Aged Care and other Legislation Amendment Bill 2022

Ms WELLS (Lilley-Minister for Aged Care and Minister for Sport) (11:24): I move:

That this bill be now read a second time.

I introduce the Aged Care Amendment (Implementing Care Reform) Bill 2022.

This bill, along with the one that I will introduce next, begins the process of returning security, dignity, quality and humanity back into aged care.

This bill puts nurses back in nursing homes.

This bill ensures more carers have more time to care.

This bill improves transparency, integrity and accountability and caps the fees paid for home care.

This bill adds to our response to the royal commission.

A royal commission that should not have been needed, for a sector that should not have been left to decay, for older Australians who should not have been left in this state of neglect.

This bill delivers on our commitments.

But it also does much more.

This morning, this government, this parliament, begins delivering on our promise.

A promise we all made upon entering this place.

A promise I made in my first speech three years ago.

A promise to ask and answer the question challenged to us by Jonas Salk-to ask ourselves every day, ‘Am I being a good ancestor?’

Being a good ancestor means leaving places better than we found them. It means using the tremendous power, privilege and opportunity of being in this chamber, and indeed of being in government, for the betterment of others.

Good ancestors can spot a unique thicket in history where change becomes possible, where a gap opens up distance enough that some meaningful reform can occur.

Rarer moments still can leave things better for those who follow, while also making them better for those here with us today.

The parliament has before it one of those rare moments.

We have the opportunity and the responsibility to make the lives of our ancestors, of our parents, of our grandparents, of our oldest Australians, lives lived with care.

For me this bill is about Pat and Jack.

It is about Raff and Bec.

It is about the people who live at Emmy Monash.

It is about Cody and Teresa.

It is about Lynda and Veda.

Pat and Jack Cook met in Cairns on Christmas Day in 1949.

Pat said they were best friends from that day on. That simple. They met, they were best mates. They were married in 1951, just shy of Pat’s father’s plea for at least two years of courtship.

Then came the big move south to Zillmere in Brisbane’s north side in the 1960s to work at the Golden Fleece petrol station and raising children from the Nudgee Orphanage.

In more recent years, Jack, living with dementia, received a home care package.

I brought the now Prime Minister to meet Pat and Jack earlier this year.

The Prime Minister and I listened to their story. What had worked well for their home care package, what had not. How the system interacted with them well and how it had not.

We promised them that, if we were lucky enough to get the support of the Australian people, we would do our best to ensure that aged care, including home care, gets better.

I visited them at the Prince Charles Hospital with the twins just after the election to give them the good news that we had won-and to renew that promise.

It’s a promise not just to have the best service, the right funding and the best administration mix for a big government program.

It is a promise that is about restoring humanity to our provision of care.

A promise to be that good ancestor, to deliver what we said we’d do for everyone in all parts of aged care.

I saw Pat on Friday. We talked while my daughter Celeste admired and administered care upon Pat’s collection of porcelain dolls.

I went to pay my respects. Jack, her best friend of 73 years and husband of 71, had passed away since I’d last visited them in the hospital those eight weeks earlier.

When I told her what I was going to be doing today she shared something special with me.

This is a picture of Pat and Jack on their wedding day.

It has stood proudly in their home, witnessing many happy moments over 71 years.

I am honoured that today it can now witness this parliament seizing the moment for better home care.

For Pat and especially for Jack I can advise the House that this bill will mean that the government can cap administration and management costs for people receiving home care.

Currently, approaches to charging differ across providers. While providers are required to publish prices for care and package management, there is little transparency about how these prices are set and there is no cap on the amount that can be charged.

That ends with this bill.

This bill is about Raff and Bec.

Raff has been an aged-care worker for 20 years in Sydney, alongside Bec. Both are incredibly hardworking professionals in their field of care.

Good reform starts by listening.

I met both of them at a roundtable I convened last week with the Health Services Union.

We spoke about how hard their work is, how challenging it is.

We also spoke about their sheer, bloody-minded determination to do their absolute best for those in their care.

Against the odds, within a system crumbling into crisis before a pandemic that made everything hard even harder.

Raff just managed to hold back her tears as she told me, ‘These poor people deserve to be treated properly, they deserve to be respected.’

Bec pulled a 20-hour shift recently. Twenty hours.

During a COVID outbreak they were so stretched that she couldn’t provide showering services to the people in their care.

To hear these two proud, caring dedicated women, not broken, but badly under pressure, was deeply moving for me.

To Bec and Raff I’m pleased to say to you that an Albanese Labor government wants to see you get a pay rise.

Within my first 20 hours as minister I wrote, with the Minister for Health and Aged Care, to the Fair Work Commission seeking leave to make a submission in the pay value case.

By 8 August the minister for industrial relations, the minister for health and myself will make that submission.

We will advocate for all workers to be valued and for their pay to reflect that.

Further, I can say that, relying on powers in the Aged Care Act, the Albanese Labor government will progress subordinate legislation in parallel with this bill to mandate more time for care.

