Division Description Changes — Bills — Aged Care Amendment (Implementing Care Reform) Bill 2022; Second Reading — 8th Sep 2022

Change	Division
representatives vote 2022-09-08#1 Edited by mackay staff on 2022-09-17 10:29:00	Title Bills — Aged Care Amendment (Implementing Care Reform) Bill 2022; Second Reading Aged Care Amendment (Implementing Care Reform) Bill 2022 - Second Reading - Small and regional facilities Description ~~<p class="speaker">Michelle Landry</p>~~ <p>All Australians want and expect our older Australians to be well supported and catered for in our community, including in residential aged-care homes. That is why in government the coalition called the Royal Commission into Aged Care Quality and Safety: to ensure our oldest and most vulnerable Australians receive care that supports and respects their dignity and recognises the important contribution they make to society. The final report of the royal commission makes 148 recommendations following 23 public hearings over 99 days, 641 witnesses and over 10,000 public submissions. They are the product of wise and compassionate scrutiny of Australia's aged-care system.</p> *The majority voted in favour of disagreeing* with an [amendment](https://www.openaustralia.org.au/debate/?id=2022-09-07.23.1) to [another amendment](https://theyvoteforyou.org.au/divisions/representatives/2022-09-08/2) moved by Deputy Leader of the Opposition and Farrer MP [Sussan Ley](https://theyvoteforyou.org.au/people/representatives/farrer/sussan_ley) (Liberal). Because this motion passed, the amendment to the amendment failed and the original motion will remain unchanged. This amendment to the amendment was introduced by Mayo MP [Rebekha Sharkie](https://theyvoteforyou.org.au/people/representatives/mayo/rebekha_sharkie) (Centre Alliance), who [explained that](https://www.openaustralia.org.au/debate/?id=2022-09-07.23.1) her amendment: > calls on the government to take into account ... that smaller and regional* residential aged-care providers which are experiencing critical workforce shortages have flexibility.* ### Amendment to the amendment text > That all words after "whilst" be omitted with a view to substituting the following words: > > "the House: > *> (1) has concerns that the bulk of the substantive measures comprising the bill are to be detailed in subordinate rather than in primary legisla*tion; and > *> (2)** calls on the Government to* > *>> (a) provide an opportunity to review the Quality of Care Principles, User Rights Principles and Information Principles proposed to be made under the** Aged Care Act 1997;* >> *>> (b) include in the** Quality of Care Principles under Schedule 2 criteria for the exercise of exemption powers which provide for smaller and regional providers taking into account critical workforce shortages among other considerations; and* >> *>> (c) specify in Information Principles under Schedule 3 financial and non-financial information of value to older** Australians, their families and the community that must be published by the Secretary, including:* >> *>>> (i) expenditure on care, nursing, food, maintenance, cleaning** and administration;* >>> >>> (ii) profits; >>> >>> (iii) payments such as rent to third parties; and >>> >>> (iv) expenditure on executive salaries". ### Original amendment text *> That all words after "That" be omitted with a view to substituting** the following words:* > *> "whilst not declining to give the bill a second reading,** the House:* > > (1) notes that, of the aged care providers who do not currently have a registered nurse on site, and on duty, at all times, 53% are based in regional and remote areas and 86% are small providers; and > > (2) calls on the Government to ensure that: > *>> (a) when amend*ing the Quality of Care Principles to make provision for an exemption to the new responsibility relating to registered nurses, the disproportionate impact on providers in regional and remote areas, especially small providers, is taken into account; and >> *>> (b) further consideration of the bill is deferred until two sitting days after a draf*t of legislative instruments relating to the following matters are made available: >>> *>>> (i) exemption from the responsibility related to registered nurses as proposed in section 54-1A** of the bill; and* >>> *>>> (ii) information about** aged care services that must be publicly available as proposed in section 86-10 of the bill".* <p>In response to the royal commission, the coalition committed $19.1 billion to a five-year plan to improve aged care, with new home care packages, respite services, training places, retention bonuses and infrastructure upgrades. The opposition remains committed to supporting the health, safety and wellbeing of older Australians and understands the important role that aged-care providers, care workers and nurses play in ensuring this support is provided in residential aged-care settings.</p> <p>Speaking to this bill hits very close to home for me. My father, who is 86 years old, is in the aged-care system at the moment, and I understand what the families are going through when it comes to aged care. I want to thank all the aged-care staff that are looking after him for their tireless work in making him comfortable. While I'm visiting him, families of other residents and patients grab me in the hallways to share their experiences, telling me about their own dire situations. They ask me for help to find doctors for their parents or elderly loved ones. Tragically, some are telling me about their mums and dads dying in agony waiting for a visit from a doctor. In some cases they are given Panadol for pain they're experiencing while they wait, and then they pass away.