Speeches Chris has made in the Australian Federal Parliament.

Bills - Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020 - Second Reading

March 05, 2020

Mr HAYES (Fowler—Chief Opposition Whip) (11:44): I would encourage colleagues opposite to stay after the quorum. This is a very interesting debate, particularly when we're talking about the most vulnerable Australians—those who actually need our assistance most. I would have thought that those opposite would have an interest in this matter. We should be clear from the outset that, firstly, as has been pointed out, we will support the passage of this bill, the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. However, in relation to the amendments that have been moved by the Shadow Minister, the Member for Franklin, it is instructive to look at the government's record when it comes to administering aged care.

No-one in this place should be fooled into thinking that this government actually cares for the most vulnerable in our community. If you look at the record that they have been able to muster over the last seven years, you'll see that they haven't really shown much care or empathy for the most vulnerable Australians, those who are in need of aged care. The Abbott, Turnbull and Morrison governments have clearly been asleep at the wheel or have simply been negligent. We've had four Ministers, billions of dollars ripped out of the aged-care system and one crisis after another. The government in its very poor way, quite frankly, has stumbled into addressing the findings of the Royal Commission into Aged Care. It has been instructive to see what the commission put in its initial findings.

Before I do that, I'd like to talk a little about what this bill seeks to do. It seeks to change the payment for home-care subsidy providers from being paid in advance to being paid in arrears. That doesn't seem much of a change. As a matter of fact, it does seem to be practical in many respects, but it is going to require some transitioning. Like many Members, I have many providers that are very low cost, many of which run on a not-for-profit basis. The change in the payment system is something that they need to be able to accommodate properly. What I've been advised is that it's not just a simple task of changing a piece of legislation. The explanatory memorandum states that the bill will 'improve the way home-care providers are paid the government subsidy on behalf of home-care package holders and will bring these arrangements in line with contemporary business practices'. I think that's probably fair. However, the Aged Care

Financing Authority, the ACFA, when they were consulted about the terms of this provision contained in the bill, highlighted a series of concerns. They said, 'The new payment arrangements would be a risk to the viability of some providers.' That's precisely the information we're getting at the coalface, in our electorates, from those providers that are not multinationals and are not major businesses but are providing significant services to some of the most vulnerable people in our community. Many of the stakeholders have raised issues, particularly drawing attention to the significant impacts that it would have on small providers and those operating in rural and remote locations.
The change from advance to arrears is to commence on 1 June 2020, which, you'd have to admit, is an extremely tight turnaround. I think that in itself is problematic as specified in this bill. There is an increased risk that some of the smaller service providers who do not have adequate cashflow will struggle not only to meet the time demand but to actually make the initial transition. As noted by ACFA, it may become necessary for service providers to resort to other financing arrangements, including loans and equity injections, to be able to accommodate the initial change. The change may also see some home-care providers become reluctant to take on new customers. That in itself would be problematic in that we do need to have greater provisioning of home-care services, otherwise we'll see a significant influx into residential aged care. What I'm trying to point out is that this is once again symptomatic of the government's piecemeal attitude to reform. This is no real reform; this is just making a minor change and being caught on the run.

Last month marked the third anniversary of this government's Increasing Choice in Home Care reforms—the third anniversary of that significant reform that they announced with much fanfare. But, three years on, we see that these reforms have done little to address the growing home care packages waiting lists. There are still more than 100,000 older Australians waiting for their approved home care packages—not waiting to go on a list or waiting to put an application in; waiting for the delivery of their approved packages. Sadly, almost 30,000 older Australians have died over the past two years waiting for their approved packages to be delivered and around 25,000 older Australians entered residential aged care prematurely. As I said before, for many people, if you can't get the services at home, the only alternative is to go into full-time residential aged care.

The median waiting time for older Australians going into residential care has also grown by over 100 days. It is no longer just one month; under the Liberal and Nationals, it has now grown to up to five months. So, after making that initial decision to actually set yourself up in aged care, you now have to wait some time. Bear in mind that the people we are talking about are some of the most vulnerable people in our community. The people going into aged care are ordinarily well into their eighties or older—and we need to support these people. These figures make it clear that the government's simply not doing enough to support older Australians.

The Productivity Commission's report on government services, released in January this year, sheds further light on the government's mismanagement. It notes that Australians waiting for high-level home care packages are waiting almost three years to get the care that they have been approved for. That's three long years for people in our communities, in our families, and in our electorates who are doing it very tough. These years that could go into improving the quality of their lives of elderly Australians. But, rather, because of the government's mismanagement, the exact opposite is happening.

Let's not forget the Royal Commission into Aged Care Quality and Safety interim report, which was handed down on 31 October last year. The interim report was interestingly titled, Neglect, and it highlighted three significant matters for this government to take urgent and immediate action to address: namely, ensuring that older Australians are getting the care at home when they need it; preventing the overreliance on chemical restraints in aged care; and, thirdly, ending the unacceptable number of young people entering residential care. The government's response to the interim report has been woeful, to say the least, especially in relation to addressing the issue of home care packages waiting lists. The commission also recommended urgent action to address home care waiting lists but, once again, what we have seen is that the government has a shortfall, putting only 5,500 home care packages into the system since December last year. That doesn't equate with more than 100,000 people, older Australians, who are currently on the waiting list. The 5,500 new packages are not really going to make a huge dint when there are 100,000 people still on the waiting list today.

My office regularly receives representations from members of my community on the issue of waiting times for approval of home care packages—and we've seen a spike in that over recent times. To highlight this, I would like to draw the attention of the House to the experience of one my constituents—and this woman has allowed me to name her. Nora David is 82 years old. Although she has been approved for a level 3 home care package, she has only been allocated a level 2 My Aged Care package. She was told that she would need to wait nine to 12 months for funding to be available for a level 3 package. With the current level 2 package, Nora has only 3½ hours of care per week. That 3½ hours is expected to meet all of her needs, including groceries, shopping, food preparation, cleaning, doctor appointments and purchasing medication, just to name a few. She goes on to say that, if she needs to visit a doctor, simply going to the surgery, taking her appointment and some wait time can basically take up her full 3½ hours, basically leaving this 82-year-old woman with no extra care for the remainder of the week.

One doctor's appointment takes out her shopping, takes out the purchase of her medication, takes out her cleaning and takes out all those things that care is supposed to be provided for. For an 82-year-old, someone who has actually been a long-term resident of this country, who has grown up here, worked and paid taxes—is that the way we really want to treat people? I remind the House that it was this Prime Minister, when he was Treasurer, who was the architect of cutting almost $2 billion out of aged care. With more than 22,000 Australians aged 65 or older in my electorate of Fowler alone, I've seen the impact of the government's continued neglect on older Australians in the aged-care system.

As parliamentarians, I think we all have a responsibility to ensure the quality of care for our elderly. We need to ensure that the sector works positively to look after their needs. If we can't spend enough time and resources looking after our elderly, doesn't that mean that we as their representatives and as parliamentarians have simply failed? At some stage I think we have to admit that. The government has to be strong enough to come out and not just make another budgetary adjustment, not just fudge around waiting times but be honest and say, 'We've failed.' I call on the government to reverse their continued cuts to the aged-care sector and look to address their broken promises. Heading towards the election, make no mistake about it, they had plenty of promises on what they were going to do about aged care, but have consistently failed to meet them.

Against this background, as I said, we'll be supporting the passage of the bill. But I think that with this situation we do need to see the government show that it has the courage of its commitment to meet its electoral promises and stand up and support Labor's call to look after the most vulnerable in our society and to look after those that we have an ongoing obligation to look after, older Australians.