Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Today I stand to make a contribution in relation to the Aged Care Bill 2024 and the Aged Care Legislation Amendment Bill 2024, which are before us. The opposition has been very clear right from the get-go that we will support sensible policies, because we need a system for aged care that is strong and delivers the dignified care that we believe every older Australian deserves in ageing.

This legislation delivers on a recommendation of the royal commission appointed by the coalition to implement a rights based act for aged care. After the royal commission brought its findings down, the coalition invested more than $18 billion to support the immediate recommendations and needs of the sector at the time. But it's really important for us to realise and remember that aged care is not a sector; aged care is a journey of ageing for older Australians and everything that goes with that. It's about respecting the older people in our society.

So, through good-faith negotiations with the government, the coalition has sought to ensure that the reform package that is before us is improved in many ways. We did so before the package was presented to the parliament, and we've continued to do so since the package has been available for public consumption, but there is no doubt that the issues that are before our aged-care system are absolutely undeniable. We've got aged-care homes across Australia. Nearly half of them are reporting that they're operating at a loss. We have an ageing population, but we have an even greater increase in the number of Australians who have a desire to stay at home as they age, which means that we have to fundamentally change the way we deliver aged care and support the needs that we need to put in place to effect that change.

There's no doubt that this bill represents a very significant package of reforms, which is why we pushed to have the bill referred to the Community Affairs Legislation Committee for inquiry. We absolutely valued this opportunity—that, at last, finally, the government was prepared to have a conversation with Australians—older Australians, their families and the sector more generally—about this significant package of reforms. Up until we put it through the Senate process, there had been an extraordinary lack of transparency about the process to date.

It was really disappointing to find, though, that the majority report that was delivered by that inquiry, which was the majority report of the government senators on that inquiry, made no recommendations around how the bill could be improved to reflect much of the concern that we heard during that inquiry. The only recommendation the majority report made was that we should pass the bill. We've been very critical of the government right the way through about the lack of consultation, but I'm even more critical of the government because, even when we got the opportunity to speak to Australians about what they thought about the bill, the government still refused to recognise many of the improvements that could be made to the bill to make it better and to make sure that it delivered on what older Australians were expecting it to. They simply just thought that they'd push it through in its original state.

We will continue to criticise the government on the things we think they have failed to do. But, most particularly, I will be critical of the government because they have yet to demonstrate to me, to the parliament or to the sector that they themselves are ready for the massive changes that this bill will bring in should it start on 1 July 2025. One great question that is yet to be answered is: are the government's IT systems even sufficiently in place for the sector to be able to plug in to their changes? There are going to be massive IT changes that the sector will have to make.

Given all the information that was submitted to the Senate inquiry, it is clear that we are going to need to make substantial amendments to this bill to make sure that it is delivering what it says it will, and I will not be rushing this through this parliament. For that reason, we will be moving a number of amendments. We are going to act on the hard evidence that we heard during the committee process. We need to recognise that there are still a number of quite significant shortcomings if this bill is actually to deliver on the promised outcomes.

We must be transparent about the release of the subordinated legislation. If there was one thing that the inquiry process delivered time and time again it was that people are concerned that they simply don't have enough information to even understand what is going to be required of them, whether that's older Australians and their families or whether that's the sector in terms of implementing this bill. Withholding this critical information from stakeholders denies them the ability to fully understand what the implications are. So we will continue to fight to make sure that we have transparency about what is yet to come. This is not the end of the journey, government. This is the start of the journey, and we will continue to scrutinise every single piece of subordinated legislation that you bring into this place to make sure that your rush and lack of consultation do not detrimentally impact on the older Australians this bill is endeavouring to support.

But can I say that the coalition remains absolutely supportive of a rights based framework for older Australians. Putting choice and control at the centre of our aged-care system is absolutely paramount. We know that that's what the royal commission recommended, and we absolutely support that. But we also need to understand the quantum of change that is before us, and we also need to understand that much else that's contained in this bill is certainly not delivering on the recommendations of the royal commission, and that is to put choice and control back into the hands of Australians.

The coalition has sought and gained significant changes from the original proposal that was delivered to us behind closed doors in March because we wanted to make sure these reforms are fairer for older Australians, particularly for older Australians who've worked hard all their lives to save for their retirement and for older Australians who find themselves in a situation where aged care is out of their reach in terms of affordability. We wanted to make sure every Australian has access to aged care in a fair and reasonable way, which is why we demanded that grandfathering be put in place. That means that every Australian who has already started their aged-care journey will see no change to their financial circumstances, whether they be in residential care, in-home care or even on the waiting list to receive a home-care package because they have already been assessed as needing one.

We will also make sure that there are caps on clinical care and caps on home care because older Australians need to understand what is going to be the quantum of the ask on them in terms of their own support of their ageing journey. We also made sure that taper rates were much lower than the ones that were previously proposed by government so that older Australians would not be hit with extreme changes as their incomes went up. We also wanted to make sure that the government guaranteed that they would always be the majority funder of aged care—most particularly around making sure that every Australian, regardless of who they are or where they are, will always receive a high level of clinical care. These were very important changes that we sought to achieve, and we're pleased that we have been able to achieve them.

We were also very concerned about the lack of recognition of rural, regional and remote Australia and the challenges of the shallow markets that are there. So we secured an additional $300 million to go to rural, regional and remote aged-care homes to make sure they were able to develop the capital works so that they could provide the facilities for people that lived in their community. We understand that getting access to these kinds of services is often a great challenge in rural and regional communities—it's hard to get the workforce but it's equally difficult to get capital building.

We also fought hard to remove criminal penalties. Our position has always been that criminal penalties were unnecessary. The royal commission didn't recognise criminal penalties because they already exist in our legal system under work health and safety, banning orders and other criminal codes, and these are adequate measures to make sure that we protect the safety of older Australians. That is not to say that in any way, shape or form we believe that the safety of older Australians should be compromised; we just believe this once again overreach. We've also successfully eliminated provisions that would have forced unionisation into every aged-care home in this country, taking away the focus from the delivery of quality care and increasing mandates felt the hardest by small providers.

While there have been significant achievements made by the coalition during our negotiations, it's important that we remember this package is still fundamentally flawed. This is a package made by the Labor government. The bill has not been co-designed. In fact, we were excluded from the process of the design of this bill almost from the get-go, and were brought into the process only after it was finalised. The issues that we believe need to be addressed that have not been addressed in this bill in any way, shape or form are issues like workforce, regulatory impacts and the implementation timeframes of this bill. These issues continue to go unaddressed, and if they do so, it could result in very serious consequences. Last year 49 aged-care homes closed, which is a very telling statistic.

The coalition is seeking to ensure the introduction of this bill will not force more closures of homes. Instead, we need to make sure it's actually going to incentivise the critical builds that we know we need. We remain very disappointed about the lack of transparency by government throughout this process, and I think the Senate inquiry highlighted the fact that many Australians were equally frustrated by the lack of consultation or inclusion in this process, and the continuing lack of consultation or any oversight for the many rules that would actually drive this particular piece of legislation.