</p> <p>I recently met with the CEO of Benevolent Living aged care, Alison Moss, about the issues they are facing delivering aged-care services in Rockhampton. They are struggling to provide quality care due to a lack of staff. They have 22 beds available in their newly built and state-of-the-art facility, but, due to struggles with staff and shortages of doctors and nurses, these beds are unable to be filled. I have also recently been notified that Access Aged Care, a provider offering clinical services to residents in residential aged-care facilities, will soon be withdrawing its services from Rockhampton. Despite intense recruitment efforts, Access Aged Care has been unable to secure the services of GPs in Rockhampton to support its care model and, as a result, will no longer be providing services. This has the potential to impact emergency departments as residents can no longer be treated on site at their facility and will be taken to the emergency department for treatment. This will affect approximately 170 residents in the local area.</p> <p>A&E at Rockhampton Hospital faces constant ambulance ramping at a rate of 45 per cent, one of the worst ambulance ramping rates in Queensland. Shortages of doctors and nursing homes mean the elderly are being sent to A&E for scripts or check-ups, which could be done by a GP in a nursing home. This is clogging up the system.</p> <p>We were told this government was going to listen, they were going to consult and they were going to care. I heard the slogans constantly during the election. They recited over and over again 'Medicare, aged care, we care.' Unfortunately, on multiple occasions I have sent correspondence to the Minister for Aged Care, Anika Wells, about the terrible state of aged care in Capricornia, about Access Aged Care pulling out of the PHN and to make her aware of a bipartisan aged-care forum I hope to host in Rockhampton and that she would be more than welcome to attend. To date I have not received a single response. This is shameful behaviour of the minister, and I implore her to stop playing politics with this important issue. The minister would be well served to remember that aged care is too important for politics.</p> <p>The Aged Care Amendment (Implementing Care Reform) Bill 2022 contains three schedules amending the Aged Care Act 1997. Schedule 1 establishes a new responsibility for providers of residential aged care to ensure that a registered nurse is on site 24 hours a day, seven days a week, by July 2023. Schedule 2 of the bill introduces a new power to enable the government to cap fees that approved home-care providers may charge care recipients and removes the home-care providers' ability to charge exit amounts. Schedule 3 of the bill introduces a new requirement for the Secretary of the Department of Health and Aged Care to publish additional information in relation to aged-care providers and their costs, with the aim of allowing older Australians and their families to make more informed care decisions.</p> <p>The opposition urges the Labor government to continue generational reform of the aged-care system for the benefit of all Australians, and to stop playing political games with older Australians and their families. Our nurses have worked tirelessly on the front line through the COVID-19 pandemic, protecting lives and keeping Australians safe. We especially recognise the amazing support that nurses provide our older Australians, particularly their critical work in aged-care homes since the outbreak of the pandemic. We know these were not easy times, yet our nurses stood up when it mattered most to protect so many older Australians, and we are grateful for their work.</p> <p>The opposition have grave concerns regarding the extreme use of unreleased subordinate legislation by the government. Instead of containing adequate complexity and information, this bill does not actually outline the necessary details on how it will impact aged-care providers in practice. The opposition considers this bill more of a legislative framework than detailed legislation. The lack of detail within the legislation and the lack of ability for parliamentary scrutiny of its subordinate legislation are serious concerns for the parliament and for the aged-care sector. These concerns were echoed by many stakeholders and witnesses who appeared at the Community Affairs Legislation Committee inquiry into the bill. The government must listen to the concerns raised by the witnesses at the inquiry and the stakeholders who will affected by this legislation.</p> <p>Schedule 1 of this bill allows the government to implement the employment of registered nurses in residential aged-care facilities on a 24-hour basis by July 2023; however, this time line is not consistent with the royal commission's final report, which recommended making it mandatory to have a registered nurse on site 24 hours a day from July 2024, with an accompanying minimum care minutes requirement. The opposition notes the unique challenges faced by aged-care providers in rural and regional Australia, particularly regarding access to the registered nurse workforce. The royal commission considered a range of factors when recommending that time line, recognising the current workforce shortages and the time required to train or access the necessary additional workforce.