanese government get this right. They've already, through their pre-election promises, made promises they knew they couldn't keep. As a consequence, over 30 aged-care facilities have already closed. Hubris is a very ugly thing in politics, and it is even worse in government, and sometimes you have to admit you got it wrong and start again—or at least fix your mistakes.

Another mistake with a huge impact by an intransigent minister, who will not admit he was wrong, was that he pulled out a policy that, five years ago, the Department of Health put to the then coalition government who rejected it as bad policy. But Minister Butler has intransigently supported the 60-day dispensing policy. I think anybody in this chamber would say there's absolutely nothing wrong with a 60-day dispensing policy, but the problem is that they're getting the pharmacists to dispense it for free. I don't know how much those opposite know about market economics, but you cannot ask any small business—and most pharmacies are small businesses—to get paid for one service and provide the second service for free. It boggles the brain to think that those opposite do not realise you cannot do that to small businesses.

Not only is it already starting to send some community pharmacies to the wall; it will also have a very significant and negative impact on residential aged-care facilities. There has been some subsidy for the support that pharmacists have been providing to homes, through homecare packages, and also to residential aged care, but most of them have been doing Webster-paks and home delivery to residential aged-care facilities for free. For something that people in aged-care facilities have been getting for free, under this Labor government's proposal it will actually cost pharmacists, small businesses, $151.7 million a year for the 188,288 people that will need the administration aids. They will have to start charging people in residential aged care, and in aged care it will cost on average $806. So this apparent saving will actually cost people over $800—and $400 for people in home care. Shame on you, Labor!

Hollie Hughes (NSW, Liberal Party, Shadow Assistant Minister for Climate Change and Energy) Share this | Link to this | Hansard source

What we will know is that Australia has an ageing population. More of us are heading toward retirement age and more of us are winding down to enjoy a little more of life and looking to enjoy the fruits of our labours, having contributed to this country's success and prosperity. Under this government, how much of that fruit remains in the nest is another story. The increase in the cost of living is having a serious impact on our most vulnerable Australians as well as poor standards in aged care. It's too expensive to receive the care that they need, to purchase medicines and to buy groceries. Rents are going up, taxes have increased, energy bills are up. The people who have toiled their whole life and have done their bit are now suffering at the hands of this government's heartless policies. They're too busy virtue signalling, helping the union mates and lining the pockets of their wind and solar industry friends. It is easy to sit here and attack this government, but we actually do want to work constructively on crucial matters to ensure that Australians get the best out of life. And all Australians want and expect our older Australians to be well supported and cared for in our community, including in residential aged-care homes.

Those of us on this side of the chamber remain committed to supporting the health, safety and wellbeing of older Australians and understand the important role that aged-care providers, care workers and nurses play in ensuring this support is provided in residential care settings. The coalition is supporting this bill because we do believe that the desire to permanently establish an inspector-general for aged care, transitioning the temporary arrangements for the interim inspector-general to a permanent one, is a good thing to ensure more oversight in the operations of the aged-care sector and to ensure better quality of life and safer care for all. The aged-care sector delivers a fundamental service to older Australians by protecting them, caring for them and supporting them on their journey of ageing gracefully, peacefully and with dignity. We need transparency and accountability throughout the system, and with the installation of an inspector-general we believe that any underlying issues can and will be better dealt with. The coalition supports the independence of the inspector-general and endorses the separation of the inspector-general from the Department of Health and Aged Care and other government bodies to ensure the office remains impartial and able to conduct itself without the concerns of politically motivated interference.

Given the number of deaths in aged-care homes since the pandemic was exacerbated under this government, it is very welcome to see this government finally listening to the coalition's calls to do something to improve the outcomes for our elderly Australians and to implement reasonable and rational measures to protect and to better serve our elderly Australians. We all remember that during the election campaign, aside from other things, Minister Anthony Albanese promised every aged-care home would have a nurse on site at all times by July this year. Well, Prime Minister, it has been over a year under your watch and aged-care homes are closing down. In fact, to the best of our knowledge we have been able to ascertain that tragically more than 30 homes have closed down. And we know that these closures impact families so directly when we have long-term married couples, one of whom needs to go into aged care, the local aged care home closes and that couple is then forced to separate not only because of the residency in the aged-care facility but because of the distance that they now have to travel to visit their spouse. This is all the result of this government's expedited 24/7 registered nurses requirement, which was foisted upon the sector during a severe workforce crisis. This is just standard play from Labor: increased demand without increasing supply. Economics 101 has been replaced by 'Albo-nomics' and 'Chalmers-nomics', but they still haven't worked this out across our country and across many sectors.

Worse still are the administrative burdens this government has imposed on registered nurses. The onsite registered nurse must report every period of 30 minutes or more that a registered nurse was not on site or on duty and the reasons. Heaven help some of these hardworking aged-care staff, who are put under this additional administrative burden whilst they're trying to deal at times with outbreaks of RSV or COVID, which is still occurring. It's happened a couple of times recently at the residential care facility my mum is at. I can tell you, I'd much prefer that the staff are there making sure that no-one has had a fall, that people are in their rooms when they should be and that there are no adverse impacts being felt by them. But, no—every 30 minutes, this insane administrative burden is crippling small regional, rural and remote providers in particular.

