Aged Care Reform

07 September 2022

I rise today to speak in support of this bill, the Aged Care Amendment (Implementing Care Reform) Bill 2022, which will stop the neglect and return security, dignity, quality and humanity to aged care.

For too long older Australians have been forgotten and neglected, and for too long they have suffered. All of us in this place have heard too many heartbreaking stories of a system that has let down many of the most vulnerable Australians. The royal commission found that 30 per cent of people in aged care have experienced substandard care. That's one in three of our parents and grandparents who have been robbed of their dignity in the final years of their lives. Australians in aged care are not a burden, and they deserve the proper care and support that they need in their later years. Aged care affects us all—our parents, grandparents, partners and friends—and many of us most likely will rely on it at some point. These are our loved ones. These people are Australians, and they deserve to be treated as we would want to be treated. That's why we need to get this right.

Over the last decade we saw 23 reports, inquiries, studies, committee reports and a royal commission, and they all told us the same story—that the aged-care sector was in crisis; that older Australians were being robbed of their security, dignity and quality of life in their later years; that aged-care workers were underpaid and overworked, and the system was being pushed to breaking point. The Royal Commission into Aged Care Quality and Safety challenged us to be better and do better. I want to say, again, thank you to those people who shared their stories through the royal commission, because they shone a spotlight on the true depth of the crisis. They told stories of malnourishment, of maggots in wounds and of older Australians being physically restrained for hours on end. I've spoken before in this place about my own family's experiences with aged care and the fact that, while the stories that were brought to light by the royal commission were completely unacceptable and shocking, for anyone who had had an experience with aged care they were, devastatingly, all too commonplace. They were not that surprising for people who'd had firsthand experience with the sector.

But Labor has heard these stories, and I am proud to be part of a government that has listened to those findings and is now taking action to fix this crisis. I'm proud to be part of a government that has a plan and will deliver on those commitments. I really want to acknowledge the work of the shadow minister for aged care in the last term, the member for Hotham, and acknowledge our Minister for Aged Care for the incredible work she has done in hitting the ground running. I know that she will give her all to fixing this crisis. Labor's plan will put nurses back into nursing homes, lift wages for workers in the sector and give carers more time to care. It will deliver better care, it will improve transparency and accountability, and it will cap the fees paid for home care.

I also want to acknowledge again in this place the incredible work of aged-care workers, the true heroes of the pandemic, who fronted up day after day to care for older Australians in spite of being underpaid and, in many cases, not properly protected with the things that they needed for their own safety as the pandemic hit. These people have been brave and strong, and they got us through. I also want to thank them for their advocacy over all the years that finally bring us to addressing these problems.

From 1 July next year, providers of residential care and of specified kinds of flexible care will be required to have a registered nurse on site and on duty at each residential facility, 24 hours a day, seven days a week. This is something that people—unions and others—have called for over many years. This will give older Australians living in residential aged care access to the nursing care that they deserve. It will also have flow-on benefits to our health system, which has been struggling with the pandemic, because this proactive care will prevent thousands of stressful, expensive and ultimately unnecessary trips to hospital emergency departments. Labor understands facilities in rural and remote areas face a tougher time in attracting and retaining staff, so there is an exemption framework within the legislation for specific circumstances. However, all exemptions will be time limited to ensure that providers do not use an exemption as an excuse to stop seeking staff or to circumvent the need to deliver quality care.

The Department of Health and Aged Care and the Aged Care Quality and Safety Commission will work with exempted providers to help them work towards meeting their new responsibility. But the Labor government recognises that older Australians living in rural and remote areas deserve the same quality of care as those living in metropolitan areas. Importantly, rural and remote providers are still required to meet a standard of care and, if subject to an exception, would still need to demonstrate that they have appropriate arrangements in place to ensure quality and safety of residents.

We recognise the difficulties that some facilities have in attracting their workforce so have established a wide range of programs to attract staff and support retention. These include initiatives such as 1,900 scholarships, support for 5,250 clinical placements and the nurses retention payment of up to $6,000 annually.

Labor wants to make aged care a place where people want to work, where they will be respected and valued for the important work that they do, and wants their pay to reflect that. That's why we are also backing a real pay rise for aged-care workers and have made a submission to the Fair Work Commission in support of increased wages for aged-care workers. We are committed to funding the outcome of the case. Increased wages for registered nurses are expected to close the gap between supply and demand. These improvements are long overdue for these incredible workers in the aged-care sector.

This bill also reflects the government's commitment to fixing home-care charges. That's why this bill will cap the amount that can be charged for administration and management to people receiving home-care packages and remove exit charges altogether. The royal commission heard of astronomical fees, that up to 50 per cent of some home-care packages were being eaten up in administration and management fees, charges that reduce care rather than improve it. That's money that should be going into care. These unacceptably high fees lead to older Australians missing out on the care that they need to keep independence and continue living at home.

This legislation will enable the government to cap these charges and maximise funding available to address the care needs of more than 210,000 older Australians currently receiving home-care packages. These proposed changes are intended to provide all-important pricing transparency for consumers and providers and greater clarity about direct and indirect costs.

We are totally committed to improving integrity and accountability in the aged-care sector. The royal commission found that a lack of transparency is a pervasive feature of the current aged-care system. We want to provide greater transparency on what aged-care providers are spending money on and other valuable information about providers' operations. The royal commission found that there is a lack of transparency and accountability about approved providers and that good quality comparative information about aged-care services is not publicly available.

The bill requires the secretary and the department to make publicly available information on residential aged-care services and provider expenditure, including information on labour, care, food and nutrition, cleaning, administration, maintenance and profit or loss. This information will be published online, empowering older Australians and their families to make better informed decisions about their care. It will also strengthen integrity and accountability of providers and incentivise good practice. These important measures respond to public concerns about the aged-care system and ensure that older Australians are receiving the care that they deserve.

I also want to acknowledge the providers in the sector that are really doing their best to deliver for their residents and the people that they care for, including those in my electorate that I have spoken to, throughout the last term, about these issues.

Significant consultation is underway to inform robust and evidence based policy that will be set out in delegated legislation. Consultation is being conducted with a range of stakeholders, including older Australians, their families, representative bodies, advocates, industry peak bodies, industrial organisations, aged-care providers and, in some cases, the general public. All amendments to delegated legislation will be subject to disallowance and, therefore, continue to be subject to parliamentary scrutiny.

The previous government wilfully neglected older Australians and the aged-care system. Labor will not turn its back on the crisis in aged care. This is not a political problem to be fixed; this is a human crisis and needs genuine commitment and a genuine solution. With this bill we are taking the right steps to ensure we leave no stone unturned and help implement all practical measures to guarantee that older Australians receive the highest standard of aged care they deserve.

Older Australians have worked hard their entire lives. They've contributed to their communities and helped to build this wonderful country. We've all benefited from their sacrifices, hard work and achievements. We can repay them by giving them support to live with dignity and humanity in their twilight years. This bill will ensure we are able to do that.