Workforce is one of the biggest issues. I don't think I've been into an aged-care home in Australia in the last 2½ years where the first thing they've said to me wasn't about the challenges they're acing in workforce. The idea that we've got some one-size-fits-all response to aged care is just ridiculous. Markets are different, geographic locations are different. We see it manifest itself in many different ways, whether that's in the financially crippling reliance on agency staff to fill shifts or the inability to fill shifts themselves, which means nursing homes are closing down or closing beds. People moving hundreds of kilometres away from their communities and loved ones just to be able to get a bed. There's throwing out of enrolled nurses and allied health when it comes to the provision of care, even though those workers are extremely valued in the care of older Australians.

I know every aged-care provider wants to deliver the highest-quality care, and I acknowledge the amazing workforce that works in aged care, but all the reforms in the world are not worth the paper they're written on if you do not have the workforce to deliver them, and if your financial viability is so threatened that you're worried you're going to have to close your doors. Today's paper showed the government's removing of homecare caps for cleaning and gardening is exactly the kind of issue that we fought really hard on, saying, 'You cannot consult behind closed doors because that's not consultation; you have to speak to people.' I'll give a shout-out to Hannah, who drove all the way from Yankalilla to Port Lincoln to give evidence at the inquiry because she could see the fallacy of these caps. Eighteen hours of gardening every year is an hour and a half a month. If Hannah was trying to prepare for the bushfire season, it was hardly going to achieve that outcome.

Through this process, at least the government have recognised the fallacy of these caps and have a bit more of a flexible approach to these things. These are the kinds of things that are happening that are completely at odds with the decision to go forward with a bill that gives choice and control to older Australians, and these stupid bureaucratic decisions that haven't been consulted remove that choice and control for older Australians that we are so keen to make sure we see.

On home care, another point that I really want to raise here is that this bill makes no reference whatsoever to the Commonwealth Home Support Program under which 800,000 Australians already are receiving a level of care in their home. The government made a decision to release 24,100 home-care packages, when we know that the waiting list is currently 76,000 and it will mean that the waiting time will blow out from five months to six months. Knowingly, this is a design feature of this government's decision—that they are actually going to blow out the waiting time. But, aside from the current failure to ensure that enough home-care packages are being delivered, the government haven't been transparent about the rules, and witness after witness after witness said that.

So we think this bill needs amending in so, so many ways, and I'll foreshadow now that I'll be moving a second reading amendment to that effect. We believe that we need to make sure that we understand transitional requirements. We need to understand the transition pathway. We need to understand information so that older Australians, their families and the sector understand. We need to make sure that the Commonwealth Home Support Program recipients have got greater clarity. We need to understand the caps that they're still proposing for the service list. We need to understand how the service list has been designed. We also need to understand things like the scale of unrecoverable debts and with whom and where they will reside. We also need to make sure that we have dignity for all older Australians in the high-quality care that we want for them.

So, as I said, we need to make sure that we do get this bill right and we need to do it right once. We cannot afford to have all of the errors that sit in this bill get passed in this place. So the opposition—and, I am sure, the Greens—will be moving a series of amendments during the committee stage to try and make this inadequate bill better. Fundamentally, we believe in a rights based framework for the delivery of Australian aged care, because we believe that having choice and control delivers the dignity back to older Australians, and that is the most fundamental reason that this bill is in this place. But, because this government can't be trusted to provide the kind of transparency and detail we need, we will continue to prosecute that case.

Larissa Waters (Queensland, Australian Greens) Share this | Link to this | Hansard source

I rise to speak to the Aged Care Bill 2024 and the Aged Care Legislation Amendment Bill 2024. Our concern is that these bills risk creating a two-tiered system that bakes in inequality. The Greens share the concerns of older Australians that these bills will increase their co-contributions and accommodation costs but don't guarantee enforceable rights or the quality of care for participants. We have significant concerns that, in buckling to the demands of the Liberal Party, the Labor Party has abandoned criminal penalties for dodgy aged-care providers, which it had promised and has now junked to get the deal with the Liberals. We've also got concerns about chapter 4, which contains the new funding model, because asking people to pay more for their care with no guarantee of improved quality is simply taking us in the wrong direction. So we will be moving amendments to address both of those concerns when we come to the committee stage on this bill.

The royal commission showed us the depths of pain and suffering that proliferated in the aged-care sector, and this was in part due to a regulatory system that was driven by for-profit providers. The deals done between the government and the coalition on these bills lead us to have significant concerns that these bills actually won't address the issues that were identified in the last royal commission and, frankly, wouldn't stop another royal commission into the aged-care sector in future.

The key concern for us is that the rights within this bill remain aspirational for providers. They are not enforceable. The removal of criminal penalties, as part of negotiations between the two big parties in this joint, has been a significant concern for us and also for many participants and advocates. The Office of the Inspector-General of Aged Care in a submission on the bill called the rights contained within it 'aspirational'. They said:

The Office considers the approach taken in the Bill to safeguard individuals' rights to be largely aspirational. In particular, the Office is concerned that it will not implement a rights-based framework as clear or as robust as Royal Commissioners envisaged, because the pathways available to individuals to understand and assert their rights lack the necessary vigour to drive real change.

This would be bitterly disappointing for participants, their loved ones, their families and advocates who have seen far too often how the rights of older people in aged care come last and are subsumed by the profiteering of the aged-care providers.

The shameful evidence we saw throughout the royal commission shows the sector lacks serious regulation, and we are concerned that, without enforceable rights, this regulation remains far too relaxed to prevent another royal commission. Professor Kathy Eagar told the inquiry that, in her view, this bill is a lost opportunity to genuinely fix aged care once and for all. She has no doubt that within a matter of years the sector will be back in crisis. The lack of enforcement of rights was also an issue for the National Older Women's Network, who told the inquiry:

It appears that the framers have been convinced that the aged-care sector is too big to fail and so their demands remain a priority. The act, by not making the rights enforceable and actually spelling out the fact that they aren't enforceable, means that we know the words of rights are window dressings to offer appeasement and focus our attention.

'Window dressing' is what these rights are if they're not enforceable. That was the view of many submitters, and it's a view the Greens share.

Post the royal commission, we cannot let providers off the hook. Older people deserve clearly enforceable rights and access to high-quality care. The lack of safeguarding those things in this bill jeopardises that purpose. We hold significant concerns that the aspirational rights for providers do not go anywhere near the heart of the problem in aged care—that its operation as a market means the incentive of providers, the profit motive, always trumps the provision of high-quality care. Further, although this bill partly reforms the complaints process, we hear time and time again from participants and their loved ones who are frustrated with the lack of real justice that they see issued against providers.