When in government, the coalition called the Royal Commission into Aged Care Quality and Safety to ensure that our oldest and most vulnerable Australians received care, supports and respect for their dignity and to recognise the important contribution that they have made over their lifetimes to society. We delivered billions in reforming the sector to provide respect, care and dignity to our senior Australians. Our 2022-23 budget responded to 10 recommendations of the royal commission and built on our existing five pillars of aged-care reform. What are those pillars, you might ask? The coalition strongly supported home care, supporting senior Australians who choose to remain in their homes. We should allow them the comfort and support that they desire in their twilight years. They've contributed years and years to our society, and it's only fair that we give something back for those contributions rather than casting them aside now they're no longer useful to us. They are useful to us. They have wisdom, they have insight and they have experience, and we should in fact be spending more time looking to them for advice, spending time with them and having that intergenerational connection that will improve both our lives and the workforce by helping us avoid the mistakes of the past. We should give our elderly the honour and dignity they deserve.

This is a failure, in many ways, across the West. There are many cultures around the world that place a far greater amount of respect on their elders, and I think we would do well to learn from them. Even our Indigenous Australians honour their elders. We acknowledge their elders every time we start up a speech or event in this country, yet we don't want to give any honour or respect to the rest of our elderly Australians.

We want to improve and simplify residential aged-care services, sustainability and access, not make operating those services more difficult, like I said earlier, by making it harder for aged-care homes to comply. We see homes shut down because they can't meet the restrictions, requirements and pressures put on them by this government. We look to the Aged Care Quality and Safety Commission to improve residential aged care. Thankfully, the addition of an inspector-general begins this task of ensuring there is quality and safety in our homes.

The coalition government understood the importance of the workforce by supporting and growing a better-skilled care workforce. Crucially, we need to entice nurses and healthcare workers to join the aged-care ranks and we need to retain those workers. As I've said, we're an ageing population, and we're still experiencing a crisis in the Australian workforce at present across all sectors. This needs to be remedied as soon as possible, especially if we were to—God forbid—experience another health crisis. Of course, the coalition, when in government, supported new legislation that would provide stronger governance.

It is imperative that the Albanese government now continues our work to support the aged-care sector. This is a step in the right direction, and we commend the government on that, but a lot of damage has been and continues to be done. Our elderly Australians—whoever they are, wherever they're from, from all walks of life, all classes and subsections of our community—all deserve the dignity and respect the rest of us enjoy, if not more because they've laid the foundations of what we proudly stand on today. I know there are some in this chamber and elsewhere who believe these foundations, our Australian foundations, deserve to be destroyed and replaced. But those who fail to learn from history are doomed to repeat it, and it happens all too often. The irony is that they believe they are the more virtuous among us. They believe they are the ones who can fix our problems. But their beliefs are built on antihuman sentiment. They want to remove the dignity of the elderly, not restore or amplify it. To them, the elderly represent a bygone era that must now be erased. A telling sign of the calibre of a society is how they treat their most vulnerable. I believe Australia to be a country with people of good character and people who believe in giving everyone a fair go regardless of who they are. This is why we must continue to do our part for ageing Australians, like what's being addressed in this bill today.

Claire Chandler (Tasmania, Liberal Party, Shadow Assistant Minister for Foreign Affairs) Share this | Link to this | Hansard source

I rise to make a contribution on the Inspector-General of Aged Care Bill 2023 and the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023. Before launching into my remarks regarding the specifics of this bill, I think it's important to frame up the importance of the aged-care sector in Australia.

I think every senator in this place likely has had a personal experience interacting with the aged-care sector, whether through their role in this place meeting with aged-care centres in their states, back at home, or through a loved one. I would put myself in both the former and the latter categories. I had a grandmother who saw out her final days in an aged-care facility in Hobart, and I had a great-grandmother likewise see out her final days in aged care when I was quite young. My memories of one are certainly better than of the other; I was very young when my great-grandmother passed away. I have seen firsthand the very good work that is provided in our aged-care facilities and the support provided to older Australians. That is incredibly important work and we here in this place should always be cognisant of doing what we can to support the aged-care sector, particularly in a situation where we know our population is ageing. I am here representing the great state of Tasmania, and the Tasmanian population is ageing; a large proportion of our population are elderly now. We need to do everything we can to support older Australians regardless of whether or not they end up interacting with the aged-care system—but we know that, fundamentally, many of them do—and make sure that the system that is in place is one that serves their needs adequately, that is compassionate and that supports them as they need to be supported. I think it's important to consider all this when discussing this very important matter here today—these important bills before us we are debating.

The coalition believes the establishment of an inspector-general of aged care is important to ensure the aged-care sector remains well supported. We will support this legislation we're debating, to permanently establish an inspector-general of aged care and an associated statutory office. Like I said, in this place we should be cognisant of supporting the aged-care sector and we think this legislation here goes some important way to doing that.

