Parliament Updates

Zali Steggall MP speaks on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Bill 2021

21 June, 2021


I rise tonight to speak on the Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Bill 2021. This bill takes a welcome first step towards addressing the very serious recommendations of the royal commission and the independent review of provisions governing the use of restraints in residential aged care. The royal commission and the independent review revealed shocking tales of neglect and abuse in this sector. This bill will address the use of restrictive practices in aged care in alignment with the definition applied under the National Disability Insurance Scheme, bringing care practices in line with the NDIS. The bill also introduces additional scrutiny on home-care packages by creating a role for the secretary of the department to conduct assurance reviews into the delivery and administration of home care. The third measure of this bill abolishes the Aged Care Financing Authority, and the new institutional arrangements have been outlined by the government's response to the royal commission. However, submitters to the Senate inquiry into this bill do seek assurances from the government that there will not be a gap in the reporting on financial reporting of the sector performance in the absence of the ACFA without a replacement as yet.

In my electorate of Warringah there are 18 residential aged-care facilities. They have responded remarkably to the COVID pandemic, and I commend the staff for their efforts during a most trying time for them and their residents. The staff of the aged-care facilities bore a huge responsibility for keeping residents safe during the pandemic, and I know it was a huge stress on them and their families. Many facilities went for over 300 days without the presentation of a single flu symptom, and there was no known transmission of COVID-19 in Warringah aged-care facilities. Thank you to the residents, their families and the staff of these facilities for your efforts, patience and understanding of the need to keep one another safe during what has been a very difficult 15 months.

I am pleased that, in this bill, the government has moved relatively quickly to address the issue highlighted by the royal commission's findings. Restrictive practices involve the use of physical or chemical restraints to control the behaviour of residents in aged-care facilities. The tales and stories were harrowing. The royal commission heard stories and the media reported tales of nursing home residents being turned into zombies and of residents being strapped to a chair for 14 hours in one day. It is horrific to think that that was occurring in Australia.

This bill amends the Aged Care Act to make restrictive practices a measure of last resort. Whilst this is good, it is not quite the whole thing that was recommended. Importantly, it requires that the quality-of-care principles limit the circumstances in which a restrictive practice can be used. It should be noted that the Law Council of Australia points out that the definition used in this bill, unlike the definition employed by the royal commission, doesn't define 'restrictive practices' as 'a restriction on a person's ability to make decisions'; rather, it defines it only as 'a restriction on a person's rights'. So there is a concern about that discrepancy. The Law Council is concerned that the definition of the bill may not as clearly apply to the use of chemical restraints as intended by the royal commission, and the explanatory memorandum for the bill doesn't explicitly address the regulation of chemical restraints. I echo the Law Council's call for the bill to be amended and clarified to ensure that 'restrictive practice' is defined to include chemical restraints and to include safeguards specific to the use of such restraints. That was one of the aspects that was most shocking to people—the extent to which chemical restraints have been used. I urge the government and the minister to consider refining the definition of restrictive practices to clarify the responsibility of providers in relation to their use and to require that much greater control be applied to any circumstances of use of restrictive practices.

The bill also creates the ability for the secretary to conduct assurance reviews for the purposes of assuring that arrangements for the delivery and administration of home care are effective and efficient. Home-care accountability audits are very important. The Council on the Ageing supports greater oversight of home-care providers and also the increased transparency for consumers through the publishing of such reports on assurance reviews, including any recommendations and conclusions. We need these assurance reviews. Leading Age Services Australia has expressed concern at this clause in the bill, including the lack of definition of the term 'effective and efficient', and the absence of a clear methodology to be employed by the Department of Health. Again, it's really important that, when these bills are put to the parliament, the government and the minister ensure that appropriate definitions for these very important terms are included in the legislation.

Increasing accountability and transparency of the delivery of home-care packages is a welcome step; however, I urge the government to increase the capacity of the home-care sector to eliminate the waitlist for home-care packages. Whilst the additional 80,000 places over two years announced in the budget are very much welcome, there is still more than 100,000 people on the waitlist, and I can't imagine that list getting any shorter with the aging population that we face in this country. The royal commission recommended that the waitlist be cleared by 31 December 2021. At present, there doesn't appear to be a plan in place to clear that list until beyond July 2023. I don't think that is good enough. This is an urgent issue and one that requires immediate attention. Whilst I will always support greater transparency, I also support action, and auditing the performance of providers, rather than rolling out more packages, and slowing down their rollout is not the action that we need right now. It is really important for both of those actions to be taken on board by the government.

The 148 recommendations of the royal commission into aged care extend from legislative change to governance, establishment of specialised facilities and care models to improving public awareness of aged care and conditions for workers. It was very extensive. Last month I supported the member for Mayo's motion to establish a parliamentary joint select committee to oversee the implementation of the response to the royal commission. The diversity of issues and the dire need for reform demand ongoing parliamentary scrutiny through a joint select committee. Huge amounts of public funds need to be expended in this sector, and there needs to be the right oversight.

I welcome the government's response to the royal commission, but I urge them to take on board the need to implement more of the findings of the commissioners and the recommendations within the final report. In particular, I need to draw the government's attention to recommendation 72, which aimed to achieve equity for people with disability receiving aged care. There is currently discrimination against people over 65. In December 2019, I presented a petition of nearly 20,000 signatures which addressed the issue of age discrimination. It was brought to me by the ever-determined Bobbie English, whose husband, Chris, had had an accident at the age of 69, giving him quadriplegia. Prior to his accident he was a fully active member of society, but, unfortunately, because his accident occurred after the age of 65, he was not able to receive the level of care that really should have been his due. The government's response to recommendation 72 was non-committal, and no further clarity has been provided on this issue.

When someone over the age of 65 has an accident—and everyone in this place should think carefully about how active people over 65 are, like some members of this place or parents of members in this place—they're not eligible for an NDIS package. An aged-care package is worth less than half that of an NDIS package. Sadly, in relation to Chris and Bobbie English, Chris passed away in January this year, but Bobbie continues to fight for equality for people who acquire disability over the age of 65. Recommendation 72 needs to be addressed. This is something that gets passed around between the minister for aged care and the ministers for social services and the NDIS. Something needs to be done in this respect. We need to make sure that age discrimination isn't occurring. Just as you brought the guidance for restrictive practices into line with that employed by NDIS, bringing support and assistance in relation to disabilities into alignment would also be essential.

I welcome the government introducing this legislation and acting on some of the recommendations of the royal commission, but much more needs to be done in this sector.