NEWS: Zali Steggall MP supports the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020

27 October, 2020


I rise to speak on the Aged Care Legislation Amendment (Improved Home Care Payment Administration No. 1) Bill 2020. I welcome this legislation. This amendment seeks to bring the payment mechanism for home care in the aged-care sector into alignment with business leading practice and the NDIS. This bill will assist in preventing the accumulation of unspent home-care packages. Currently, there is nearly $800 million in unspent home-care packages in Australia. Under current arrangements, if a home-care package of $40,000, for example, is provided to a person and only $30,000 is spend, the remaining $10,000 is not reallocated and these funds build up in a person's individualised budget.

There are more than 100,000 people waiting for approval of their home-care packages. This is not a good outcome. Figures from the Department of Health released last month show that, in the last two years, 28,000 people died while on the waiting list. Government needs to urgently enable the reallocation of funding where allotments are underspent. The government missed the opportunity to fix the backlog problem. It announced—and I welcomed it—the additional 23,000 places, but, in a situation where the waiting list is still over 75,000, clearly more should have been done. While this bill will help, I encourage the government to consider how they can assist providers who may need support through the transition to this new payment measures.

The submission made by Leading Age Services Australia to the Aged Care Financing Authority was an important one and highlighted that consideration of the financial impact on home-care providers is a result of changes in payment arrangements whose report is included in this bill. The submission notes that 40 per cent of surveyed home-care providers would find the implementation of these measures financially challenging to manage their cashflows. So phase 1 of the implementation of this bill was initially due to commence in June 2020, but was delayed for at least six months due to the COVID-19 outbreak, and I think that's a good thing because, clearly, managing that transition will be important.

Aged-care provider peak bodies—the Aged & Community Services Australia, Leading Age Services Australia and Catholic Health Australia—all stated that they supported the proposed changes in principle, but they raised a number of concerns that they identified as needing to be addressed prior to the implementation of the proposed amendments. And so I urge the government to listen to those peak organisations, resolving outstanding payment issues prior to transitioning to new arrangements, resolving potential cashflow issues for providers and resolving the need for flexible and responsive payment systems—for example, providers receiving funds within 48 hours of submitting a claim. The announcement of a delay in implementation in March this year was welcomed by these peak bodies, allowing them to focus on the health of their clients.

Locally in Warringah, aged care is a key issue, as 15.7 per cent of the total population is aged over 65. This proportion is growing. I have spoken with the CEOs of several aged-care facilities in the electorate, including Anglicare, Allambie Village and Twilight Aged Care. They've told me that families are very emotional and frustrated, because they've taken the right steps but are not getting the help they need. Families feel guilt, because they can't supply the care their loved ones require.

The wait for home-care packages can be long and often with dire consequences. Families wait up to two years for their home-care package following the assessment. By this time their parent's condition has deteriorated and the family can no longer cope in caring for them. The elderly deserve respectful, affordable, accessible and safe aged-care options that are offered in a timely manner. We want aged care that promotes independence and wellbeing with choices so that people can stay at home longer while being healthy and connected. We need more options for a suitable mix of home help and medical support.

We can't talk about aged care without talking about carers in the system. It's really important to understand the needs carers also have. Residential respite is a key issue for those who provide full-time care to their loved ones. Two weeks ago we celebrated carers week, and I'd like to thank all of those who continue to dedicate their lives to the care of others and use this opportunity to highlight some of their needs. Carers, of all people, need to be able to plan ahead. The logistics involved in preparing for an absence are huge.

I've received many, many letters requesting clarification on the government's policy on residential respite. I ask that the government consider the proposal that the subsidy for residential respite be allowed to be used towards a resident carer in the patient's home. In the words of many of my constituents, 'Imagine not being able to plan or look forward to your next break from work, which is not just nine to five, five days a week, but is actually 24/7 for 365 days a year with no weekends and is both physically and emotionally draining to the point of desperation.' Respite has become a key issue during the COVID pandemic, with carers feeling even greater pressure than before. The stress of working with vulnerable people and the constant strain on carers, not wanting to be the one who brings COVID into the homes of those their care for, has been enormous.

The inability of carers to get together to share their stories and debrief their experiences has been very much curtailed. So I urge all of those working in home care to look out for one another and to engage with mental health providers and support as and when you need them.

I've met with Anglicare, Twilight and Allambie village. All these facilities are also feeling the strain, but they are very pleased and so proud—and we are proud as well—of their staff and residents and how they responded to the pandemic.

Those who offer home care are feeling the pinch as well. We should not forget that, like child care, the burden of this unpaid and unrecognised labour falls disproportionately to women, and, in this regard, I continue to call for greater gender equality and balance in caring arrangements. There's no doubt that, for so many women, time is taken out of the workforce not just for child-rearing duties but also for caring duties for elderly parents, and this is something that's simply not addressed.

There are still many issues with the sector. There's an inherent unfairness in the age cut-off for NDIS eligibility. Once someone hits 65, they're no longer eligible for the NDIS but only for aged-care plans. But the support provided under My Aged Care plans does not come even close to that provided under the NDIS in meeting the costs incurred by people and their families. Last year, I presented a petition to parliament calling for an end to the age discrimination in the NDIS. So I urge the government to address this issue as a priority, for all those older Australians who continue to suffer from a lack of adequate care. They are not many, but they do fall between the cracks of these two systems.

The aged-care royal commission is ongoing and of course continues to raise horrific stories of neglect. The concerns and recommendations are many, emanating from over 10,000 submissions received to date. The interim report, which was presented nearly a year ago already, highlighted three areas where immediate action could be taken: to provide home-care packages to reduce the waiting list for higher-level care at home; to respond to the significant overreliance on chemical restraints in aged care, including through the 7th Community Pharmacy Agreement; and to stop the flow of younger people with a disability going into aged care and speed up the process of getting those young people who are already in aged care out of that system.

I support this bill and its efforts to more efficiently allocate the limited funding that is available to home-care providers for our elderly population. We need to look after our ageing population and those who look after them, including both paid and unpaid carers.