As has already been raised in debate this evening, the establishment of an inspector-general implements recommendation 12 of the royal commission, which was supported by the coalition. It will also cast a light on some of the most pressing challenges for the aged-care sector at the moment. Again, referencing those remarks I made upfront, we need to make sure that we support our aged-care sector. We need to understand the challenges that that sector is facing. The royal commission has gone a very long way towards identifying and addressing some of those concerns, but this didn't end when the royal commission did. This is something that, as I say, with an ageing population we need to be continually cognisant of and we need to be continually monitoring to ensure that our aged-care sector provides older Australians with the quality of care that they deserve.

In talking about what those pressing challenges within the aged-care sector are at the moment, we know that the important issue facing the sector is workforce. Workforce shortages are putting serious pressure on Australia's entire health system, not just the aged-care sector. It is clear that this crisis is impacting on the viability of aged-care homes across our country. According to recent reports, a shortage in directly employed nurses is increasing demand for agency nurses, which is costing aged-care providers significantly more. Agency staff now cost providers just over $17 per bed day, which is an increase of $9.86 per bed day compared to the same period last calendar year. This isn't sustainable for aged-care providers who are trying to comply with government regulation. That is why the coalition has been calling out for a whole-of-care sector workforce plan. When we know that there are these workforce issues, I think it's only sensible that we work with the whole sector to come up with a plan to address their workforce needs.

That's also why the government must facilitate operators being innovative and creative in delivering the best possible care for older Australians, instead of enforcing a once-size-fits-all model. We have heard some very good contributions from my coalition colleagues in this place this evening in relation to some of the issues that are facing aged-care facilities, particularly in terms of workforce and particularly in rural and regional Australia. Instead of implementing punitive measures, the government must look at encouraging providers to use technology like telehealth and support the sector to value and upskill enrolled nurses to become registered nurses and remain in the sector.

During the election campaign in May last year, the Prime Minister promised that every aged-care home would have a nurse on site at all times by July 2023. That month has just passed. As a result of this requirement being demanded a year earlier than recommended by the royal commission, under the Labor government's watch we know aged-care homes are closing down. The first of July was a date that was dreaded by aged-care providers across the country as the expedited 24/7 registered nurse requirement as implemented by Labor sooner than originally anticipated by the royal commission—they made an election commitment in relation to that—hit the sector amidst a severe workforce crisis. I'm advised that, to the best of our knowledge, more than 30 homes have tragically closed down as they weren't able to meet the government's legislated requirement. This means that residents are often being forced to move out of their homes and away from their families and their communities, all because the government hasn't enabled a more flexible approach to staffing requirements during a workforce crisis.

Even more frustratingly, in a blatant attack on transparency, the government won't provide the exact details on how many homes have closed in total as a result of this premature policy. They are in effect hiding these important facts from the public. Like I said, to the best of our knowledge, we in the coalition understand that more than 30 homes have closed, but we don't know that for a fact. I suspect the government do, but they haven't availed us of that information yet. Their refusal to table the documentation that was requested in Senate estimates to advise exactly how many homes have closed since their time in government flies in the face of the transparency platform they campaigned on during the 2022 election. Frankly, I would like to say I'm surprised by this, but to be perfectly honest I'm not. We have been in this chamber many times since the election last year, holding the mirror to this government that pledged transparency and pledged accountability in the lead-up to the election in May 2022, and since then has been anything but accountable or transparent.

Now we're a month on from when this expedited and somewhat rushed policy, I must say, came into effect, and we know that it was not just the rushed policy but also the extremely limited exemption criteria that forced aged-care homes to close. The prescriptive exemption criteria only offered an exemption to providers with fewer than 30 beds in Modified Monash Model locations 5, 6 and 7. For providers to become exempt from the requirement to have a registered nurse on site 24/7, they must report every period of 30 minutes or more that a registered nurse wasn't on site or on duty and the reason why that was the case. Every 30 minutes to me seems pretty impractical at best and a massive administrative burden on these aged-care facilities. Quite frankly, I'm sure that there are better things that the people who work at these facilities could be doing with their time than reporting some nominal noncompliance every 30 minutes.

In the last month we have seen a number of providers close, stating that it was this reporting requirement that placed such a high administrative burden that they simply could not fulfil it. I find it a little disappointing that the government is comfortable watching homes shut down, not just because of these legislative requirements that they have placed upon aged-care facilities but also because of a seemingly very narrow approach to applying exemption criteria. These aged-care providers are crying out for help; they're not crying out for more restrictions. It is time that this government should step in so that more aged-care facilities are not forced to close. It is for this reason—and this was foreshadowed by my colleague Senator Canavan earlier—that the coalition will be moving an amendment to encourage the inspector-general to immediately review the impacts of the government's expedited policy and to provide advice on how the sector could be better supported through its current workforce shortages.

Of course, we unequivocally support older Australians receiving the best care possible. However, bringing forward the time lines that were set, for very good reason, by the royal commission and imposing rigid constraints on the aged-care sector is reckless and damaging to that sector. We are certainly hopeful that, by establishing an inspector-general of aged care, that officer's independent oversight of the sector will be able to assist governments and policymakers through overseeing the whole sector. We support the independence of the inspector-general and we endorse the separation of the role of the inspector-general from the Department of Health and Aged Care and the other government bodies responsible for administering and regulating aged care. This is an important safeguard that will guarantee the impartiality required to monitor, investigate and report on systemic issues across the aged-care system.

