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Monday, 1 August 2022
Page: 83

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Senator STEWART (Victoria) (17:44): I rise to speak on and support the measures contained in the Aged Care and Other Legislation Amendment (Royal Commission Response) Bill 2022. For countless generations, elders have provided care, wisdom, guidance and authority over our culture, country and people. Elders have been our story keepers, our protectors of cultural knowledge and teachers of our young people. Their contribution to our culture and to our country is immeasurable. As I touched on in my first speech, I would not be standing here in the Senate today if it were not for my own elders—especially my great-grandmothers, Alice Kelly and Annabelle Jackson, and my grandparents, Alvie and Joe Kelly. Elders, along with all older Australians—including generations of migrant communities—have helped build and create modern-day Australia. Older Australians have worked hard, paid their taxes and raised their families. It is our elderly, and their sacrifices, who have paved the way for us today and for the generations of tomorrow.

Older Australians have every right to expect that the federal government will support them in their later years. That's what they deserve; that's what they've earned after a life contributing to their communities and to our country. However, as tragically exposed through the Royal Commission into Aged Care Quality and Safety, the care and treatment of our elderly in aged care has been far from acceptable, to say the least. The royal commission's findings were clear: it exposed an aged-care system that has been in crisis. As the royal commissioners wrote:

Over the last several decades, successive Australian Governments have brought a level of ambivalence, timidity and detachment to their approach to aged care.

The royal commission heard countless stories of neglect, of a system in crisis and of thousands of Australians crying out for just a little bit better—for just a little care, for just a sense of humanity.

In particular, it was the Abbott, Turnbull and Morrison coalition governments that have neglected older Australians and the aged-care system for the best part of a decade. It is a national disgrace. However, I'm proud to be part of an Anthony Albanese Labor government that is committed to fixing the aged-care crisis. In this regard, I would like to acknowledge our new Minister for Aged Care, Anika Wells, the Assistant Minister for Health and Aged Care, Ged Kearney, and the Assistant Minister for Indigenous Health, Senator Malarndirri McCarthy, for having hit the ground running to begin the hard work of reforming and rebuilding our aged-care sector.

Just as we promised at the election, the Albanese Labor government will take practical measures consistent with the recommendations contained in the royal commission report to ensure older Australians receive the care and dignity they deserve. This bill amends aged-care law and other legislation to implement a series of urgent funding, quality and safety measures, several of which were recommended by the royal commission into aged care. The bill replaces the outdated Aged Care Funding Instrument with a new model for calculating aged-care subsidies called the Australian National Aged Care Classification model, which has been developed in consultation with the aged-care sector and consumer groups. Importantly, the bill includes several measures that will provide additional protections directly to older Australians. These protections cannot be delayed any longer. The Serious Incident Response Scheme will be expanded to establish obligations on approved providers of home care and flexible care in a community setting to report and respond to incidents and to take action to prevent incidents from reoccurring. A new code of conduct will set high standards of behaviour for aged-care workers, approved providers and governing persons of approved providers to ensure they are delivering aged care in a way that is safe, competent and respectful. Improved information-sharing between care and support sector regulators will enable proactive monitoring of cross-sector risks and better protection of consumers and participants from harm. An interim solution for the provision of consent for the use of restrictive practices will also be established while the state and territory consent arrangements are reconsidered.

The bill also includes a series of measures that provide greater transparency and accountability for providers. Star ratings will be published for all residential aged-care services on My Aged Care by the end of 2022. Star ratings will enable senior Australians and their families and carers to make informed decisions about their aged care. From 1 December 2022, approved providers and their governing bodies will be required to meet new responsibilities that will improve governance. Approved providers will be required to notify the Aged Care Quality and Safety Commission of changes to key personnel, and the current disqualified-individual arrangements will be replaced with a broader suitability test. Amendments will also be made to increase financial and prudential oversight in respect of refundable accommodation deposits and bonds, and the functions of the renamed Independent Health and Aged Care Pricing Authority will be expanded to include the provision of advice on healthcare and aged-care pricing and costing.

The bill makes a series of important and urgent changes that will improve the health, safety and wellbeing of older Australians and will assist older Australians and their families to understand the quality of care and operations of providers. As a First Nations senator, I'm particularly interested in ensuring that policy reform and investment to further enhance aged-care access, service and quality is provided for Aboriginal and Torres Strait Islander communities, as well as for other marginalised and disadvantaged communities.

The royal commission's report, with respect to First Nations peoples' experience of the aged-care system, in talking about First Nations people, stated:

They descend from the first inhabitants of the land we now know as Australia, having developed, over millennia, a rich, varied and unique cultural heritage. In contemporary Australia, Elders and older Aboriginal and Torres Strait Islander people are 'cultural knowledge holders'. They provide the 'social glue' within their communities. They are central to the continuation of Aboriginal and Torres Strait Islander cultures and communities.

However, the royal commission raised serious concerns with the level of access and care provided to support our First Nations elders through the aged-care system, saying:

There is strong evidence that Aboriginal and Torres Strait Islander people do not access aged care at a rate commensurate with their level of need …

…   …   …

A combination of factors creates barriers to Aboriginal and Torres Strait Islander people's access to the aged care system. These arise from social and economic disadvantage, a lack of culturally safe care, and the ongoing impacts of colonisation and prolonged discrimination. Access issues are further compounded by Aboriginal and Torres Strait Islander people's additional vulnerability arising from higher rates of disability, comorbidities, homelessness and dementia. To feel secure and obtain culturally safe services, many Aboriginal and Torres Strait Islander people prefer to receive services from Aboriginal and Torres Strait Islander people and from Aboriginal and Torres Strait Islander organisations. However, there are currently not enough Aboriginal and Torres Strait Islander people, and other people with high levels of cultural competency, employed across the aged care system.

