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Thursday, 24 June 2021
Page: 6


Senator POLLEY (Tasmania) (10:01): I rise to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Bill 2021. This bill will make urgent amendments to the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018 to implement three measures in response to recommendations of the Royal Commission into Aged Care Quality and Safety. In the case of restrictive practices, this bill responds to the independent review of legislative provisions governing the use of restraints in residential aged care.

The royal commission handed down a damning account of the state of Australia's aged-care sector. It's a national disgrace. Scott Morrison is responsible for the aged-care system, he is responsible for the funding cuts and he is responsible for the terrible neglect identified by the royal commission. The Liberals failed to listen to Australians in aged care, to their families and to the workers. The Prime Minister failed to listen to the 22 expert reports and now even the report of his own royal commission. So we argue that this is not 'a once-in-a generation reform to aged care'. The Liberals had ample opportunity to reform the sector, and now I feel that they have fallen short again.

In question time yesterday, we learnt that only 15.6 per cent of residential aged-care staff have been fully vaccinated. They still don't have a register set up to track the number of staff who have been vaccinated. Just a few months ago, aged-care workers were told they will get vaccinated on site in aged-care homes. That never eventuated. The Morrison government also said that aged-care workers would be first in line. Now they're being told that they have to drive hours out of their way in their own time at their own expense. These are some of the lowest-paid workers in this country, yet they're on the front line during this pandemic. They don't necessarily have ready access to transport, and they have other commitments. So these workers should have been able to be vaccinated in their workplaces as a matter of priority. The federal government, the Morrison government, have failed in the rollout of the vaccine program in this country.

But let's go back to the bill. Schedule 1 of this bill makes amendments to further strengthen the legislation on the use of restrictive practices in aged care. The bill defines the term 'restrictive practices' in the Aged Care Act in alignment with the definition applied under the National Disability Insurance Scheme, the NDIS. This is something that Labor welcomes, as the new definition is clearer than the one it replaces and ensures that all restrictive practices are included.

The bill also expands the Aged Care Quality and Safety Commissioner's ability to respond to breaches which approved aged-care providers are responsible for in relation to restrictive practices, which is very important. The commissioner can issue written notices to providers who do not comply with their responsibilities and can also apply a civil penalty order if a provider does not comply with a written notice. The schedule will also provide that the Quality of Care Principles must set out matters in relation to restrictive practices, including when an aged-care provider is able to consider the use of restrictive practices.

While, at first glance, this schedule does provide more guidance, from my work as the chair of the scrutiny of bills committee I'd have to question why a number of key matters and definitions regarding when it is appropriate to use restrictive practices will be left to delegated legislation. It is concerning that matters such as these cannot be scrutinised appropriately by the Senate.

Additionally, this schedule seeks to provide that the Quality of Care Principles may provide that the requirements of the principles do not apply if the use of restrictive practices is necessary in an emergency. This provides the minister with extensive power to determine in delegated legislation when the requirements for the use of restrictive practices no longer apply. I would add that there is also nothing in this bill, on the face of it, which defines what constitutes 'an emergency'. The royal commission specifically heard about the excessive use of physical and chemical restraints in residential aged care which rob older Australians of their dignity and autonomy. Older people with mental health issues—particularly those suffering from later stages of dementia—are often heavily medicated or physically restrained. It is so important that we help prevent the use of restrictive practices and restraints so that older Australians can age with dignity. I still question why the minister has so much discretionary power to determine when it is appropriate and why a definition for 'an emergency' is not in this bill. I would argue that 'administrative flexibility' is not a significant or sufficient response.

The second schedule of this bill will amend the Aged Care Act to empower the Department of Health secretary to conduct reviews. These reviews will ensure the arrangements for the delivery and administration of home services are effective and efficient. The assurance reviews will inform the continuous improvement of the home-care policy and the education of approved aged-care providers. The introduction of these reviews, while not specifically recommended by the aged-care royal commission, is welcomed. However, that is only if they do as described and increase the effectiveness, efficiency and transparency of the home-care system. We know that there are many aged-care providers doing amazing work who are dedicated to the health and wellbeing of those they care for—and it's not just the providers but, more importantly, the workers who are carrying out this care—but we also know that there are far too many providers who are not. It is highly concerning that an additional $17.7 billion will be spent throughout the aged-care sector without what Labor would deem an adequate level of transparency and accountability measures. Every dollar that is spent in the aged-care sector by the government should be going into care and not providers' profits, and we fear that, given the current parameters, this cannot be guaranteed.