Regarding matters that we would like the inspector-general to consider, once established, I would like to raise that the provisional lack of the COVID-19 Aged-Care Support Program Extension Grant is one. It is disappointing that, according to the last data that was provided by the health department, more than $570 million worth of grants remain outstanding. The Department of Health and Aged Care revealed in May that 561 aged-care providers have outstanding applications. Since this astonishing revelation, the government has again not been able to provide any update on the status of the payment of these grants, despite the fact that we in the coalition have requested this information repeatedly. These grants, which were introduced by the former coalition government to reimburse aged-care providers with the additional costs of managing COVID-19—which we know were significant—are simply being withheld and delayed by this new government. This is money that providers have already spent and, in some cases, even borrowed to support their residents during the pandemic with the promise from the coalition government that they would be reimbursed. At a time when, like I said earlier in my contribution, the sector is battling with serious workforce shortages, massive financial stress and these rushed regulations that we're discussing here this evening, which they are not able to meet, it's frankly astonishing that such a huge amount of money, $570 million, is being withheld from hardworking aged-care providers.

As I said in my initial comments, our aged-care sector in this country does a huge amount of work supporting older Australians. We need to be doing everything that we can to ensure that that sector is run in a way that provides a good and genuine service to older Australians. This legislation that we are debating here this evening goes some of the way to do that, but, as outlined in my contribution and the contributions of several of my coalition colleagues, we still have some genuine concerns about what is in this legislation and the impact of this regulation on the aged-care sector.

(Quorum formed)

Slade Brockman (WA, Liberal Party) Share this | Link to this | Hansard source

Apologies to the chamber for not being here at my appointed speaking slot. Shocking. Shocking. I too rise to speak on the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023.

Whilst the coalition will be supporting this bill, we do wish to raise a few issues that are of concern in this sector. I suspect it will shock nobody to hear that my concerns are particularly about the impact on regional Australia of some of the changes made by the Labor government. In travelling throughout regional Australia over the last little more than a year since Labor has been in power, I have seen a great deal of concern about some of the changes that are impacting on the sector and impacting its long-term viability and its ability to service particularly smaller regional communities. I will get to some of the detail of that.

But right across the sector we have seen a concern with the increasing regulation that is being required of aged-care providers, not just in ensuring a high quality of care but in micromanaging the detail of shift lengths, in having to monitor 30-minute increments of nurses being present when they don't meet the 24/7 standard, especially for facilities, as I have said, in regional areas, where the level of administrative support is simply not as great as it is for the large chains, which are predominantly based in urban centres.

Regional aged-care facilities are often community supplied, community run. They are often heavily reliant on volunteers to do things like serve meals and to do some activities with those who reside in those facilities. The level of administrative support, as I have said, is simply not there in the same way it is for the larger chains in the cities. Understanding that while still understanding the preference for people to stay in communities they have potentially been born into, have grown up in, have their families in, rather than having to move away to larger centres, be they larger regional centres such as Bunbury, Albany, Geraldton. To move to the city is obviously something that is greatly distressing for people, particularly at a time of life when stress of that sort is the last thing they need.

I will not name facilities because, obviously, this is a very confronting issue for small communities and for those small facilities in country towns. But there is a degree of uncertainty, a degree of a worriedness about how they are going to cope into the future with the constantly increasing demands upon that part of the sector, which I think is something that all governments do need to confront. Sometimes we are effectively saying that smaller facilities in regions will never be able to meet some of these requirements. Is it then better to say that facility should not be allowed to operate under a different arrangement or should be forced to close down? That is a very difficult decision and a very confronting decision for those smaller community based facilities.

But just to give a couple of examples—not all of these are going to be in the regions—there was a hostel facility not far from where I live in Perth, a lodge facility that was closing down. There was a range of reasons why it was closing down. It was an older facility, it was hard to meet standards and it was hard to maintain compliance with the new requirements. But I think I am correct in saying that, almost universally, the residents of that facility would have preferred it to keep going. There is no accusation that there was any mistreatment. There was no accusation that anything negative or bad had happened within that facility; it just hadn't kept up with the standards. It was an older facility, it was a lodge type facility and it didn't meet modern requirements.

I think we do have to have a conversation about that situation—where there is actually no accusation or imputation that there is anything negative happening—and about whether we should allow residents to actually stay in those facilities if that is what they want. Maybe we should give people the option as well to leave, but maybe we should actually look to see if there are ways of preserving facilities like that. Maybe that's a more cost-effective way for governments and a better way for those patrons, because, let's face it, when you're in that stage of life, the disruption caused by having to move accommodation can be quite significant. I think we actually have to take that into account.

In Perth, a larger provider was looking to close three residential facilities, basically because, in the wake of the royal commission, they were considered to be too old and too small to be able to be brought up to spec and then to also be economically viable with the new 24/7 RN requirements. Obviously having those requirements for smaller facilities is, by definition, going to be more difficult. These were residential facilities in urban areas, and they were under similar pressure to that which regional facilities are facing.