The removal of the worker voice during negotiations between the government and the coalition is also of deep concern. Workers are at the coalface of this sector, and they are the ones who see when things are going wrong. Removing their ability to influence the safety of their workplace is a detriment to them and to participants. We've seen appalling conduct from industry consultants, lobbyists and providers who try to game the system, and we've seen this most clearly with the failures of the star-rating system and a watering down of care minutes. A worker's voice would have gone some way towards ensuring aged care is monitored properly. We're also concerned about the strength of whistleblower provisions. In the absence of a worker voice, it is critical that participants and workers are protected from adverse consequences for whistleblowing. The royal commission showed us that people must feel safe to speak up when something is wrong, particularly in a sector like aged care, when it can be a matter of life and death for people.

Now I move onto issues pertaining to funding in chapter 4 of the bill. While the Greens support the wealthy paying their fair share, opening the door to an expanded user-pays model only risks serving to increase the profits of private providers that are already robbing older Australians blind. If more emphasis on user pays is the answer, then you are asking the wrong question. The government needs to be responsible for funding an accessible system for all Australians who need it. We have significant concerns that this bill takes aged care down a pathway that will be very difficult to unwind. Instead of treating aged care as health care, as it should be, this bill and this government, with the support of the opposition, are completely embedding it as a marketplace. Participants and the government will continue to subsidise for-profit aged-care providers.

This bill entrenches aged care as a marketplace, and all the while it turns the screws on co-contributions from participants. The varying contribution levels risk pushing older people to ration the care that they receive. In the submission that ACOSS—the Australian Council of Social Services—wrote on this bill, they say:

Australia has a longstanding principle to provide universal, essential health care services, so that decent care is available to everyone, regardless of their means. Such services have traditionally been provided either free of charge (such as public hospitals), or at modest cost (such as General Practitioner consultations).

The Bill now puts this principle in direct jeopardy.

That is ACOSS saying that the principle of universal health care that we pay taxes to fund is in peril because of this bill. Additionally, in the submission to the bill from the Nursing and Midwifery Federation, ANMF, they pointed out:

Aged care should be publicly funded and owned, particularly as the sector relies heavily on taxpayer support and … The proposed … separation of clinical and non-clinical care also creates an unnecessary distinction that can lead to financial burdens for residents while undermining comprehensive care.

Further, the increase to the maximum room price is of significant concern. There is little evidence that there'll be any limitation on providers simply lurching to increase the room price as soon as they can to collect another $250,000. This bill lacks safeguards to protect against that. The government should be increasing taxes on billionaires and big corporations to properly fund the overburdened aged-care system rather than continuing down this pathway of rationing care and opening the door to unaffordable services and higher profits for private aged-care providers.

Beyond the substantive concerns with the bill, the community and the Senate have been provided with very little time to consider the full implications of these reforms. This bill is substantive, and participants and advocates were given just two weeks to read the over-500-page bill, to put in a submission and to participate in the inquiry process. We heard from many people in the community who felt that they had been completely sidelined during that process. Feedback through the inquiry highlighted how complex a task for participants and advocates this has really been. Participants also highlighted the emphasis on provider perspectives. One lived-experience witness told the inquiry:

The airwaves have been dominated by government and corporate provider lobbyists, and our voices have not been heard and certainly not sought. So we are indeed grateful that this committee is prepared to hear evidence from us, although hearing time still seems to be dominated by commercial interests.

Many submissions also noted that the significant delegation to the rules has meant that it's incredibly difficult to appraise the full implications of the legislation. There are over 600 references in the bill to the rules. We haven't actually seen all of the rules. I understand there's only one tranche of them. So the Senate is essentially being asked to form a position on legislation when we don't know the full shape of it yet. That should be ringing alarm bells to everybody in this chamber. The significant amount of delegation to the rules under the bill also leaves much of the decision-making up to the government of the day. With the amount of contribution levels that have been delegated, we're concerned that this is leaving it open for a future government to turn the screws, notwithstanding that some of those rules will be disallowable.

Every person fortunate to live into old age will need to be cared for, and if this really is the once-in-a-generation opportunity for reform, then it's critical that the government gets it right. We cannot risk a two-tiered system that bakes in inequality. The elderly are not commodities; they're human beings. It should be an obligation of any moral society for the government to ensure that older people can get the care that they need. I want to acknowledge the work that Senator Allman-Payne, who is our aged-care spokesperson but is currently suffering from COVID—though thankfully seems to be on the mend—has done in this area. She, through me on her behalf, wants to thank all of the older people, their families and their advocates who took the time to give evidence and engage in this process—both the Senate inquiry process and also the royal commission process that preceded it. That inquiry process was far too brief, and those people really feel like their voices were not properly considered, which is an indictment on this government rushing through such big reforms. We want to thank the people who did take the time to engage and reassure them that we've heard them, that our view is that people in their later years deserve dignity and safety and that we will always fight for them.

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

I rise to speak on the Aged Care Bill 2024. This bill responds directly to recommendations of the Royal Commission into Aged Care Quality and Safety and addresses, or partly addresses, 58 royal commission recommendations in total. The Aged Care Bill also responds to the Aged Care Taskforce, established in 2023, which considered how to sustainably fund aged care into the future.

In other words this bill addresses the neglect of those opposite during the 10-year period that they were in government. In fact, during that 10-year period that they were on the government benches, they changed ministers more often than they changed their underwear. To have the contribution today by the senator from the opposition talking about how bad this legislation is—for 10 years they did nothing. Their government neglected aged care in this country and was so bad that they called a royal commission into their own failings. That says to people in the community that they can't trust those that are now in opposition and Peter Dutton if he ever becomes Prime Minister of this country. We know what he did when he was the health minister. He gutted it by $3 billion. That's what he did. They can't risk having Mr Dutton on the government benches as Prime Minister.

When we took office we said that we were going to respond to the royal commission and its recommendations, look at those and act as quickly as we could. We have made sure to reform this piece of legislation so that it will deliver quality care for senior Australians living in residential care and for those who are still able to live at home. So the government did respond. It's not like all of a sudden people have only just found out that aged care is in such crisis. We knew it for the 10 years that they were in government. We've been in this place on this side of the chamber for less than three years, and we are already responding to that royal commission.

Senator Marielle Smith, as chair of the Community Affairs Legislation Committee, went out and listened to the concerns. Not only did that committee listen to the concerns but this government has actually acted on the concerns and the issues that were raised through that appropriate process. The royal commission determined that the aged-care sector at the time was existing as a systematically failing system, where treating older people without dignity was normalised. That's what happened under their government for 10 years. It was a sector in crisis. It was in that much of a crisis that they finally realised it themselves and called a royal commission, and rightly so. Most Australians were shocked by the findings of the royal commission and the systematic abuse occurring within our aged-care system across the country. Those opposite were beholden to the sector and were unwilling to make the necessary reforms to the sector that were so badly needed.

With this new bill the Albanese government is delivering a new comprehensive pathway; mandatory aged-care food standards, which is pretty basic but very important because we all know what people in residential care were being fed under the previous government; statutory duty of care for registered providers of aged care; and worker screening. Workers can no longer be sacked from one aged-care residential home and then go down to the next suburb and get another job. We have done that in this legislation. There are stronger investigative powers for the regulator, new civil penalties and new whistleblower protections.

