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senate vote 2018-09-10#8
Edited by
mackay staff
on
2018-10-26 16:05:23
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Title
Bills — Aged Care (Single Quality Framework) Reform Bill 2018; in Committee- Aged Care (Single Quality Framework) Reform Bill 2018 - in Committee - Staffing levels
Description
<p class="speaker">Rachel Siewert</p><p>I did indicate in my second reading contribution that I had a couple of questions around the transition funding—the $50 million for residential services to help them transition to the new standards. I indicated that I'd like a bit more information about how that's rolling out and why it's only for residential services. Perhaps we could deal with that issue first and then move to the amendments.</p> <p class="speaker">Glenn Sterle</p>- The majority voted against [amendments](https://www.openaustralia.org.au/senate/?gid=2018-09-10.163.1) moved by Senator [Derryn Hinch](https://theyvoteforyou.org.au/people/senate/victoria/derryn_hinch), which means they failed. The amendments would have introduced the concept of staff-resident ratios into the bill to address staffing shortage issues.
<p>I'm really happy to be guided by the Senate. Minister?</p> <p class="speaker">Linda Reynolds</p><p>Senator Siewert, I'd be happy to answer those questions and get some more information for you. Perhaps we could go to Senator Hinch first and I'll come back with the answers to those questions.</p><p>The TEMPORARY CHAIR: That's great; we have a nod. Thank you, Minister. Senator Hinch?</p> <p class="speaker">Derryn Hinch</p><p>My apologies for not being here. By leave—I move amendments (1), (2) and (3) on sheet 8448 together:</p><p class="italic">(1) Clause 2, page 2 (table item 1), omit the table item, substitute:</p><p class="italic"> <i>[consequential—commencement]</i></p><p class="italic">(2) Schedule 1, item 10, page 4 (line 19), omit "Act", substitute "Schedule".</p><p class="italic"> <i>[consequential—transitional rules]</i></p><p class="italic">(3) Page 4 (after line 28), at the end of the Bill, add:</p><p class="italic">Schedule 2—Further amendments</p><p class="italic"> <i>Aged Care Act 1997</i></p><p class="italic">1 Paragraph 54 -1(1 ) ( b)</p><p class="italic">Repeal the paragraph, substitute:</p><p class="italic">(b) to maintain an adequate and safe ratio of appropriately skilled staff to care recipients, to ensure that the care needs of care recipients are met;</p><p class="italic">2 At the end of section 54 -1</p><p class="italic">Add:</p><p class="italic">(3) For the purposes of paragraph (1) (b), the ratio of appropriately skilled staff to care recipients is an <i>adequate and safe ratio</i> if, for aged care provided by an approved provider at a particular time, the ratio of appropriately skilled staff to care recipients is equal to or greater than the minimum ratio required to be provided by the Quality of Care Principles for:</p><p class="italic">(a) the number of care recipients receiving care through the aged care service at that time; and</p><p class="italic">(b) the type of care and level of care provided.</p><p class="italic">3 At the end of Division 54 of Part 4.1</p><p class="italic">Add:</p><p class="italic">54 -6 Staff to Care Recipient Ratio Standards</p><p class="italic">(1) The Quality of Care Principles must set out Staff to Care Recipient Ratio Standards. Staff to Care Recipient Ratio Standards are standards for quality of care and quality of life for the provision of aged care.</p><p class="italic">(2) The Staff to Care Recipient Ratio Standards mustset out the minimum ratio of appropriately skilled staff to care recipients required to provide care at an aged care service at a particular time taking into account:</p><p class="italic">(a) the number of recipients receiving care at that time; and</p><p class="italic">(b) the type of care provided; and</p><p class="italic">(c) the level of care provided.</p><p>The TEMPORARY CHAIR: The question is that the three amendments on sheet 8448 be agreed to. Those of that opinion say aye; against, no. The noes have it.</p><p class="italic">Senator Hinch interjecting—</p><p>The TEMPORARY CHAIR: I didn't hear a second voice, I'm sorry. I'm happy to put it again if we need to. Sorry, Senator Polley, did you wish to make a contribution?</p> <p class="speaker">Helen Polley</p><p>Yes.</p><p>The TEMPORARY CHAIR: Okay. Then I'll come back to you, Senator Hinch, and recommit it.</p><p>I want to make some comments in relation to the amendments put forward by Senator Hinch. The intent of this legislation is to make provisions for a single set of aged-care quality standards. This is not an appropriate bill to deal with these issues. We will not be supporting these amendments. With regard to staffing arrangements in residential aged-care facilities, the roles of nurses and personal care workers in the care of older Australians is critical and will only become increasingly important. Labor also understands the importance that other health professionals, such as GPs, occupational therapists, physiotherapists and dietitians have on the overall wellbeing of older Australians.