…   …   …

Aboriginal and Torres Strait Islander people … experience earlier onset of ageing-related conditions and disability compared to the rest of the Australian population. Long-term health conditions affect 88% of Aboriginal and Torres Strait Islander people over the age of 55 years. Dementia is also more prevalent. By any objective measure, they should be receiving proportionately higher levels of aged and health care.

The current aged care system does not ensure culturally safe care for Aboriginal and Torres Strait Islander people.

The report also states:

After a lifetime of experiencing marginalisation, discrimination, disadvantage and racism, the Elders and the older people descendent of the first inhabitants of this ancient land deserve better than this.

Furthermore, with respect to non-English speaking communities and other disadvantaged communities' experience with the aged-care system, the royal commission's report found:

Older people who migrated to Australia from non-English speaking countries find it hard to access care that meets their cultural and language needs. Older people with disability receiving aged care do not have access to services and supports at the same level as those provided to people through the National Disability Insurance Scheme. Other groups that have experienced trauma, such as veterans, people from LGBTI communities, and care leavers, find it difficult to find care that meets their needs.

This bill, thankfully, begins to make a series of urgent changes that will begin to help improve the health, safety and wellbeing of Aboriginal and Torres Strait Islander elders, as well as those of older Australians from non-English-speaking and other minority groups in the aged-care sector. As outlined by the Victorian Aboriginal Community Controlled Health Organisation, we have a significant opportunity to continue to enhance aged-care services for elders.

The Aboriginal and Torres Strait Islander population is projected to grow by 59 per cent by 2031, but the 65-and-over Aboriginal and Torres Strait Islander population is projected to grow by 200 per cent by 2031—much faster than the population aged zero to 24, which just sits at just 47 per cent. The rapid population growth is even more prevalent in the cohort of Aboriginal Victorians of retirement age, with this cohort projected to increase by 142 per cent by 2031.

Along with the reforms being introduced today, I look forward to advancing a number of the findings and recommendations contained in the royal commission's final report which will work to enhance options, access and care for the increasing number of First Nations people who will require aged care in the coming years. They include the following:

A Commissioner of Aboriginal and Torres Strait Islander Aged Care will oversee the transformation of aged care services for Aboriginal and Torres Strait Islander people and create a new flexibly-funded Aboriginal and Torres Strait Islander run service pathway within the aged care program to deliver culturally safe care.

…   …   …

The pathway should incorporate the best aspects of the National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP), including pooled and flexible funding.

…   …   …

The proposed Aboriginal and Torres Strait Islander aged care pathway should be embedded in a single national system available across Australia, bringing culturally safe and flexible aged care that meets the needs of Aboriginal and Torres Strait Islander people wherever they live.

I look forward to working with my parliamentary colleagues on helping to progress not only the reforms being debated today but also these future reforms, which will help improve aged-care services for First Nations elders.

In this regard, we do not have to start from scratch. Along with the tremendous work that has been undertaken through the royal commission into aged care and the many submissions provided by stakeholders, when it comes to First Nations aged-care needs, we have pre-existing and longstanding models to draw from and build on. Along with the Rumbalara Elders Facility, which is based in the Shepparton region, Aboriginal Community Elders Services, based in Brunswick in Victoria, have for 31 years operated and served the specific needs of First Nations elders across Melbourne's northern region.

ACES was the first Aboriginal residential aged-care facility established in Victoria and was established due to the tireless work of the late Aunty Iris Lovett-Gardiner and other elders both past and present. They were concerned that elders were dying in mainstream nursing homes without any Aboriginal cultural practices being observed. Since opening their doors in 1991, ACES have been providing invaluable and tailored care to generations of elders through culturally appropriate services and engagements.

I had the pleasure of visiting ACES, along with our then shadow minister for ageing, Clare O'Neil, and the federal member for Wills, Peter Khalil, to announce a $2.1 million election commitment to help ACES continue providing improved service for the growing number of First Nations elders. While the $2.1 million commitment has been warmly welcomed by ACES as it will enable them to upgrade their facilities, as only a 25-bed residential aged-care centre, they will continue to require more investment to expand to cater for the growing number of elders anticipated to require culturally tailored care over the coming years.

In this regard, Labor's broader package to support First Nations aged care contains a number of key elements that will assist across the sector, including investing $115 million to build culturally safe aged-care facilities over four years and $106 million to provide face-to-face support for older First Nations people. This also includes implementation of a Trusted Indigenous Facilitators program to build a First Nations workforce to help individual older First Nations people and their families and carers to access aged-care services that meet their physical and cultural needs. In partnership with the federal government, the National Aboriginal Community Controlled Health Organisation will work with Aboriginal community controlled organisations to assist older First Nations people and their families to navigate and access aged-care services. A workforce of around 250 Aboriginal and Torres Strait Islander staff across Australia will provide this trusted support.

This government is committed to delivering aged-care and health services that meet the needs of our elders and enable them to remain close to their homes and connected to their communities. The royal commission into aged care recommended the government 'ensure that the new aged-care system makes specific and adequate provision for the diverse and changing needs of Aboriginal and Torres Strait Islander people', and so we are doing just that.

Labor has a plan to put security, dignity, quality and humanity back into aged care. Only an Albanese Labor government will treat older Australians with the respect that they deserve. I commend this bill to the chamber, and I look forward to advancing these reforms and many others we will progress, particularly to ensure we provide better aged-care services for First Nations elders and elders from multicultural communities.