I'm proud to stand here before you and speak on this bill because for years I've advocated for many of these reforms, which is why they are now becoming part of reality. I want to remind those people opposite of how many failed ministers they had in their decade in government. As the assistant shadow minister for ageing under opposition leader Bill Shorten, I travelled the country and heard directly from residents, from their families and from providers who were advocating for change to the sector. They were advocating for more money to be put into the sector. But what happened? Nothing happened until the Albanese government was elected at the last election, and we've taken the action that was needed.

When we first came to government we got on with the job of reform of the aged-care sector, and I want to acknowledge the hard work of Minister Mark Butler. When we were in government previously, we actually started the process with Living Longer, Living Better. We knew that senior Australians deserved better support, better care. And then finally, after 10 years of neglect, we were elected and now Minister Butler, along with Minister Wells, has taken those actions. I'd also like to acknowledge Minister Julie Collins for her leadership when she was the aged care minister. I worked with her when she also had the shadow portfolio. I also acknowledge Shayne Neumann for his leadership over many years. We travelled the country and we were listening, and now we've had the opportunity to act. I'm very proud of all of those people who have made a contribution to this legislation.

This was so serious for us that our first act, on coming into government, was to pass the reforms in the first piece of legislation that our government tabled. We have placed older Australians as a priority since we were elected to government. We delivered a new funding mechanism for residential aged care and a sector-wide code of conduct. We expanded the Serious Incident Response Scheme and created stronger provider guidance. We implemented aged-care reforms, delivering greater transparency, capping homecare fees and, most importantly, putting nurses back into nursing homes. Those opposite didn't care enough to put them back when the sector was crying out for them, when families and older people were crying out for them.

The creation of the Inspector-General of Aged Care reinforced the Albanese government's commitment to being open with the Australian public about how aged care is administered and how it will be administered into the future. We have made aged care more transparent with star ratings for residential care, informing senior Australians and reassuring them about the importance of family and having communications between the resident and the provider that are open and transparent.

And in line with our commitment to working people and wage growth, the Albanese government proudly delivered an investment of $11.3 billion in an historic pay rise for aged-care workers. Those opposite did nothing about wages. We still have a shortage of workers, but at least now they're getting paid for the valuable work that they perform for our loved ones, and one day maybe they'll do that for some of those who are in the chamber right now. It was a 14 per cent pay rise. When you listen to what those people on that side say, remember that their government's policy was to keep wages low. Try telling that to an aged-care worker who's trying to buy a home or put food on the table—or, during COVID, having to work in two different aged-care homes, spreading COVID because they had no other choice. That all happened under the watch of those opposite.

Just as we have provided funding for early childhood educators, we are investing in the care economy. The care economy is about caring for senior Australians and it's about educating our young. Our reforms have a positive impact on the lives of older people, on their families, on their friends and on the workers who are caring for them. As I speak in this chamber, there is a registered nurse on site in aged-care residential places 99 per cent of the time across this country. Older Australians are receiving an additional 3.9 million minutes of care every single day, of which 1.7 million are delivered by a qualified registered nurse. We should never accept anything less than that. This is what delivering for senior Australians looks like, and we're not stopping there. The new legislation framework for aged care will place high-quality, safe and compassionate care and services at the centre of the scheme.

The Aged Care Bill includes a statement of rights for older people and a positive duty for providers to uphold those rights, as well as a single-entry point to the aged-care system with clear eligible requirements and a fair, culturally safe assessment process. It is the framework for delivering a range of aged-care services including residential care and the new Support at Home program which will offer improved access to supports and services to help people remain independent in their own home.

At the end of the day, we all know this will save governments money, but it's about more than that. It's about supporting people to stay in their own home, where they can be independent and where the majority of older people want to age. We will be providing higher levels of care in the home so that, as I said, people can stay at home longer. The bill will provide mechanisms for the Commonwealth to fund aged-care services, including aged-care related grant programs and fair contributions from those who can afford to contribute to the cost of aged care, and to make sure the aged-care system is sustainable in the future.

I've been in this place long enough to know that those opposite were urged to do something about making those people who can afford it pay a contribution to aged care. That's because the need for aged care in this country is going to grow exponentially. This is a good thing; we all want to grow old. But those opposite were not prepared to take that step because they didn't want to deal with any political backlash. When you're in government, you have to be accountable to your people. You have to make sure that you have services and you protect older Australians who have worked to create the country that we have the privilege of living in and that I have the privilege of serving.

This bill is a new approach to aged care. This is about restoring dignity, and it's about restoring respect. It's about respecting those people who work in aged care. It's about respecting the rights of the individual who has to go and live in a residential home. We must always remember a residential home is that person's home. It's just that they're not well enough or they don't have the support to be able to live independently at home anymore. So this is one of the best things that this Labor government has done, and we've done it because we respect older people. We believe that people working in this care economy deserve to be supported. They deserve fair pay.

We've taken another really important step, and that is to legislate so that only people aged 65 years and older can live in residential homes. That's so people with disability, often younger people, aren't put into an aged-care home that is totally wrong for them. Somebody who's in their 30s should not be placed in an old people's home because they have a disability and have nowhere else to go. That's part of this legislation as well.

This is good legislation. I have been in this place for a long time. There is no such thing as a perfect piece of legislation. That is why we have been negotiating with those opposite for over 12 months. For 12 months, we've been trying to get them to the table, to actually vote and to support this legislation, but we never walked away from it. We were never going to go away from our belief that this was really important.

The other priority in this bill is something I've been passionate about from my first day in this place—that is, empowering workers to be able to care for, and to be well trained and well skilled to deal with, those who are on their dementia journey. Dementia is, unfortunately, the biggest killer of women in this country. It's not heart attacks. Women die predominantly from dementia, so more and more Australians will go into residential care, and we need skilled, caring, supportive staff to help them.

I'm very proud, and I urge people to support— (Time expired)

Maria Kovacic (NSW, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on the Aged Care Bill 2024 and the Aged Care Legislation Amendment Bill 2024. While these bills are ambitious in scope and the coalition will support their passage, they contain a number of concerns that should be addressed to achieve their intended goals.

Earlier this month the community affairs committee tabled its final report on the inquiry into the Aged Care Bill 2024. I thank the shadow minister for health, Senator Ruston, for facilitating the opportunity for senators to scrutinise these reforms via public hearings before their passage through this chamber. Throughout the inquiry, senators heard directly from providers, and from older Australians and their families.

While there is broad support for the reforms proposed in these bills, many stakeholders emphasised the need for adequate time to implement these changes effectively. This concern is especially relevant given that much of the detail remains in subordinate legislation which has yet to be released in full. The coalition has agreed to the passage of these bills because it is necessary to embed a rights based framework and to ensure a world-class aged-care system in our country. However, the coalition remains deeply concerned about the lack of appropriate transparency, particularly the absence of critical rules and implementation guidelines.