</p><p>The number of people aged 85 is rapidly increasing compared with younger age groups and is projected to double by 2032. We will need to see a tripling of the aged-care workforce in the next 30 years to provide a high standard of living and care for this growing proportion of older Australians. Given the government dumped Labor's $1.5 billion workforce compact and the supplement after the 2013 election, we have consistently called for the development of a comprehensive aged-care workforce development strategy to address issues of training, staffing levels and an ageing workforce.</p><p>The government's finally addressed workforce issues by announcing $1.9 billion for the Aged Care Workforce Strategy Taskforce in the 2017-18 budget. However, when the government made its task force membership public six months later, it failed to include any representatives of the aged-care workforce. This task force report has been with the government for nearly three months. We urge the government to give its full attention to this report and respond now with some urgency. Labor also takes this opportunity to thank the chair of the task force, John Pollaers, for his important work.</p><p>We believe that the government must work with unions and aged-care providers to implement this strategy to meet growing demands. This strategy must consider things such as the proposal for 24-hour registered nurse coverage in residential aged-care facilities. Labor also successfully pushed for the reconstitution of the Senate inquiry into the future of Australia's aged-care workforce. The Senate Standing Committees on Community Affairs report tabled in parliament in June this year was adopted unanimously by all political parties and made a series of recommendations in relation to workforce development. The Senate report also provided valuable analysis of the issues confronting the aged-care workforce.</p><p>Whether it is aged-care providers, workers or consumers the message has to be consistent. The government must take action to ensure we have an adequately skilled and equipped aged-care workforce to care for our rapidly ageing population.</p> <p class="speaker">Rachel Siewert</p><p>I indicate the Greens will be supporting these amendments. They're not very prescriptive. They also don't adopt some of the more intense set ratios. We have indicated that we do think, broadly, ratios need to be a part of the process because of the problems that we've seen, but we don't want them to be too prescriptive. We want a process for being able to establish them, depending on the situation and the acuity of residents, the types of residents we're talking about, the ratio of allied nurses to people with professional qualifications and, of course, care workers, who provide so much of the care that's essential when you think about the fact that this is a person's home. It is not a hospital; it is a person's home. And care workers—who will, in fact, be visiting this place again on Wednesday—play an absolutely essential role in the provision of care. I'm so sick of hearing from both nurses and care workers that there are just not enough staff on the floor to provide the medical attention that's needed but also the personal care.</p><p>I've also seen some very excellent examples of residential aged-care facilities where they have excellent staff-resident ratios and the care provided is excellent. So we support the concept of ratios, but we're not endorsing any particular ratio at this stage. We also recognise that you have to be careful that it's not too prescriptive because circumstances are different in many of the residences. As I said, we're talking about a person's home. We're also talking about their care, and we need to make sure that we've got that balance right. So we will be supporting these amendments to register our support for the concept of ratios, bearing in mind that we don't think that they should be too prescriptive and restrict the ability to make sure we have that balance of care and staff present in the home right.</p><p>I chaired the workforce inquiry, as Senator Polley just articulated. I'm deeply disappointed that we haven't seen an outcome from the task force to date. I think that we were pretty clear in that report that it's absolutely essential that we get on top of that workforce issue because we have an ageing population. We have people going into residential care who are older and frailer. They're staying in homes longer, which is really strongly supported by the community. So it is really important that we get these workforce issues dealt with now.</p><p>Having been involved in the discussions over Living Longer Living Better, I was similarly disappointed when the previous workforce arrangements were abolished by the incoming government. There were some amendments made and some concessions made when that was being negotiated at the time. I think that we've unfortunately stagnated, despite having the task force. I acknowledge that action was taken to get that task force in place, but basically progress on a lot of the workforce issues has stalled and it is absolutely essential that we have a skilled workforce of personal care providers, allied health professionals, RNs and ENs on the floor of these places. But it is also absolutely essential that we have a plan in place. Otherwise, we will not be able to provide the care that is needed for our ageing population because we just won't have the workforce ready.</p> <p class='motion-notice motion-notice-truncated'>Long debate text truncated.</p>
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