There was an article in the Geraldton Guardian just a few weeks ago about the number of elderly people who were forced to stay in the hospital in Geraldton due to the lack of aged-care beds in that community. I think at one point they had a higher number of 'temporary' aged-care residents in the Geraldton Regional Hospital than in any hospital in Western Australia. One in six beds were being occupied by patients because they were in the queue for an aged-care placement and not because they were in need of hospital care. Again, that is a concerning statistic and one that is not necessarily going to be fixed by making the requirements on regional aged-care facilities more onerous. It is something that I think we need to have a mature and sensible conversation about.

Obviously all Australians want and expect our older Australians to be well supported and cared for in our community, including in residential aged-care homes. We remain committed to supporting the health, safety and wellbeing of older Australians, and we understand the important role that aged-care providers, care workers and nurses play in ensuring this support is provided in residential aged-care settings. This is reflected in the two pieces of legislation in the package. The Inspector-General of Aged Care Bill 2023 seeks to permanently establish an Inspector-General of Aged Care and the relevant statutory office. The Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023 seeks to transition the temporary arrangement for the interim inspector-general to permanent arrangements.

Establishing the inspector-general and relevant statutory office was recommendation 12 of the Royal Commission into Aged Care Quality and Safety. We believe that the establishment of the Inspector-General of Aged Care is important to ensure that the aged-care sector remains supported, and we will support this legislation to permanently establish the Inspector-General of Aged Care and associated statutory office. The core function of the inspector-general will be to improve transparency and accountability across our aged-care system, through monitoring, reviewing and publicly reporting on systemic issues. I hope this will instil a greater accountability, a greater level of transparency and more understanding of the work that occurs across the aged-care sector.

I'll pause there briefly to say that it's very important that that information is reflected not just for urban based centres—which obviously are the vast majority of aged-care homes and aged-care facilities across Australia—but it is also reflected, and not in a negative way, for the very important work that is being done in the community sector in rural and regional Australia, to make sure that those ageing-in-place places, which give the ability for people to remain in their communities, continue to exist.

I also wish to acknowledge Mr Ian Yates, who is the interim Inspector-General of Aged Care. He has had 20 years experience as the chief executive of the Council on the Ageing Australia. Mr Yates has also been chair of Aged Care Council of Elders and has served as a member of the National Aged Care Advisory Council, the Aged Care Quality and Safety Advisory Council and the Aged Care Financing Authority.

Just before I run out of time, I do wish to touch again on this issue of 24/7 nurses and workforce shortage because it is just so important to the regions. During the election campaign the Prime Minister promised that every aged-care home would have a nurse on site at all times by July this year. Now, one year later, under this Labor government's watch, aged-care homes are closing down due to this election commitment. The date of 1 July was dreaded by aged-care providers across the country as Labor's expedited 24/7 registered nurses requirement hit the sector amid severe workforce shortages. To the best of our knowledge, so far more than 30 homes have, tragically, closed down because they could not see a way to meet the government's legislated requirements. This has meant that residents—often dedicated community members who wanted to live close to families, often in rural and regional or outer metropolitan areas—have had to find somewhere else to live. I think this is a great shame.

We're now a month on from when this expedited policy came into effect and we know that it wasn't just the rushed 24/7 policy that forced homes to close; sadly, the punitive exemption criteria have had the same effect. The exemption criteria offered exemptions only to providers with fewer than 30 beds in Modified Monash Model 5, 6 and 7 locations. People managing these facilities in regional Australia look to the future. They know how hard it is in regional Australia to get, in particular, RNs. They see that the only way they will probably be able to secure them is by robbing their local hospital or robbing their local GP's practice, if they're lucky enough to have an RN. So it really did put a massive question mark over those facilities and the sheer level of perseverance that is required, and that continues to ratchet up. This means that those facilities are constantly under greater and greater pressure.

I think it's a conversation that we need to have. We need to talk more about how we can continue to deliver aged-care facilities in smaller communities and in rural and regional communities and about how we allow those communities to make some of their own decisions about what those aged-care facilities may look like, without necessarily having a prescriptive Canberra model being imposed upon them. It's not an easy discussion—I understand that—but I think it is a discussion that the sector and all sides and all parties in this place need to have.

David Fawcett (SA, Liberal Party) Share this | Link to this | Hansard source

I, too, rise to make some remarks on the Inspector-General of Aged Care Bill 2023 and the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023, and I flag upfront that I, like the coalition, will be supporting these bills. As I make these comments, though, I do note that, through my entire time in the parliament, both in the other place and here, aged care has been a consistent thread, although much of my time has been characterised by involvement in national security affairs and, in particular, defence. In fact, in preparing to make these remarks, I went back to the Hansard from 2004. One of my very first contributions in the other place was about the regional communities in Wakefield. I particularly mentioned the communities in places like Balaklava, and we had Mill Court in Hamley Bridge, and in Mallala people like Ian Jenkin was the chair of the community hospital, which had an aged-care wing.

I came out of the military to become the member for Wakefield. In the military we had very good health care and everything was provided and laid on. I have to say it was a real eye-opener to work in regional communities where the hospital was funded by fundraising events and the aged-care home was funded and staffed by locals, albeit the aged care had some Commonwealth funding for beds. But much of the control and investment, both financial and emotional, was provided by the community because they were caring for their families in those locations.