Under that legislative instrument everyone living in a residential aged-care facility will receive an average of 200 minutes per day of care by 1 October 2023, and an average of 215 minutes of care per day by 1 October 2024.

I am working closely with providers, unions, advocates, the allied health sector and, most importantly, the people receiving and giving care, on the detail of this regulation.

Bec joins us in the gallery today, another witness to this parliament finally taking action to return care, to support some of the hardest working Australians and to start to make this system a little bit better.

It brings us to the magnificent team at Emmy Monash in Melbourne.

Two weeks ago I visited Emmy Monash with my dear friend the member for Macnamara.

For the past 12 years that aged-care home has provided nursing care around the clock.

That’s what Emmy Monash’s CEO, Tanya Abramzon, an amazing migrant from Ukraine, who trained as a nurse herself, just called ‘a no-brainer’.

This bill takes that no-brainer idea from Emmy Monash and makes it the standard for all aged-care homes in Australia.

As the member for Macnamara and I walked and spoke with older Australians, and even joining them for some morning exercise and some light crafts, all I could think about was my thrilled anticipation that, in just a fortnight, this place would be making their standard everyone’s reality.

I know that Tanya is watching us this morning online from Emmy Monash-another witness to the importance of what we are doing here today.

This bill is for registered nurse Cody, who I met two weeks ago.

Cody told me how he doesn’t think that clinical staff get enough recognition for the acute services they provide in residential aged care.

He told me what I’ve seen myself as I visited homes around the country, from Gladstone to Melbourne to Burwood: the case load of residential aged care has changed so much from the origins as lifestyle homes with long-term stays to becoming shorter-and-shorter-term acute care, with increasingly high numbers of dementia care.

To Cody, I say: ‘I hear you and I hear the voices of your fellow nurses. I hear the voices of the people in your care who are coming into residential care for acute needs and for high clinical service.’

I say to those people and to the House that schedule 1 of this bill introduces a new responsibility for approved providers of residential care and of specified kinds of flexible care.

From 1 July 2023, these providers will need to have a registered nurse onsite and on duty at each residential facility for 24 hours a day, seven days a week.

The schedule includes a mechanism for exemptions or conditions to be specified in subordinate legislation.

I commenced consultation with unions, providers, advocates and people in care in late June on these measures and these exemption details will be specified following that body of work and any inquiry the Senate may choose to conduct.

Cody and his colleagues today bear witness to this reform.

This bill is for Teresa, a home care worker I met who told me to take on the royal commission report to, in her words, ‘dig it up, dust it off and let’s get working’.

Teresa-we could not agree more.

The government is committed to improving transparency, integrity and accountability in aged care.

The royal commission found that ‘a lack of transparency is a pervasive feature of the current aged care system’.

Former Treasury secretary Ken Henry told the commission:

… the sector is not very transparent. I mean, as a client of the system, you wouldn’t know the relationship between what you’re paying for and how much it’s costing the provider …

The government agrees.

To enact recommendation 88 of the royal commission we are not just going to expect greater transparency; we are going to mandate it.

I can inform the House that the amendments in schedule 3 will ensure that older Australians have access to more and better information on aged-care services and providers, including how much money is spent on their care.

This will empower older Australians to make more informed decisions about their care and will strengthen integrity and accountability of providers and incentivise good practice.

Every single member of parliament would have heard stories where aged care has not met our expectations.

The royal commission report is riddled with examples of people whose lives were up-ended by astronomical fees, by home care packages that were eaten up in administration costs and management charges that reduced care instead of aiding it.

Stories like Lynda Henderson from Gerringong on the New South Wales South Coast.

She told the royal commission her dear friend Veda had paid administration fees of up to 34 per cent.

She is now a fierce advocate for older Australians.

She wrote in her submission to the royal commission how Veda had been invited to share some words about her rare form of dementia with the World Health Organization.

Veda had Lynda write that, ‘All I want from dementia is love, and to learn something.’

Lynda said, ‘This “dementia community” is remarkable.’

How could you not agree with that?

I let Lynda know about today’s bills and asked her to watch along. She bears witness to our work today in the House.

Mr Speaker, I say to you and to Lynda that schedule 2 of this bill will enable the government to reduce the high level of administration and management charges for home care.

It will remove providers’ ability to charge care recipients for ceasing care-the so-called exit fees.

This bill is for Pat and Jack. It’s for Raff and Bec. It’s for all the team at Emmy Monash. It’s for Cody and Teresa.,

It’s for Lynda and for Veda.

The royal commission challenged us to be better and to do better.

The royal commission said this:

Every single provider should be thinking about, and talking with the older people in their care and their workforce about, what they need to do to improve their care and to make a genuine difference to the lives of older people.

The rewards will be immeasurable.

The same challenge applies to government and to parliament.

The results can truly be immeasurable.

If we do more, if we listen more, if we take hold of the challenges and strive-then we can truly call ourselves good ancestors.

I commend the bill to the House.

Debate adjourned.