</p> <p>Given the government have brought the start date of this recommendation forward by a year, they must specifically outline what support will be provided to regional and rural providers and other providers already struggling with viability and workforce challenges. The government must outline how they plan to get the additional nurses into aged-care homes in regional and rural aged-care facilities, following their jobs summit. The opposition supports the royal commission's recommendation on 24/7 RNs in aged-care facilities where it is possible by 2024 and in line with the royal commission recommendation.</p> <p>The opposition also calls on the government to provide oversight of the delegated legislation that puts in place the mechanism and details of possible exemptions. The government has not been transparent with any of the details of this exemption clause. This lack of transparency creates uncertainty for providers, who are already under stress from the COVID-19 pandemic. This information is particularly critical for rural and regional providers, who are likely to be subject to significant difficulties in finding the additional workforce to meet the requirement within the time frame set by this bill.</p> <p>I'll now speak to schedule 2. The former Minister for Health, Greg Hunt, and the former Minister for Senior Australians and Aged Care Services, Senator Colbeck, required, for the first time, that information be published relating to the median prices charged for home-care services, increasing the transparency on home-care prices. This bill now enables the government to cap charges that approved home-care providers can charge care recipients and removes home-care providers' ability to charge exit amounts. The opposition supports these reforms, as they are sensible amendments broadly supported by the sector. We remain committed to ensuring downward pressure on home-care prices and older Australians being able to make informed decisions about aged-care services.</p> <p>Speaking on schedule 3, the opposition agrees that we need more transparency in the aged-care sector to ensure older Australians and their families are able to make informed care decisions. That is why in government we introduced substantial reforms to increase transparency, including from 1 July 2019 requiring all home-care providers to publish their pricing information in a standardised schedule published on the My Aged Care website, providing greater visibility of median prices, and investing in the My Aged Care website to ensure that older Australians and their families are able to easily access and compare information about aged-care providers. The publication of additional information to increase sector transparency and to increase consumer understanding of this sector is supported by the opposition. I believe that more information assists in making more-informed choices.</p> <p>The coalition has a proud and constructive history of delivering for the aged-care sector. The coalition's 2022-23 budget delivered funding for aged-care reform of $522 million, which built on the funding contained in the previous budget. This brought our total investment in response to the final report of the royal commission to more than $19.1 billion. Our 2022-23 budget responded to 10 recommendations of the royal commission and built on our existing five pillars of aged-care reform. We delivered record investment across the aged-care system over the forward estimates—from $13.3 billion in 2012-13 under Labor to $30.1 billion in 2022-23 under the coalition. By 2025-26, funding in aged care was estimated to grow to $34.7 billion per year under the coalition.</p> <p>We also remain committed to providing our older Australians support to live in their own homes for longer. That is why we increased new home-care packages from 60,308 under Labor in 2012-13 to 275,597 in 2024-25, an increase of 357 per cent. We are currently in the second year of the five-year plan and it is imperative that the government now continue our work to support the aged-care sector. I also implore the Labor government again not to play politics with aged care. People like my father and the families I meet deserve better.</p> ~~<p class='motion-notice motion-notice-truncated'>Long debate text truncated.</p>~~

~~Michelle Landry~~
All Australians want and expect our older Australians to be well supported and catered for in our community, including in residential aged-care homes. That is why in government the coalition called the Royal Commission into Aged Care Quality and Safety: to ensure our oldest and most vulnerable Australians receive care that supports and respects their dignity and recognises the important contribution they make to society. The final report of the royal commission makes 148 recommendations following 23 public hearings over 99 days, 641 witnesses and over 10,000 public submissions. They are the product of wise and compassionate scrutiny of Australia's aged-care system.
