Royal Commission into Aged Care Quality and Safety Interim Report

December 02, 2019

I move: That this House:
(1) notes:

(a) that the Royal Commission into Aged Care Quality and Safety handed down its interim report on 31 October 2019;

(b) the commissioners identified three areas where there is a need for urgent action—these include, to:

(i) provide more home care packages to reduce the waiting list for higher level care at home;

(ii) respond to the significant over-reliance on chemical restraint in aged care, including through the seventh community pharmacy agreement; and

(iii) stop the flow of younger people with disability going into aged care and expediting the process of getting those younger people who are already in aged care out;

(2) recognises:

(a) the commissioners stated in the interim report that they did not see any reason to delay action on these three areas;

(b) the Government’s own Royal Commission report stated it is ‘neglect’ to not provide more home care packages;

(c) the commissioners stated in the interim report that they have been alarmed to find that many people died while waiting for a home care package while others prematurely move into residential care;

(d) the commissioners also stated that funding should be forthcoming from the Government to ensure the timely delivery of home care services;

(e) more than 16,000 older Australians died waiting for their approved home care package they were assessed for in 2017-18—sadly, that was around 300 older Australians that died each week in that year waiting for care; and

(f) more than 14,000 older Australians entered residential aged care prematurely because they couldn’t get the care they were assessed and approved for in 2017-18—sadly, that was around 200 older Australians each week having no other choice but to enter residential aged care; and

3) calls on the Government to take urgent action immediately and respond to the three areas included in the Royal Commission’s interim report.

When your own royal commission describes as 'neglect' the Morrison government's failure to provide more home care packages to support elderly Australians staying in their own home, you know you're facing a crisis.

The commissioners, in their interim report, say they can't see any reason why action should be delayed in this area and in two other areas, the over-reliance on chemical restraint in aged care, and the appalling situation of younger people with a disability going into aged care. If members have spoken to anyone involved in the sector—from residents to family members, to staff, volunteers and even operators—you could have predicted that we were well overdue for some tangible action in each of these areas. Yet you could almost blink and miss the government's response on in-home care. A mere 10,000 additional home care packages have been announced.

Let's put this in perspective. There are 120,000 older Australians waiting for home care. They've been assessed. They've been approved. Now what they're waiting for is for a package to become available. What does that actually mean? It means that someone who currently has a package at the level that they require has to either go into an aged-care facility and no longer need that package or, if they die, the package becomes available. That's what people on the waiting list are waiting for in lieu of a significant additional investment by this government.

There is simply not sufficient funding in the home care package system to meet the need—and 10,000 makes such a tiny difference. I recall when a similar announcement was made about a small increase in the number of available packages, and Thelma, from Blaxland, who is in her mid-90s, called me to say she had naively thought it might improve her chances of receiving the small amount of assistance that she requires—a level 1 package. She said she phoned the department to see if it would make any difference to the year-long wait that she'd been told to expect, and they broke the news to her that it wouldn't make any difference—none at all. There's no guarantee this latest miserly package will make a difference either. When I last spoke with Thelma, she was still waiting, joking that she'd be dead before it came through. Sadly, that isn't a joke, because 16,000 elderly people died in just one year waiting for home care.

I think what angers me most is the rhetoric from this Prime Minister about how he values older Australians, and yet his actions do not match his words. In his first budget as Treasurer, this was the man who ripped $1.2 billion from aged care. This is the man who has failed to act as the waiting list for home care grew from 88,000 to 120,000. And this is the man who ignores advice from the Department of Health—as recently as April, in the lead up to the last budget, that provided advice on how to fix the home care crisis, yet did absolutely nothing.

It's a similar story for the efforts being made to address the issue of younger people in aged care. The Morrison government, less than a month ago, claimed it was doing 'enough', despite the royal commission's demand for increased action. The minister for the NDIS must have missed the criticism of the government, as the commissioners described the issue as a 'national embarrassment' and a 'human rights issue'. How's this for an assessment of the government's action plan, released in March: significant gaps, lacks ambition and should not be relied on as a solution—the commission's words, not mine.

We will be closely monitoring the response of this government to the overuse of chemical restraint to ensure that it is actually an effective response. I personally believe a much more significant approach is going to be needed to change the practices in aged-care facilities, and I believe it will go to the heart of the problem, staffing levels and resources. I want to finish on that point. Aged-care operators themselves tell me that it is really tough to run a high-quality operation with the cuts to ACFI funding, which mean facilities have to do the same with less. More able residents raise with me things like the quality of food and general standards. And I've had a steady flow of feedback about the quality of places available around the state from families currently looking for suitable residential care for either a partner or a parent. Clearly, we are not consistently treating elderly people with respect and dignity, and the stories of the royal commission tell us that in too many cases it is not even humane. The government can't just do enough; it has to do more than that.