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Wednesday, 20 June 2007
Page: 136


Ms ANNETTE ELLIS (5:49 PM) —I rise this evening to speak on the Aged Care Amendment (Residential Care) Bill 2007. This bill seeks to replace the old RCS classification system with a simplified system. It also seeks to give the secretary of the department the power to stay the suspension of a service provider. It will remove the requirement to reassess aged-care residents when they have changed facilities and will also remove the requirement that residents be reassessed every 12 months. Reassessments will now be optional in these circumstances.

Almost five years after the Hogan review into pricing arrangements in residential aged care was announced, the government has finally brought to this parliament some legislation to deal with aged-care affordability and changes to the classification system. This bill is another example of this government sitting on its hands when recommendations have been made. We have seen it with climate change and with other policies, and we are seeing it again. For more than six years, we on this side of the House—I in particular—have been calling for action to be taken, particularly in relation to the RCS. The aged-care industry has called for action to be taken as well. Since coming to office 11 years ago, this government has had, amazingly, seven ministers responsible for aged care. I have not checked, but one would suspect that there could be a revolving door on that ministerial office. In fact, I think two of the previous ministers are in the chamber at the moment. That record is appalling and it is a clear sign to older Australians about the level of importance that this government attaches to aged care and the people who are in aged-care facilities. Just how important is this portfolio that we have such a revolving door for the ministers? However, we are finally here to debate some of the changes recommended in the Hogan review.

Over many years, I have been very critical of this government regarding the RCS, or residential classification scale. The lack of flexibility under this assessment instrument has hampered aged-care facilities in delivering quality aged care specific to client needs. It could have been much easier and far less stressful for many people working in those facilities if the RCS review had occurred earlier. Furthermore, the red tape attached to the RCS has been a real impediment to aged-care providers doing what they do best—providing good patient care, not assessing and reassessing clients with reams and reams of paperwork.

Accountability is critical in the aged-care industry, and I do not debate that for one moment. After all, this industry looks after many of our community’s most vulnerable people—our aged and infirm and sometimes our younger people, who find that they have nowhere else to reside but in an aged-care facility. We need a balance where clients are protected and aged-care providers are not devoting scarce resources to comply with what has become overly onerous paperwork.

In the past we have seen some horror stories about aged care. However, I want to make it very clear that the vast majority of aged-care providers and their staff work very hard to provide the best care for their clients that the system in which they find themselves can possibly allow. Many staff choose to work in this field—and thank heavens they do—despite lower pay compared with other parts of the medical or health sector. Generally speaking—in fact, I think overwhelmingly—they do a fantastic job. Like many in this place I have personal experience to back up those claims.

Let us have a look at what the industry has had to say about this government’s pace with regard to reform in the aged-care area and what it has had to say in relation to this bill. In an undated media release that was put out following this year’s budget announcements, one of the peak bodies representing aged-care service providers, Aged Care Association Australia, ACAA, has said that it:

... remains disappointed that the Government has not listened to the advice of Professor Warren Hogan and addressed what Hogan estimated to be a $6 billion funding shortfall by financial year 2022 unless the fundamentals of the current scheme are changed. The package announced in February ... does not address Hogan’s projected shortfall and unfortunately, nor does this budget.

In my view, that is a pretty damning assessment of this government’s performance in this area. But it gets even worse. Mr Rod Young, the CEO of ACAA, went on to say:

Aged care providers across the country have been signalling to the Association that financial year 2006-07 has been the most difficult they can recall ...

That is the legacy of this government on aged care. The system of aged care has really suffered in recent years with regard to the reforms that are required. That is not me saying it; it is the peak body for the aged-care industry—an organisation that I am sure we all realise knows a thing or two about aged care. Mr Young had another couple of comments to make. He said:

... they (providers) are not prepared to make further substantial investment in the industry until Government is prepared to address the fundamentals surrounding operating and capital income streams.

Surely members opposite must start to wonder what is happening in their own electorates. Do they have a shortage of beds within their own electorates? If so, why? Are sufficient new facilities opening in their local area? Are those facilities correctly geared to the needs of the people within their community? The answers are quite simple.

I am strongly of the view that the government should have responded more quickly with the reforms that were required and that have been spoken of so much by the industry and, more importantly, by the people working within those facilities and within the industry who really do have the hands-on experience of what needs to be done. I think back to a statement that I think the Prime Minister made when he announced in February the ‘securing our future’ package. Its ‘unintended consequence’ was that it ripped out nearly $300 million in capital and care to providers over the life of that package. In the budget, the government then had to fix that up by reinstating the two subsidies that they abolished only four months earlier.

This bill will replace the burdensome RCS with a new assessment tool to be known as the Aged Care Funding Instrument, the ACFI. The ACFI will have fewer basic funding categories than the old RCS and will have attached to it two new supplements aimed at better targeting funding towards those with high-care needs, especially residents with dementia and other challenging behaviours and those who have complex care needs like palliative care. Probably the most sensible reform in this bill is the abolition of the requirement to reassess residents every 12 months. Under this bill, service providers have the option of reassessing a resident after 12 months but are not necessarily required to do so. This reform will take the pressure off service providers and their staff and allow them to focus on the more immediate needs of residents. Additionally, the removal of the requirement to reassess a resident when they change facilities has been removed, with the new provider being able to accept a classification given by the previous provider of aged-care services. Again, this is a sensible change that should reduce the overly onerous paperwork burden on those hardworking health professionals.

Another sensible reform in the bill is the ability of the secretary of the department to stay the suspension of a service provider for failing to correctly assess residents in a proper manner, subject to the provider meeting certain obligations. I understand that these obligations would be remedial in nature, such as appointing an adviser at the provider’s expense or undertaking appropriate training.

One area of concern that I have is in relation to the levels of funding attached to each classification level. My understanding is that the aged-care industry itself has not yet been provided with this information, and we are debating the bill relative to it. I would ask the minister how any industry, let alone this one—which is very complex and challenging—can be kept in the dark over what levels of funding will be available to them under the new system. How can they plan for future investment, how can they conduct business modelling and how do they know that they will be able to afford to keep operating in the fullness of time? As I said, we are debating the legislation and yet I understand that information has not been made available. As the quotes from ACAA which I mentioned earlier indicate, providers cannot invest with security, they cannot conduct business modelling and many do not know if they can afford to keep operating in the way they have been. It is ironic that one of the certainties in life for many lucky ones is ageing, but there seems to be very little certainty in the aged-care sector under this government.

In closing, I want to emphasise—and probably every member in this place would endorse what I am about to say—that the people who choose to work in the aged-care sector do so with our thanks. They do it with difficulty. They do it as virtually a calling. Many of them—and I know this from my own experience—take on what I would call extracurricular activities and services within those facilities purely because they enjoy what they do and they enjoy seeing the joy that those added services bring to residents within the facilities. I applaud every one of them for that.

Our job in this place is to ensure that the legislation that looks after the aged-care sector is open and fair, gives every possible encouragement to those care providers and relieves them of any of those burdensome bureaucratic arrangements that have been in place to date. I welcome these changes. I am sure there are many more that we would welcome if we could see them come forward. Of course, the other big question—which we are not debating today but which I make note of—is the increasing cost to people in the aged-care sector and what we can do to ensure that the aged-care sector has a full and healthy future.