This bill doesn't meet the aged care royal commission's recommendation to establish a right to access care. It lacks clear timelines and reporting mechanisms to track wait times from application and assessment to receiving care. Witnesses also raised concerns that the bill includes no safeguards to prevent the government from reducing the number of aged-care places. Genuine reform cannot succeed without clarity, consultation and an achievable timeline for the providers who must deliver these changes.

Aged care reflects our values as a society. The way we care for older Australians mirrors our commitment to dignity, respect and humanity. These reforms should embody that commitment, but they fall short.

Over half of the aged-care homes in Australia are operating at a loss. In the last year alone, under this government's watch, 49 aged-care homes have closed. By 2042, a mere 18 years from now, the number of Australians aged 85 years and over is projected to double, increasing to over one million people. By the 2060s, just 36 years away, one in five Australians will be aged over 65.

It is important to note the work the coalition has done in aged care. We initiated the Royal Commission into Aged Care Quality and Safety and delivered over $18 billion in immediate funding to the sector following that royal commission. We've secured critical changes to this legislation, including grandfathering arrangements, fairer financial contributions and additional support for rural and regional providers.

Workforce shortages are a critical issue in the sector, with aged-care providers struggling to attract and retain staff. Financial pressures on families and providers are escalating, compounded by inadequate support for essential services.

The substantive bills have been rushed through the parliament, leaving providers and older Australians unable to properly prepare for their impact. During the inquiry the CEO of Community Based Support, Ms Allyson Warrington, stated:

… we haven't had enough detail on the overall rules and change to be able to financially model what that care management looks like …

Transparency is lacking, with key details hidden in subordinate legislation which is yet to be released.

This bill implements the first of the recommendations of the royal commission—a new rights based framework for aged care—and it seeks to promote dignity and independence for older Australians. They are both critically important. However, arbitrary caps on things like cleaning and gardening services undermine the ability for older Australians to age at home. The primary message we got from the inquiry is that people want to age at home for as long as possible. These services are essential; they are not luxuries. Mr Jim Paterson, the senior manager at Advocacy Tasmania, told the committee that the 52-hour-per-year cap was far too low. He said:

The cap at 52 hours in a year is very low for cleaning, and, for some people, 18 hours for gardening is also extremely low. And, for some people, when you look at consumer directed care, they might be the two items that they want actually more of, compared to some of the other items they may not need yet in their package …

Foundation director of the Australian Health Services Research Institute, Professor Kathy Eagar, expressed concerns that the shortfall in services would lead vulnerable elderly Australians to move to the cash economy:

If you can only get an hour of gardening or cleaning, you'll end up being in the cash economy, paying somebody locally. For an older person, particularly someone who's got cognitive loss, this is a really risky issue. We actually want a community aged-care system that is socially engaging with people and that people trust to identify their needs as they get older.

Ms Beverly Baker, Chair of the Older Women's Network New South Wales, captured the human element of the issue when she stated during the Newcastle hearing:

An hour of cleaning a week—for heaven's sake! It takes me longer than that to clean up my kitchen after one meal. It is absolutely unreal. If you're living in Sydney, with our climate, you can hear your grass grow … As you get older your eyesight isn't as good and maybe you don't see the dirt as clearly as you could when you were younger. Those sorts of things are really important. Older women are not dirty. Sometimes they simply can't see what's in a shadow or in shade … It is an insult to say to somebody, 'You can clean your house in an hour.' That is not possible. It doesn't matter how small your house is; it's going to take you longer than an hour to clean.

Evidence presented during the inquiry raises important questions around these caps. Who exactly determined this to be a reasonable community expectation? Which segments of the community were consulted to assess whether these timeframes truly reflect needs?

The $10,000 grants available for providers for ICT upgrades not only are inadequate but also fail to reflect the complexity and cost of implementing these changes. We also don't know whether the department itself is ready for the changes with their own ICT upgrades. Evidence presented during the Senate inquiry highlighted that ICT upgrades involve significant financial and operational challenges, including updating systems, training staff and ensuring compatibility with government systems. The costs far exceed the limited funding on offer.

Coalition senators recommend that transition arrangements include a provision delaying the start date for any changes requiring ICT builds until six months after key milestones have been met. These milestones include receiving pricing from the Independent Health and Aged Care Pricing Authority, tabling the chapter 4 rules and ensuring that all associated government ICT changes are either in place or scoped sufficiently to provide certainty around system capabilities.

If this government is serious about delivering historic reforms, it must match its ambition with meaningful structural and transitional support. Without realistic timelines, providers will struggle to implement the necessary changes and deliver the outcomes that these reforms are intended to achieve. The push to move elderly Australians from hospitals into aged-care facilities prioritises system efficiency over individual needs. We need to ensure that older Australians are given options to return to their home after extended hospital stays, rather than being directed to the aged-care residential system. Such transitions should be guided by personal preferences, wellbeing and the opportunity to age respectfully at home. The government has failed to release key subordinate legislation, leaving stakeholders in the dark. Providers and families cannot adequately plan for these proposed changes.

The Albanese government is introducing punitive tax changes on superannuation balances over $3 million. These changes will double the tax rate on some super earnings, including unrealised capital gains. Younger Australians and self-funded retirees will ultimately bear the brunt of these tax changes. Simultaneously, these same cohorts of Australians are being asked to pay more for aged-care services, with no real guarantees of improved quality. Rising property prices and rents are eroding Australians' abilities to save for aged-care costs, like refundable accommodation deposits and daily accommodation payments. This comes at a time when this government is expecting Australians to depend on their home equity to fund their aged-care needs. Risks preventing Australians from building long-term financial security required to meet their aged-care needs are something that we need to address.

As of 31 March 2023, 63 per cent of Australians aged 65 and over received income support payments, with 92 per cent of those receiving the age pension. This amounts to around 2.8 million people. This number will only continue to grow as a greater proportion of our population ages. Without homeownership, these Australians face significant financial insecurity as they age.

The aged-care sector faces a workforce crisis. Staff shortages are placing significant strain on providers, with rural and regional areas hit the hardest. It is also where aged-care workers are overburdened and underpaid, leading to higher turnover rates. The government has failed to outline a clear strategy to address these workforce challenges.

Since coming to power, the Albanese Labor government has introduced over $315 billion in additional spending, much of it poorly targeted. Rising inflation and interest rates are compounding financial pressures on families and providers. Australians are facing higher taxes and fewer services with no relief in sight. Ensuring Australians can age at home, if they choose, with adequate support is critical. Demanding the release of all subordinate legislation and clear timelines for implementation are critical. Targeting training, retention and recruitment to build a sustainable aged-care workforce is also critical.

Aged care is not just a policy issue; it is the measure of our humanity. In the current form, and without the full scope of subordinate legislation, these bills lack the clarity and transparency needed to fully address the challenges facing aged care in Australia. The coalition will continue to advocate for reforms that deliver dignity, choice and quality care for older Australians, and we will hold this government accountable and ensure that every Australian can access the care they deserve. We have a duty to our older Australians to ensure they are treated with dignity and respect, and we have an equally urgent responsibility to young Australians to safeguard them from inheriting the crushing tax burden of a broken and inefficient aged-care system.