The majority voted in favour of *disagreeing* with an [amendment](https://www.openaustralia.org.au/debate/?id=2022-09-07.23.1) to [another amendment](https://theyvoteforyou.org.au/divisions/representatives/2022-09-08/2) moved by Deputy Leader of the Opposition and Farrer MP [Sussan Ley](https://theyvoteforyou.org.au/people/representatives/farrer/sussan_ley) (Liberal). Because this motion passed, the amendment to the amendment failed and the original motion will remain unchanged.
This amendment to the amendment was introduced by Mayo MP [Rebekha Sharkie](https://theyvoteforyou.org.au/people/representatives/mayo/rebekha_sharkie) (Centre Alliance), who [explained that](https://www.openaustralia.org.au/debate/?id=2022-09-07.23.1) her amendment:
> *calls on the government to take into account ... that smaller and regional residential aged-care providers which are experiencing critical workforce shortages have flexibility.*
### Amendment to the amendment text
> *That all words after "whilst" be omitted with a view to substituting the following words:*
>
> *"the House:*
>
> *(1) has concerns that the bulk of the substantive measures comprising the bill are to be detailed in subordinate rather than in primary legislation; and*
>
> *(2) calls on the Government to*
>
>> *(a) provide an opportunity to review the Quality of Care Principles, User Rights Principles and Information Principles proposed to be made under the Aged Care Act 1997;*
>>
>> *(b) include in the Quality of Care Principles under Schedule 2 criteria for the exercise of exemption powers which provide for smaller and regional providers taking into account critical workforce shortages among other considerations; and*
>>
>> *(c) specify in Information Principles under Schedule 3 financial and non-financial information of value to older Australians, their families and the community that must be published by the Secretary, including:*
>>
>>> *(i) expenditure on care, nursing, food, maintenance, cleaning and administration;*
>>>
>>> *(ii) profits;*
>>>
>>> *(iii) payments such as rent to third parties; and*
>>>
>>> *(iv) expenditure on executive salaries".*
### Original amendment text
> *That all words after "That" be omitted with a view to substituting the following words:*
>
> *"whilst not declining to give the bill a second reading, the House:*
>
> *(1) notes that, of the aged care providers who do not currently have a registered nurse on site, and on duty, at all times, 53% are based in regional and remote areas and 86% are small providers; and*
>
> *(2) calls on the Government to ensure that:*
>
>> *(a) when amending the Quality of Care Principles to make provision for an exemption to the new responsibility relating to registered nurses, the disproportionate impact on providers in regional and remote areas, especially small providers, is taken into account; and*
>>
>> *(b) further consideration of the bill is deferred until two sitting days after a draft of legislative instruments relating to the following matters are made available:*
>>>
>>> *(i) exemption from the responsibility related to registered nurses as proposed in section 54-1A of the bill; and*
>>>
>>> *(ii) information about aged care services that must be publicly available as proposed in section 86-10 of the bill".*
In response to the royal commission, the coalition committed $19.1 billion to a five-year plan to improve aged care, with new home care packages, respite services, training places, retention bonuses and infrastructure upgrades. The opposition remains committed to supporting the health, safety and wellbeing of older Australians and understands the important role that aged-care providers, care workers and nurses play in ensuring this support is provided in residential aged-care settings.
