Parliament Updates

Zali Steggall MP speaks on the Aged Care Legislation Amendment (Emergency Leave) Bill 2020

13 May, 2020


I rise to speak on the Aged Care Legislation Amendment (Emergency Leave) Bill 2020. I am supportive of the intent of this amendment, which allows residents to take leave from their aged-care facility during an emergency, such as the one we are in currently, and for the provider to retain eligibility for the residential care subsidy. The bill will compensate residential care providers by maintaining eligibility for relevant subsidies and will reduce financial pressure on those providers in emergency situations. The bill will also provide relief for the residents so that if they depart their facility during an emergency, they will not be liable for additional fees to reserve their place. This is a fair policy. But I do fear for some facilities who may have higher costs due to their location or services offered. They may suffer greater financial impact than others. As we discovered with the impact of the recently-introduced childcare legislation, well-intentioned policy can create dire circumstances for those in the industry.

Regarding the current funding provided to aged-care providers, many are saying that the costs that they are incurring as a result of the COVID-19 pandemic far outweigh the additional support that has been provided by the government, and many of them report not yet having received any additional funding. The increased costs include the need for personal protective equipment, the additional cleaning services, the technology to maintain family connections, and the need to pay staff on sick leave as well as those who are backfilling. I've spoken to a number of aged-care providers in Warringah and some have claimed that they are yet to receive any additional funds. Nor have they been contacted by the Department of Health via the usual channels with any advice on how to access the funding. It's a timely reminder to the government that when press conferences are held and public announcements are made, certain expectations follow and are created. I urge the government to remember that well-intentioned promises are commendable, but they must be followed up with speedy and accurate action.

I understand that some $52.9 million of the funding is to be provided via a grant under the COVID-19 Aged Care Support Program. However, as the minister has stated publicly, the government has announced nearly $850 million in funding for the sector. I would appreciate the minister's advice on this matter and will be writing to him accordingly to raise the issue.

There's no doubt this period has created unprecedented strain on our aged-care facilities in Warringah and on the individuals who call them home. Like many of my parliamentary colleagues, I'm sure, my electorate office has received phone calls and emails from those with loved ones who are housed in aged-care facilities. There was, of course, no one consistent line. Some are asking for stricter restrictions, some are asking for a relaxation. All are concerned.

In speaking with those who manage these facilities in Warringah, it's clear that their absolute No. 1 priority is keeping their residents safe, and I commend them and their workforces for the amazing work they're doing to make that happen. To the credit of the facilities in Warringah, with the steps they have put in place, including the provision of PPE and extra staffing, there have not been any cases of COVID-19 locally, and that's how we want it to stay. For those who manage those spaces, those who work there, those who live there and those who have loved ones there, that is a consistent theme: to keep COVID-19 out and to keep the residents safe.

That includes nurturing their mental health, of course, as this age group are particularly vulnerable to the virus. For weeks, and sometimes months, many of our elderly have been isolated from their loved ones. This has led to severe mental deterioration for some individuals. For aged-care facilities within Warringah, this has been difficult. They regard the mental health of their patrons and residents as of the utmost importance, and I've been very pleased to see the innovations and programs they have implemented, and the approaches put in place to address the mental health needs of their residents. I encourage the industry and the government to retain that focus on mental health for this vulnerable section of our community. It's one of the reasons I was pleased to see the industry come to an agreement collectively on the access code of conduct. In doing so, they recognised that, yes, the healthcare needs of residents and staff are important—most important. But we must also find a way to cater for the emotional and compassionate needs of the residents—maintaining good physical health does not necessarily mean we have to sacrifice emotional health.

When this access code was still a draft and placed on public exhibition, I immediately let my community know and I encouraged them to submit their feedback. There was a very tight time frame for comment from providers and users alike, and, while the comments and assessments of the code were diverse, it was clear that all were driven by the need to keep these facilities as safe as possible—even if it meant that contact with friends and family had to be compromised or rethought. Now that the code has been released, I've provided a copy to the aged-care facilities in my electorate and I'll consult with them to provide feedback. The code's 13 principles are a good foundation and will be reviewed later this month. It's now even more imperative that the government funding promised to these facilities and this sector arrives in a timely manner to help facilitate the implementation of the code.