This is a pivotal moment, a chance to create an aged-care system that not only rises to the challenges of today, but becomes a foundation of fairness, sustainability and dignity for generations to come. I move the amendment as circulated in Senator Ruston's name on sheet 3072:

At the end of the motion, add ", but the Senate calls on the Government to:

(a) revise the transitional arrangements of the Support at Home Program to allow sufficient time for implementation by in-home aged care providers;

(b) provide certainty to the aged care sector through a clear transition path, including implementation information beyond 1 July 2025, recognising the cost, both in staff training time and monetary value, of the measures in this bill;

(c) undertake an extensive education and information campaign about the measures in this bill, targeted at both older Australians and their families and the wider aged care sector, to address the understanding gap clearly articulated throughout the Community Affairs Legislation Committee inquiry;

(d) expedite the design of the Commonwealth Home Support Program (CHSP) replacement program to:

(i) give aged care providers sufficient time to make necessary changes and to prevent the challenges associated with rushed policy implementation as seen with this bill,

(ii) enable providers to undertake ICT changes for both Support at Home and the CHSP replacement program concurrently, and

(iii) ensure greater emphasis is placed on the additional value delivered by organisations, such as Meals on Wheels, when determining contracts and pricing for services;

(e) undertake further consultation on care management fee caps and service delivery, including with clinicians, to:

(i) provide greater transparency about the factors used to determine the Service Lists,

(ii) ensure arbitrary decisions such as the caps on cleaning and gardening services do not remove choice and control from the centre of aged care, and

(iii) ensure that there is greater flexibility in use of care minutes so that residential aged care homes can deliver individualised, fit for purpose care that is within the limitations of their market, while still ensuring high quality care;

(f) immediately assess the scale of risk in relation to unrecoverable debts and ensure that the liability for any unrecoverable debts rests with the appropriate entity; and

(g) ensure that:

(i) consideration is given to regulatory requirements to ensure that dignity of risk is never removed from the centre of high-quality care,

(ii) aged care providers are not adversely penalised until transitional measures in this bill are completed, while protecting the rights of older Australians, and

(iii) consideration is given to the exclusion of Refundable Accommodation Deposits (RADs) from aged care asset testing provisions where the person has sold their family home to pay the RAD, to align the treatment of RADs to their treatment in the age pension assessment and recognise that residential aged care is an individuals' home".

David Pocock (ACT, Independent) Share this | Link to this | Hansard source

I rise to also offer a contribution to the debate on the Aged Care Bill 2024. Over the last few months, I've been speaking with Canberrans about these proposed changes and about what they want from our aged-care system here in Australia. My team and I had a great time speaking with seniors about this bill at the COTA ACT Seniors Expo. We also conducted a survey of Canberrans and, with the support of the amazing team at COTA ACT, we held a townhall at the Hughes Community Centre to walk through what has been proposed and to listen to what the Canberra community has to say about the government's proposal.

Broadly, Canberrans have told me that they are comfortable with these changes but with some caveats. The vast majority of people I have spoken to have told me they are happy to contribute more to their aged care in the future but only if it means that they have access to better services. The reality at the moment is that people are not getting what they need from our aged-care system. They are not getting the services that they are paying for. Many can't even find the services that they need.

There is still concern for people's wellbeing while they are in residential aged care. Recently, I had somebody tell me that they fought with a provider for a full year just to get them to stop feeding their diabetic partner sugar. This should not be happening. It should not be happening given what we learned through the royal commission and given the commitment of the parliament to actually looking after senior Australians.

That complaint was left unresolved by the commission, even after that man passed away. For this reason, I was not surprised to learn that 58 per cent of people that are surveyed said that they weren't confident that the aged-care system would be able to meet their needs. A further 51 per cent of people told me that they didn't think aged-care providers had people's best interests at heart. The trust in the system is not there, the trust in aged-care providers is certainly not there, the trust in our regulators is not there, and the services simply don't exist to meet people's needs, even in our nation's capital.

That's clearly why change is necessary, and that's why I'm supportive of what is being proposed today. We need a system that is available for the next generation and the generation after that. We need more funding entering the system to improve wages, quality standards and accommodation. In general terms, this bill delivers on that, helping to secure the future of the aged-care system and regear it so that it focuses on providing support to keep people at home for as long as possible.

However, there are a few issues that Canberrans have raised with me that I want to call out today, the first being aged-care assessments and the time it takes for someone to get a home-care package. Before anyone can even start receiving support, they first need an assessment. Here in the ACT, the wait to get an assessment has been unacceptably long. I've heard from people who've waited a full year for an assessment—12 months just for an assessment—and then they have to wait another year for the package to come through. The end result is that a lot of Canberrans have ended up hospitalised waiting for their package, or Canberrans are told, 'Just go to the hospital, and you'll get your assessment much faster if you say it's an emergency.' That's disgraceful. It is truly disgraceful to have a system where people are resorting to going to emergency and landing in hospitals that are already clogged, just to get an assessment for a home-care package.

I want to put on the record my frustration with the finger-pointing that has occurred between the federal government and the ACT government, who can't seem to provide a straight answer on where things have been going wrong here. The ACT government say that they've been dudded on funding and they haven't been given enough, and the federal government say that that's not true—that the ACT government have been given funding and they haven't actually employed enough people to do these assessments. Whatever the case, we need both governments to work it out so that our senior residents are not paying the price. We have people who are paid big bucks, and they need to accept responsibility for actually fixing things rather than pointing at the other government and trying to handball this issue.

I recognise that the government has committed to lowering waiting times to three months. But let's be real: that three months presents just one component of the journey. It doesn't account for the time it takes to get an assessment and then the time it takes for the services to actually commence. So we need to be much more transparent about the whole process, not just the element that the government feels that it can control directly, where it can go out there and promise three months. Let's break it down and be upfront about what that process will actually look like and how long it's actually going to take to be delivered. That's why I'll be asking the Senate to support amendments to provide greater transparency around wait times so we can keep a sharp eye on where we may be failing communities across the country.

The other big issue I want to raise is how we're treating people who become disabled over 65. From a number of people I've met and whose stories I've heard, it's pretty appalling. If you become disabled over the age of 65, you are guaranteed to receive far less support than a person with a disability aged under 65. This was brought to my attention by two Canberrans who have become familiar faces in these halls—Peter and Lorraine.

In late 2012 Lorraine, at the age of 72, fell off her bicycle and injured her spinal cord. Tragically, this rendered Lorraine quadriplegic. Because she was over 65 at the time of her accident, Lorraine will never be eligible for the NDIS. The aged-care system is the system that provides support to her and she receives that support through a home-care package. But the aged-care system has not been designed for people with disability. When they first got their package, many aged-care agencies turned them down. Many of them simply said Lorraine needs disability care, not aged care. When they asked disability agencies, they were told, 'If she's not in the NDIS, we can't help her. We're not interested.'