Speaking to this bill hits very close to home for me. My father, who is 86 years old, is in the aged-care system at the moment, and I understand what the families are going through when it comes to aged care. I want to thank all the aged-care staff that are looking after him for their tireless work in making him comfortable. While I'm visiting him, families of other residents and patients grab me in the hallways to share their experiences, telling me about their own dire situations. They ask me for help to find doctors for their parents or elderly loved ones. Tragically, some are telling me about their mums and dads dying in agony waiting for a visit from a doctor. In some cases they are given Panadol for pain they're experiencing while they wait, and then they pass away.
I recently met with the CEO of Benevolent Living aged care, Alison Moss, about the issues they are facing delivering aged-care services in Rockhampton. They are struggling to provide quality care due to a lack of staff. They have 22 beds available in their newly built and state-of-the-art facility, but, due to struggles with staff and shortages of doctors and nurses, these beds are unable to be filled. I have also recently been notified that Access Aged Care, a provider offering clinical services to residents in residential aged-care facilities, will soon be withdrawing its services from Rockhampton. Despite intense recruitment efforts, Access Aged Care has been unable to secure the services of GPs in Rockhampton to support its care model and, as a result, will no longer be providing services. This has the potential to impact emergency departments as residents can no longer be treated on site at their facility and will be taken to the emergency department for treatment. This will affect approximately 170 residents in the local area.
A&E at Rockhampton Hospital faces constant ambulance ramping at a rate of 45 per cent, one of the worst ambulance ramping rates in Queensland. Shortages of doctors and nursing homes mean the elderly are being sent to A&E for scripts or check-ups, which could be done by a GP in a nursing home. This is clogging up the system.
We were told this government was going to listen, they were going to consult and they were going to care. I heard the slogans constantly during the election. They recited over and over again 'Medicare, aged care, we care.' Unfortunately, on multiple occasions I have sent correspondence to the Minister for Aged Care, Anika Wells, about the terrible state of aged care in Capricornia, about Access Aged Care pulling out of the PHN and to make her aware of a bipartisan aged-care forum I hope to host in Rockhampton and that she would be more than welcome to attend. To date I have not received a single response. This is shameful behaviour of the minister, and I implore her to stop playing politics with this important issue. The minister would be well served to remember that aged care is too important for politics.
The Aged Care Amendment (Implementing Care Reform) Bill 2022 contains three schedules amending the Aged Care Act 1997. Schedule 1 establishes a new responsibility for providers of residential aged care to ensure that a registered nurse is on site 24 hours a day, seven days a week, by July 2023. Schedule 2 of the bill introduces a new power to enable the government to cap fees that approved home-care providers may charge care recipients and removes the home-care providers' ability to charge exit amounts. Schedule 3 of the bill introduces a new requirement for the Secretary of the Department of Health and Aged Care to publish additional information in relation to aged-care providers and their costs, with the aim of allowing older Australians and their families to make more informed care decisions.
The opposition urges the Labor government to continue generational reform of the aged-care system for the benefit of all Australians, and to stop playing political games with older Australians and their families. Our nurses have worked tirelessly on the front line through the COVID-19 pandemic, protecting lives and keeping Australians safe. We especially recognise the amazing support that nurses provide our older Australians, particularly their critical work in aged-care homes since the outbreak of the pandemic. We know these were not easy times, yet our nurses stood up when it mattered most to protect so many older Australians, and we are grateful for their work.