The reason I highlight that and go back to that thread is that through much of my time in the parliament, from 2004 through to the present, aged care has arisen as an issue. I recognise that circumstances for both our ageing Australians and the providers who look after them are changing consistently, particularly as more people choose home-care packages, so residential aged care is somewhere where people with more acute needs often go. But community expectations also change.

I look at some of these country homes where it was wives, sisters and daughters who were providing care—and perhaps they might have a couple of professionals on the staff as well. Their boards had a constant battle to make sure they met compliance requirements to have people suitably qualified to care. In most cases they were also significantly supported by members of the community who worked there. In fact, in Mallala's case, I think they were the largest provider in the town. Some 52 people in the town were employed by the combined hospital and aged-care unit.

What that means is that, as expectations around care change and we see the responses to various issues that come up that put in place more and more compliance options, we have to ask the question: does compliance represent assurance to the families that their loved ones are being cared for, or does it represent a burden that drives good people and good operators out of the system, particularly in regional areas, which actually then removes the ability of families to have their older family members remain in the location? That has been an issue that's been ongoing for many years, and many of the people who made contributions here today have highlighted similar concerns around the burden of compliance. I have seen, even in the electorate of Wakefield that I represented, some fantastic homes: some not for profit, some for profit and privately run. Some were just awesome and some really left a fair bit to be desired. Clearly, there is a need for standards and for checking and compliance, but that balance has to be right, such that people can afford to run those homes.

This bill is an outcome of the royal commission which was announced in September 2018, and the trigger that led to the royal commission finally being announced by then Prime Minister Morrison, I think about three weeks into the job, was Oakden in South Australia, a state-run facility. It was one of those places where the treatment was pretty awful. Whilst it was the trigger, it was not the only home, and over years, under both sides of politics, there have been aged-care facilities where additional support and additional measures have been required. Again, I'm not convinced that we've always got it right in terms of the application of compliance and burden versus support and help for staff in terms of qualification ratios et cetera, but as we look at this bill I do think it's important to look at the context of the circumstance that kicked it off.

Some people say, 'You just need to spend more money,' but if I look back at 2017-18, funding for aged care, as announced at the time, was then at record levels. Aged-care expenditure was estimated to reach $18.6 billion, growing to $23.6 billion over the five years from that point. So funding alone is not the answer. It's obviously needed, but it alone is not the answer, because, despite that record funding, we still had failures in the system. At the time, that transition to home places was well and truly underway. The demand was high, and the government had announced that it'd spent some $1.6 billion creating 20,000 high-needs home-care packages, as well as $50 million being provided for dementia-specific programs. A whole raft of changes was occurring at the time. But it was the revelations in May 2017 about the Oakden facility that triggered the royal commission. There was a huge amount happening at the time, with that in conjunction with the Review of National Aged Care Quality Regulatory Processes, the legislative review of aged care and the More Choices for a Longer Life Package that led to a bunch of measures in 2018, the legislation around new aged-care quality standards, the first upgrade of standards in nearly 20 years that occurred in 2018. The royal commission was put in place, and the evidence was very clear that this was not one sector alone, it was not one part, whether for-profit large or small, regional or metropolitan. There were a range of issues across a range of facilities, and so the royal commission was commissioned at that time.

This bill flows directly out of recommendation 12 from the aged-care royal commission, and recommendation 12 went to the establishment of an inspector-general of aged care. Reading from the recommendation in the report, it says:

The Australian Government should establish an independent office of the Inspector-General of Aged Care to investigate, monitor and report on the administration and governance of the aged care system. This should be done by:

a. conducting reviews on its own motion and/or at the request of the System Governor or the Minister or Parliament to ensure the quality and safety of aged care

b. reviewing regulator decisions on a systematic basis to ensure regulator integrity and performance

c. reviewing the performance of functions by the System Governor, the Quality Regulator, the Prudential Regulator and the Pricing Authority

d. monitoring the adequacy of aged care data collection and analysis

e. monitoring the implementation of the reforms recommended by the Royal Commission, and

f. reporting annually to the Australian Parliament on systemic issues in the aged care system and the extent to which the aged care system attains the objects of the new Act.

Those who've listened to my speeches in this place before will know that I inevitably come back to the aviation industry, which was my actually background. Whether I'm talking about financial services or, in this case, aged care, I welcome the focus of the royal commission here on the systemic factors, because one of the key lessons that the aviation sector has brought not only to aviation but to medicine and other places is that, if you want to drive good outcomes, you actually need to understand the system. You need to understand the incentives, understand the things that motivate actions and investment by people.

I think one of the ways you can alleviate the compliance burden on individual homes and staff is by making sure that, at a systems level, your settings are right, your incentives are right. That's so good operators are free to operate and provide the services with the focused and detailed care that they wish to provide, but the system is such that those who are failing will be recognised or identified early, and either remedial or punitive action will be taken either to lift the care or to remove people from the care if it's not capable of being remediated. Often that compliance burden on the individual, whether you're talking about an airline, a small operator or an aged-care home, will be so much easier to actually achieve if the systemic construct and monitoring are right. So I welcome the fact that there is in this recommendation such a focus on the systemic issues.