Peter and Lorraine did find support in the end but the package simply does not provide the support that Lorraine needs. Within their package they can scrape together enough to help Lorraine get out of bed in the mornings but they do not have enough to help get her to bed in the evenings. Lorraine's husband, Peter, turns 86 next month. He has told me he fears the day he will no longer be able to help his wife in the evenings. He asks us to consider: 'What should I do when I no longer have the strength to lift my wife into bed? The only option will be residential aged care.'

Lorraine is an active member of our community. She attends lectures and is a member of the Women's International Club. She has an active life and it would be the greatest shame for Lorraine to have to enter residential aged care before she needs to, simply because the system will not give her the support she needs to get into bed at night. That's the opposite of what the system should be doing and it runs contrary to the strong recommendation of the royal commission that the aged-care system provide support to older Australians with disability comparable to supports funded through the NDIS.

I will be moving an amendment to recognise that this system is the system that has to support people who become disabled over 65. I hope that the Senate will support that amendment for the benefit of people like Lorraine, who want to remain at home and remain part of our community.

I want to finish by talking about the statement of rights. This is something we debated quite a bit at the town hall. Canberrans have told me that, while they appreciate the strong statements of right within the bill, they worry that these rights are essentially unenforceable, that they are rights on paper. They are like the mission statements that you see up on the walls of offices and businesses around the country—they are there but no-one really pays much attention to them. It's true that a person can't take action in a court if they feel their rights have been breached. But looking into the details of the bill, it's unclear to me if even the commissioner can take action if people feel their rights aren't being upheld. It seems the commissioner only has to consider whether providers have procedure manuals in place, not whether these rights are being upheld each and every day in practice. And everyone in this chamber knows it's one thing to have a procedure manual but another thing to actually use that and ensure that those procedures are being implemented.

I'd like to finish by reading to the chamber some of the feedback I've received from Canberrans. This is from Eileen:

The royal commission proved it is not a matter of a few bad apples or isolated incidents. The abuse and neglect is systemic and it continues unabated without consequence for the service providers. Nothing in the new act will change that. Many providers are still not meeting the service quality standards more than one year since they were meant to be fully implemented. These are standards for only bare-minimum care, not even for good care.

This is from Vicki: 'How will the government ensure that contributions made by senior Australians to the cost of their aged care are used to improve the quality and number of services provide to residents and not simply used to increase the profits of aged-care providers? Aged care is expensive already, and service quality varies significantly across the sector. If being asked to contribute more, then the services provided must be monitored and standards enforced.'

This is from Donna: 'Dad's strongest wish is to remain in his home until he dies. My sister lives with him and is committed to helping him realise that wish. Her role as carer is largely unsupported by the community, and avenues for subsidised assistance aren't readily apparent to her. Review of Dad's care package takes a long time, and the services he needs are difficult to access. My sister's role as carer is close to 24/7. It's not sustainable. She's in her 60s, and both of them might end up in care.'

Finally, this is from Bronwyn Vincent: 'The system is a nightmare. I don't understand how aged people without support or an advocate navigate the process. I provide support for my almost 90-year-old mother, who lives independently in her own home. I've been trying for months to get her additional support, and although her application has been approved months ago, she is still waiting for the paperwork to go through. This is ridiculous. They keep reassessing her. She doesn't need a new assessment; she just needs someone to do the paperwork. This is so frustrating.'

I thank the government for bringing forward these reforms. I sincerely hope they will support amendments that I think strengthen the aims of this bill and really ensure that we are living up to the pact that we should have with older generations. The things we enjoy are due to their hard work, and we will respect them, look after them and ensure that they can live a life of dignity as they age. As we know, for most people, that is living at home for as long as possible. Whilst a number of things in this bill will do that, the timeliness of that process to get an assessment and a package has to have more transparency, so that we can ensure it is delivered to Australians around Australia.

Marielle Smith (SA, Australian Labor Party) Share this | Link to this | Hansard source

I also rise to speak on the Aged Care Bill 2024. The Community Affairs Legislation Committee, which I chair, conducted an inquiry into this bill primarily through the month of October, reporting early November. It was a considerable inquiry, and I just need to put some facts on the record regarding the extent and thoroughness of that inquiry as well as some of the other consultations which have gone into the development of this bill. We held nine public hearings over a matter of a few weeks. We went to every single state and territory, not just capital cities but regional areas in the states and territories as well. We heard from over 150 people, including 28 witnesses who shared their lived experience of aged care. We held five panels of lived-experience witnesses across the course of our hearings. We added an additional one towards the end to make sure we could bolster the lived experience we were receiving as evidence to our committee. In total, we received over 180 submissions by people affected by aged care and by their advocates and representatives, as well as by service providers and other stakeholders across the aged-care sector.

It was a substantial inquiry. I want to thank the committee secretariat for their tireless work to organise these hearings in a very short timeframe, particularly Claudia Kevin, who stepped up as acting committee secretary for a significant portion of the inquiry. I know a number of other Senate staff members attended our hearings and helped facilitate our inquiries, because we had so many around the country in such a short period of time. Government senators turned up to every single one of those inquiries for the entire duration of the day. I want to acknowledge Senator Urquhart and Senator Pratt for their presence and also for their assistance to me in chairing some of those inquiries.

This built on a consultation process conducted by the Department of Health and Aged Care before the bill was introduced. The exposure draft of the bill was released for public consultation for four months, during which nearly 1,000 people attended face-to-face or virtual workshops on the legislation, including specific sessions for culturally and linguistically diverse communities and Aboriginal and Torres Strait Islander people. The department hosted three public webinars with more than 9,600 people in attendance, and facilitated roundtable discussions that engaged aged-care experts, advocates, providers and representatives to discuss and provide comment on the exposure draft. I'm advised that these consultations in total resulted in almost 14,500 separate points of engagement on the bill, including more than 440 submissions and 1,500 survey responses.

The consultation on this bill and these reforms was extremely thorough, not just by our committee but also by the department before it, and that consultation extended to people with lived experience of aged care. It was not just about providers, and it extended to almost every corner of Australia. And as chair of the committee, I am so grateful for the heartfelt, passionate and sometimes deeply personal testimony we received, which was instrumental in developing our report and shaping our views.

But what we heard loud and clear over the course of this inquiry was that this bill was urgent and necessary, and that there is absolutely no time to waste to pass it through the Senate so that the government can implement these vital reforms. This bill is part of a reform process which isn't months long—it is years long, after significant advocacy from people in aged care, from their families and from their loved ones. It responds to the Royal Commission into Aged Care Quality and Safety from October 2018—the report of which left absolutely no doubt about the urgency of a reform. That interim report was titled Neglect, and let us never forget it. From a royal commission report call Neglect, something had to happen. This bill represents a substantial part of the government's response to that report and a substantial part of the reform process we know needs to take place in aged care to make sure that high-quality care can be delivered in a sustainable way to ensure it will be there for all the generations that need it.