The opposition have grave concerns regarding the extreme use of unreleased subordinate legislation by the government. Instead of containing adequate complexity and information, this bill does not actually outline the necessary details on how it will impact aged-care providers in practice. The opposition considers this bill more of a legislative framework than detailed legislation. The lack of detail within the legislation and the lack of ability for parliamentary scrutiny of its subordinate legislation are serious concerns for the parliament and for the aged-care sector. These concerns were echoed by many stakeholders and witnesses who appeared at the Community Affairs Legislation Committee inquiry into the bill. The government must listen to the concerns raised by the witnesses at the inquiry and the stakeholders who will affected by this legislation.
Schedule 1 of this bill allows the government to implement the employment of registered nurses in residential aged-care facilities on a 24-hour basis by July 2023; however, this time line is not consistent with the royal commission's final report, which recommended making it mandatory to have a registered nurse on site 24 hours a day from July 2024, with an accompanying minimum care minutes requirement. The opposition notes the unique challenges faced by aged-care providers in rural and regional Australia, particularly regarding access to the registered nurse workforce. The royal commission considered a range of factors when recommending that time line, recognising the current workforce shortages and the time required to train or access the necessary additional workforce.
Given the government have brought the start date of this recommendation forward by a year, they must specifically outline what support will be provided to regional and rural providers and other providers already struggling with viability and workforce challenges. The government must outline how they plan to get the additional nurses into aged-care homes in regional and rural aged-care facilities, following their jobs summit. The opposition supports the royal commission's recommendation on 24/7 RNs in aged-care facilities where it is possible by 2024 and in line with the royal commission recommendation.
The opposition also calls on the government to provide oversight of the delegated legislation that puts in place the mechanism and details of possible exemptions. The government has not been transparent with any of the details of this exemption clause. This lack of transparency creates uncertainty for providers, who are already under stress from the COVID-19 pandemic. This information is particularly critical for rural and regional providers, who are likely to be subject to significant difficulties in finding the additional workforce to meet the requirement within the time frame set by this bill.
I'll now speak to schedule 2. The former Minister for Health, Greg Hunt, and the former Minister for Senior Australians and Aged Care Services, Senator Colbeck, required, for the first time, that information be published relating to the median prices charged for home-care services, increasing the transparency on home-care prices. This bill now enables the government to cap charges that approved home-care providers can charge care recipients and removes home-care providers' ability to charge exit amounts. The opposition supports these reforms, as they are sensible amendments broadly supported by the sector. We remain committed to ensuring downward pressure on home-care prices and older Australians being able to make informed decisions about aged-care services.
Speaking on schedule 3, the opposition agrees that we need more transparency in the aged-care sector to ensure older Australians and their families are able to make informed care decisions. That is why in government we introduced substantial reforms to increase transparency, including from 1 July 2019 requiring all home-care providers to publish their pricing information in a standardised schedule published on the My Aged Care website, providing greater visibility of median prices, and investing in the My Aged Care website to ensure that older Australians and their families are able to easily access and compare information about aged-care providers. The publication of additional information to increase sector transparency and to increase consumer understanding of this sector is supported by the opposition. I believe that more information assists in making more-informed choices.
The coalition has a proud and constructive history of delivering for the aged-care sector. The coalition's 2022-23 budget delivered funding for aged-care reform of $522 million, which built on the funding contained in the previous budget. This brought our total investment in response to the final report of the royal commission to more than $19.1 billion. Our 2022-23 budget responded to 10 recommendations of the royal commission and built on our existing five pillars of aged-care reform. We delivered record investment across the aged-care system over the forward estimates—from $13.3 billion in 2012-13 under Labor to $30.1 billion in 2022-23 under the coalition. By 2025-26, funding in aged care was estimated to grow to $34.7 billion per year under the coalition.
We also remain committed to providing our older Australians support to live in their own homes for longer. That is why we increased new home-care packages from 60,308 under Labor in 2012-13 to 275,597 in 2024-25, an increase of 357 per cent. We are currently in the second year of the five-year plan and it is imperative that the government now continue our work to support the aged-care sector. I also implore the Labor government again not to play politics with aged care. People like my father and the families I meet deserve better.
~~Long debate text truncated.~~