I join with many of my parliamentary colleagues who have taken this opportunity to thank the nurses, the orderlies and other staff of aged-care facilities who are at the frontline of care, who are working long shifts and putting their own health on the line to attend to our elderly and vulnerable. We can't imagine the thoughts they must have each morning as they get ready for work, or the thoughts they have each night as they return home to their families or loved ones, uncertain if it was the day their luck changed and that maybe they had been exposed to the virus. These nurses and other staff are daily walking that line between life and death, and it is here that I would like to raise the issue of nursing ratios.

During the 2019 election campaign, I supported a call for better nursing ratios within our healthcare facilities, including aged-care centres, and I remain true to that commitment. We need to make sure that these vital workers—essential workers—do not become exhausted workers, hollow workers, broken workers. They need to be able to focus on providing the highest standard of attention and medical assistance to those in their care, and when the ratios are unworkable they simply become stretched beyond their capabilities.

I commend the work of my crossbench colleague, who unfortunately cannot be here due to the crisis, the member for Mayo, who has previously tabled legislation regarding staffing ratios, specifically in aged-care facilities. Her bill, introduced in 2018, aimed to provide greater transparency for families moving loved ones into residential care. The intent of that bill was to require aged-care facilities to disclose staffing ratios on the My Aged Care website, and there were mandatory time frames for reporting any changes. That bill was warmly welcomed by numerous organisations, including National Seniors Australia, the Council on the Ageing Australia and the nurses and midwives association. Sadly, her noble attempts were ultimately unsuccessful in creating that much needed change, but I think it's timely for this government to be reminded of that important measure. I call on the government now to revisit this issue of staffing ratios.

This pandemic has shone a light on systemic problems within the age-care system. As we emerge from the crisis, we must put aged-care reform at the heart of our recovery. In my electorate of Warringah aged care is a key issue, with 15.7 per cent of the total population aged over 65—and this proportion is growing. I've spoken with the CEOs of several aged-care facilities in Warringah, and they've told me that families are emotional and frustrated because they have taken the right steps but they're not getting the help they need. They feel guilt because they can't supply the care their loved ones require, and the wait for home-care packages is far too long and needs to be addressed as a matter of urgency. Families wait for up to two years for their home-care package following an initial assessment. By this time their parent's condition has deteriorated and the family can no longer cope in caring for them, so the difficult decision is made to placed their loved one into an aged-care facility.

At a time when we are focusing on encouraging Australians to stay home, this must be a priority for the government. 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, and more options for a suitable mix of home health and medical support being available.

It's important when we talk about this sector to also consider the needs of carers. Residential respite is a key issue for those who provide full-time care to their loved ones. Carers, of all people, need to be able to plan ahead for the huge logistics involved in preparing for an absence. I have received multiple letters requesting clarification of 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 having a resident carer in the patient's home. In the words of my constituent: '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-hours a day, seven day a week, 365 days a year, with no weekends, and is both physically and emotionally draining to the point of desperation.' We should not forget that, like child care, the burden of this unpaid and unrecognised labour falls disproportionately on women. In this regard, I'll continue to advocate for greater gender equality and balance in caring arrangements.

I support this bill and its efforts to provide flexibility under emergency circumstances. But we also need to ensure that crisis funding that was promised is adequate and arrives for providers to ensure essential services are delivered and to facilitate the implementation of the code. We also need to look forward to our recovery and to ensure we address systematic problems in our aged-care system and the unnecessary burden on our carers.

In conclusion, I refer to the ongoing Royal Commission into Aged Care Quality and Safety. The intent of this bill reflects one of the key systematic problems identified by that commission in their interim report released last year—namely, that the current system is designed around transactions, not relationships or care. This bill seeks to introduce an element of compassion, reflecting the importance of relationships and the need for care at a time when our elderly are vulnerable and their families need it most. While the proceedings of the royal commission have been placed on hold due to the crisis, there's no denying that its work has taken on even greater importance. This pandemic has shone an even greater light on the sector, and I, like many in Warringah and indeed across Australia, will be eagerly anticipating the outcomes and recommendations the royal commission will hand down. I'm sure the government will take heed of those findings, and I encourage them to implement any eventual recommendations in full and with haste.

To the staff of Warringah's aged-care facilities, I say thank you so much for the work you are doing in such challenging times. I say to the residents of those facilities, some of whom I visited prior to the crisis, and your loved ones, that I can assure you this parliament is doing all it can to ensure you are protected, nurtured and empowered at this difficult time.