In its final report, the royal commission has made clear that change was needed and that people in aged care want to be treated with care, dignity and respect, but that it had been far too easy for older people and their families to become disempowered in what can be a depersonalised, confusing and overly bureaucratic aged-care system. Recommendation 1 of the royal commission was that a new aged-care act be passed by this parliament, and the passage of the bill will respond to around 60 of the recommendations of this royal commission report.

This bill is about putting older Australians at the heart of the aged-care system and raising the standard of care across the nation, and sustainable funding is an essential part of that mission. By changing how aged-care providers deliver services to older people in their homes, community settings and residential care homes, there is an opportunity to ensure that older people are treated with the respect that they deserve. This bill implements a much-needed, rights-based legislative framework for aged care, as was recommended by the royal commission.

We all know the stories—the horrific stories—from years past about what has happened in aged care in this country. The royal commission report was called Neglect for a reason, and none of us should be comfortable maintaining the status quo that produced a report called Neglect. The bill before us today is about responding to that report, saying a report called Neglect does not leave us with any option but to embark on a substantial agenda of reform. Sometimes that requires hard decisions, but it actually does require coming to the table, coming to the party and trying to resolve a problem—a massive problem which was hurting too many of the people we love and too many members of our own families. It would have continued to hurt and harm if a reform agenda were not ambitious, bold and brought to this chamber, as this bill today.

I think this is a good bill. Throughout our inquiry process we found some things which we thought needed work and needed to be addressed. We made commentary throughout our report on the committee's view, and I acknowledge the work and the response of the government to some of those issues raised. That's the purpose and part of having an inquiry process. But it is also really important that we come together and do something about this and that we don't think the status quo, in a system which led to a royal commission report called Neglect, is ever going to be superior to a reform agenda which seeks to put older Australians at the heart of aged care, because that's not an acceptable scenario either. It's not acceptable and not at all reasonable to put your heads in the sand on this one. We need to come together as a parliament to deliver reform. That's what our community expects of us, and that's what this bill will deliver.

Those reforms go to secure and sustainable funding. They go to the Support at Home program, which will make a tremendous and massive difference to many people's lives. We know it is a core part of what older Australians and their families expect and want from the aged-care system and what this bill will help us deliver, including changes to those waiting lists and making sure that more Australians are supported to be able to age in their homes—an absolutely critical request of older Australians and their families.

The aged-care sector absolutely needs reforms. These reforms are once in a generation, and I commend the minister who has worked tirelessly, since she was sworn into this portfolio, on seeking to deliver a reform program which responds to that report and responds to the title Neglecta report that this chamber should never be able to ignore—and a response of the complexity, detail and, at times, compromise necessary to change this system to ensure that it works for older Australians, that older people get the care, dignity and respect they deserve, that we do that in a sustainable way and that we don't shirk our responsibilities in this parliament to respond to that No. 1 recommendation to deliver reform and to deliver a new act this term. That's our opportunity today. I commend the bill to the Senate.

Richard Colbeck (Tasmania, Liberal Party) Share this | Link to this | Hansard source

I rise to make a contribution to the debate on the legislation before us, the Aged Care Bill 2024 and the Aged Care Legislation Amendment Bill 2024. These are important pieces of legislation, and I acknowledge the commentary from the chair of the community affairs committee in relation to that. But, if this is such important legislation—if it is so important, as the government tell us—why have they left it so late in the term to legislate? Why have they allowed the program of the response to the royal commission put in place by the previous government to slip by so much? Why are we here at quarter to 12, just before an election, urgently needing to pass a piece of legislation that should have been done over a year ago? Why have they allowed that to happen? Why have they allowed the waiting time for home-care packages to slip from 30 to 90 days, where it was under the funding provided by the previous government, out to 15 months? I heard Senator David Pocock talking about waiting times. Why is their ambition for delivery of a home-care package out to 90 days? The coalition got the time down to 30 to 90 days for a home-care package at any level and to fewer than 30 days for a high-needs package. Yet the government, in this legislation, is saying that the acceptable standard for receiving a home-care package is 90 days, and Senator Pocock thinks that's okay. I don't, and neither do people receiving care.

It's worth noting that this government, the Labor Party, still has not responded in full to the royal commission. The document that they're working off is the response tabled by the Morrison government in the budget of 2021 in its response to the royal commission. It's a bit cute, I have to say, to listen to members of the Labor Party—who still haven't responded formally to the 148 recommendations of that royal commission—taking credit for decisions made by the previous government. They're all important reforms. It's good that they're happening: the star rating, standards on food, the new funding model—the AN-ACC system—where providers all knew their funding regime before the 2022 election came to pass; and financial reporting. These were all things that were planned decisions made under the previous government. It's good that they're in place. These are important reforms in response to the royal commission.

But we saw, before the last election, the politics of aged care played by Labor, when they opposed pieces of legislation that were proposed by the coalition and then brought them back immediately after the election in mostly the same form to pass them and claim credit for them. That's fine, but, as part of that process, for example, they reduced the standards of clinical care required in aged-care facilities for Indigenous Australians. Why do Indigenous Australians deserve a lesser standard of clinical oversight than everybody else? I would argue that they don't, but that's what this government did. They excluded Indigenous-run aged-care facilities from the clinical governance and the governance oversight required of every other provider in the country. It is shameful.

It is shameful that they let the waiting time for home-care packages slip out to 15 months. The reform of the home-care system was one of the key elements of the royal commission report—'a cruel lottery', they called it. The Prime Minister talked before the election about 'returning the care to aged care'. The reality is that all he has done is delay the process and return the waiting lists. It is shameful that people are now waiting 15 months for a home-care package when all of the investment and all of the hard work done by the sector and the previous government had got the waiting time down from 90 to 30 days. That was a commitment that we made very early in the previous parliamentary term.

There are some other catches within this legislation that haven't been talked about. The government talks about a lifetime cap on expenditure. It has been referred to by a number of people, but the thing that this legislation does is discriminate against people on lower incomes. If you can find the money to pay a RAD—a deposit for your home, which is a lot of money; potentially, up to a million dollars—that money is protected by the system, but, if you pay a DAP, a daily accommodation price or a daily accommodation fee, that is not included in the cap, and you will pay that every day. So, if you're someone of low means who can't afford to pay a RAD, all of your resources can, over time, be gobbled up through the daily accommodation fees. It is not part of the cap; it's not protected. The only thing that is included in the cap is the clinical care fees.

Of course, the new design of the home-care system will drive people out of home care and out of their homes. They might just need that little bit of home care around the house or around the garden. Senator Pocock talked about it, and so did the Greens in their contribution. They might just need that little bit of assistance with some of those daily chores to stay in their own homes. But, with the way that the funding system has been designed under the government's new model, you might as well pay on the cash market than try and go through a home-care package because you will pay more. And, if you're in the upper echelon of wage earners, you could pay double what you're paying on the private market. The design of the scheme is designed to push people out of home care. The waiting times for home care are, quite simply, unacceptable.

Now, the government talks a big game. I go back to the title of the interim report, not the final report, of the royal commission, and the government has a long, sad history of misrepresenting the royal commission—

Debate interrupted.