The key points of this bill are to establish the inspector-general of aged care, the office, with functions to monitor, investigate and report on the Commonwealth's administration of the aged-care system. I guess that—other than the state-run facilities—is the pinnacle of the system that we are talking about. It includes independent reviews to identify and investigate systemic issues, making recommendations to the Commonwealth for improvement. This role is one of seven institutions that the Royal Commission into Aged Care Quality and Safety recommended to improve the governance of aged care. I must confess I'm not a fan of big government, and seven institutions seems like an awful lot of overhead, but, given we are dealing with some of the most frail and vulnerable in our community, if the institutions actually help to get the system right then I will continue to support that.

Importantly, the Community Affairs Legislation Committee have considered this bill, and, as well as the Senate Standing Committee for the Scrutiny of Bills, they indicated their support for it. But I'm hoping that, during the committee stage of this bill, we will get some answers to some of the concerns they raised, particularly on the protection from civil liability. The committee had concerns regarding the exclusions from civil liability contained in the IGAC bill. Clause 58 in particular provides that if a person discloses information in accordance with the requirements set out in clause 57, that person is not subject to any civil, criminal or administrative liability or subject to a contractual or other remedy. The committee said this provision removes any common law right to bring an action to enforce legal rights unless it can be demonstrated that the person knowingly made a false or misleading statement. The committee expects that if a bill seeks to provide immunity from civil liability this should be soundly justified. I'm assuming the staff over there from the appropriate department will be getting ready to brief the minister during the committee stage, and I'm hoping we'll get some clarity around that concern of the committee.

The evidential burden of proof was another point. In order to rely on the exemptions set out in subclause 23(2), the disclosure of a draft report or its components, or clause 64, the authorisation of the disclosure of information by an entrusted person, the defendant bears the evidential burden of proof. The IGAC bill also provides that if a person wishes to rely on the protection set out in clause 58, then that person bears the evidential burden of proof. The committee made the point that it's ordinarily the duty of the prosecution to prove all elements of an offence and expressed concerns regarding the reversal of the evidential burden. Again, I look forward to some clarification during the committee stage of the bill.

As I indicated, I will be supporting this bill. Aged care is a sector that has looked after many Australians, including my own parents, but in some cases it has let them down. It is a complex area. It is a challenging area for providers. It is a challenging area for families seeking to get their family members into the area. The coalition, having launched this royal commission, supports recommendation 12 and the establishment of this inspector-general, and I will be supporting the bill.

Ross Cadell (NSW, National Party) Share this | Link to this | Hansard source

Imagine an Australia where, no matter where you live, no matter how far from the city you are, aged care at the highest level is a given—where your family would be close to you, you would be looked after and all the things you hoped for in your retirement would be provided. It's incredibly hard in a country like Australia, where we are so spread out, where we are so wide, where we have such tyranny of distance in many of our areas. This role of inspector-general can help sort some of these problems out. We will never have a perfect aged-care system not because of a lack of care, and not for lack of trying, but because it is so hard to care for everyone. But we can strive, and these bills, the Inspector-General of Aged Care Bill 2023 and the Inspector-General of Aged Care (Consequential and Transitional Provisions) Bill 2023, are a step in that direction.

I was disappointed to see, with what is strong support across the chamber for these bills, that some speakers earlier reverted to 'everyone on this side, everything done on aged care bad; everyone on that side, everything done on aged care good'. That's wrong. I was sitting in the chamber when I was told people on this side did not care. That is a horrible thing to say. I had family members in aged care. All of us probably will have or have had the same thing. To be told we don't care is wrong. These are people that have given us their best lives, that have given us their love, and we are just trying to repay them towards the end of their lives so they can also live like that.

It is hard. I get this. The royal commission wasn't put in place because we've got this nailed and it's all great and everyone's having that great life we spoke about. The royal commission was to get evidence to work out how we could do this better, and well done to this government for implementing things like the inspector-general out of that review and out of that royal commission. And well done to the previous government, which I also wasn't a part of, for starting the royal commission, starting the process. We have to have a role of constant improvement, of looking for opportunities to make things better, and this full-time inspector-general will help us do so. The interim selection of Mr Ian Yates AM is a great selection for that role—he's from the Council on the Ageing and he's going into this with deep knowledge—in seeing some of the processes going forward.

We saw the horrors of COVID and what that did in aged-care centres, despite the best intentions of everyone. It wasn't negligence; it was best intentions everywhere. There have been more COVID deaths in the last 12 months than there were in the previous two years in aged care, but it is not the fault of people not caring. When we come into this chamber it's: 'Hopeless, hopeless. Don't care. That side bad, this side good.' But there are more issues like this one which strike us all, so we have to work together.

In the regions we have a problem, and I'm going to use these two words here: unintended consequences. It is all well and good to come in with the goal of elevating the care of the aged throughout Australia—as I said, it's a good thing—but this is where the rubber has to meet the road. At the moment it doesn't. This bill isn't an Audi RS Q8 race car. It's something, but there are no tyres on it. It has no grip; it has no traction in the bush. What we're not seeing is a better aged-care system in the bush. We're seeing no aged-care system in the bush because of this. I say unintended consequences, and I hope it is that—I hope it is not by design that we are making these changes to make aged care in regional and remote areas unviable. I hope it is an unintended consequence. This bill is a step. It's not a race car. It's not great as the rubber is not on the road. We are seeing these problems and we are ignoring them.