The third schedule makes amendments relating to the Aged Care Financing Authority. The government replaced ACFA with a new working group that will report to the National Aged Care Advisory Council. The council was recommended by the royal commission under recommendation 7. Also, it was about time the Liberals overhauled the Aged Care Funding Instrument. We've known for many, many years—for the eight years this Liberal government has been in power—that it was an outdated system and did in fact need replacement. The government has just sat on reports, and this report, in particular, they have had for the last four years. So this government has been dragging its feet, trying to delay putting appropriate levels of funding into the aged-care sector. It then had to call its own royal commission into its own failings and five or six ministers that have had responsibility for aged care in this country in the last eight years. It finally called a royal commission into its own failings.

But it is disappointing to see that the government's response to the royal commission's final report, Neglect, falls short of resolving a number of key issues within the aged-care sector. It will also fail to deliver the improvements and reforms for the long term. Mr Morrison has failed to listen to Australians in the aged-care sector, he's failed to listen to the families and in particular he's failed to listen to the warnings of those people working in this sector.

There have been 22 reports handed down to this government alone, and they've failed to act. Now we see they're still failing to act on all the recommendations of their own royal commission. The Liberals are failing to deliver significant reform. We know that the aged-care workers in this country do a fantastic job. The majority of them are very dedicated, but they're overstretched and they're underpaid. We know that there was an opportunity for this government to put in a recommendation of support to ensure that aged-care workers in this country received a pay rise. But what did the government do? Nothing at all.

We know that the number of aged-care workers will need to almost triple to over a million workers by 2050. How can we attract people into the sector if we are allowing wages to currently stay at $21.09 an hour? How can we improve the care and quality in the aged-care sector if we don't acknowledge that properly remunerated staff are warranted and deserved in this country? Yet they're sending $3.2 billion to providers with basically no strings attached. There is no real guarantee that any of that money will go to provide actual better care, better food and better pay to these workers. That money should not be going into management's fitting-out of their offices. That money needs to go to ensuring that older Australians are treated with dignity and they get the care that they deserve.

This government has also ignored the recommendations of the royal commission to provide a nurse seven days a week, 24 hours a day. Without having appropriately staffed nursing available to them, we see older Australians ending up in accident and emergency, being left in emergency rooms, waiting for hours and hours to be treated. This is not good enough. We need to see the full recommendations, the 250 mandatory care minutes per resident provided in residential aged care. Again, staffing levels are central to many of the areas of quality care problems that we have seen and that have been reported over so many years being rectified.

I am happy to say that the Tasmanian Liberal government yesterday made the announcement that they're putting $3 million into training for aged-care and disability workers. Fantastic. I always acknowledge money that's invested into these areas. But, again, what we aren't seeing is any assurances that we are going to stop what we see as a transient workforce within the aged-care sector. People are using it as a measure to have a job while they're looking for something that pays better wages. What we need to ensure is that we have the best trained, most highly skilled, most motivated and best paid workforce in this sector and in disabilities.

But, if we go to the area of home-care packages, we see the failings of this government under Scott Morrison, who used this sector as his own personal ATM. He left minister after minister who has failed in this sector day in, day out. He reappointed Senator Colbeck as the minister with responsibilities in this area. I must say, most of the real decisions have been made by Minister Hunt. What is left is somebody who we have seen demonstrate failure to be across the issues in this chamber every single time he's asked a question in relation to aged care or vaccination of older Australians and aged-care workers. This government has failed to deliver home-care packages in a timely manner to people who have been assessed as needing the highest care in this country, the level 4 package. They have announced more money to go into aged-care packages but they've done nothing to ensure that there are aged-care workers who can deliver level 4 and level 3 care in a timely manner.

This is a government that uses smoke and mirrors. They like to make these announcements but they are never there for the follow-up. As a former Treasurer, Scott Morrison is responsible for taking out billions of dollars. Time and time again he has used this sector as his own ATM and spent that money in other areas. Now we are in a crisis. We have been in a crisis for the last eight years. We've seen this government fail to turn this around at every opportunity. They failed so much that they had to call a royal commission into their own failings. That's how good this government is! Mr Morrison says to the Australian people, 'Aged care is a priority.' Well, I would hate to see what this Prime Minister would do if this weren't a priority, because it's a bungled system that has been gutted by this government. (Time expired)