We have an instance up the road from me—about one hour 20, from Redhead to Bulahdelah—where John Sahyoun was in an aged-care facility that could not meet these criteria and was shut. However, the only other aged-care centre in town that could meet those criteria was full, so John is now an hour away from his family and friends. So I say thank you for trying to make his care better, but damn you for making his life worse. That's what I say to the policy people there.

There needs to be greater understanding of what actually happens, and I will get political here. When Labor represents only 10 per cent of the landmass of the states of Australia, they don't see that difference in the bush. They don't see how it tears families apart, and it happens time and time again. Let's go to the states and see what happened in the council merger debate. In a city you wake up in one local government area, you drop your kids at school in another local government area, you go to work in another local government area. In the regions and remote areas there is still community. When you are removed from your community, when you are removed from your support networks, when you are removed from everything you have known, it hurts. It can ruin a person. I feel this is an unintended consequence of the changes to aged care. I hope it is, because if it is by design heads need to roll. This has to be unintended for me to be able to live with it. I hope this inspector—if it's Mr Yates and he becomes permanent; whoever it is if he doesn't—has the access and the ability and the voice to tell these stories for John, for his wife, for everyone who goes forward in this respect.

As I said, aged care is a right at the end of your life. When you've given so much to your country, when you've given so much to your family, you need to have dignity at the end of your life, to be able to enjoy it for as long as you can. I know my nan was in aged care far too long. She lost cognitive ability. Every now and again she would have these bright sparks, and there was that joy when you knew she connected with you and was fine. The people that work there did so much; they are great people. I can see why we want registered nurses, I can see why we want the various best people and I can see why we want higher pay for these people—because they looked after nan. They may look after my parents. Dad keeps telling me only the good die young, and, God knows, dad is probably immortal! But this is what we have to do going forward.

When we have an inspector going around, he—he, she, they—can see what's going on on the ground, and they can come to government and say these things. The royal commission was there to do this. Aged-care wasn't horrible. People didn't die in COVID because people on this side or that side didn't care. I know we all did.

But that is the way we should do that, and I would just ask that the government consider what is going on. It's not just one thing. Senator Canavan spoke about the need for 24-hour registered nurses in aged care and about requiring five registered nurses in far-flung places. This is on the back of the NDIS feeding demand for health professionals everywhere. Demand is so great. Wages are so great. It is so hard to attract these people. These communities are close to dying anyway. We have seen schools shutting down. We have seen vital services shutting down. When we talk about Indigenous Australia, most of the battle is not the colour of skin or race; it is the dislocation from services. It is the dislocation from cities, from doctors, from health and from education; it is these things. It is the same in aged care and the same in most things for regional Australia. We sit here in debate and talk about the life expectancy of rural and remote Indigenous Australians. It is life expectancy for rural and remote people of all races as well—I accept they are lower for Indigenous Australians—because of a lack of services. What happens and we take the people from their homes and move them to cities? It falls lower. They lose the will to live because they have nothing to live for.

We have this great program now to make this better. We have this first challenge, for me, in talking about the numbers of aged-care centres that close—one a month, I'm told—in rural and remote Australia. I keep saying: I hope it is not by design of government. Because that would be unforgivable and unbelievable.

But let's see these unintended consequences. Senator Polley spoke about the transparency of government in this. That transparency in rural and remote Australia is because they are so paper thin on substance you can see through it. It is not because anything else occurs. We don't want to be up here in the bush saying, 'I told you so.' We would prefer to say, 'Oh, gee, they've got us on this; they've got a good policy,' but it is not happening. So many times, in this place, consequences are pointed out. What could happen is pointed out. What is going on and what could happen—all of these things are spoken about—except with an agenda: I was appointed; I have a mandate. I get that. You won. We're bad; you're good.

But these things need to be a work in progress. When they are not, people suffer. They are not nobodies. These are people, some of them, at their weakest in life. All of the steps that are taken, all the steps we do, everything we want to do in this space needs to be done. You can never spend enough money. We don't have enough money. You can never build enough facilities. You can never put 20 registered nurses on. We want that best practice. I want cocoon pools in every aged-care facility, where people feel alive every day when they go swimming. That is what we are after: you won't get old and you won't ever die!

This is what we strive for, and I hope that this inspector, even with some of the concerns about common law that Senator Fawcett raised, and all the little things we want to ask questions about in committee—put that aside. We are giving them a voice. Just please listen to it. This inspector-general is nothing if the government won't take the advice, won't listen and won't make the changes. We are governing for people who live within 100 kilometres of a capital city or a secondary city like Newcastle, where I am close to, and that is not taking the country with us. The haves and the have-nots are no longer wealth divided or earning divided; they are becoming geographically divided. So I just say— (Time expired)

Jess Walsh (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Thank you, Senator Cadell, you will be in continuation. The time for this discussion has expired.